Farewell depression?

I am very happy to finally feel that I am shedding the last horrible remnants of my recent depression. I feel much better, possibly slightly on the high side, which I find hard to admit, much harder, actually, than saying I’m depressed. And it’s not too bad, so why worry?  Nothing that can’t be managed with a bit of medication manipulation. I’m sure most people think I’m just back to my usual self, which is true. It’s easy to blame things on one mood-side or the other, but I am often grumpy (not necessarily depressed) and I like wearing bright colours (not necessarily high).

But the truth, if I can admit it, is that I like being slightly above myself, if that makes sense. After all these months of depression, who could grudge me a bit of fun? A bit of laughter, a bit of making up for lost time. And this is also why I have to acknowledge it to myself: as my husband kindly points out – what goes up might well go down. For both of us, that is the worry. I don’t really think my mood will escalate, constrained as it is by lithium and quetiapine. I have always had a desire to get my mood to 6.5/10 and keep it there, something I’ve probably written about before. That is where I feel productive, happy, good-looking even! I may talk too much, but that’s OK, given how little I’ve spoken in recent months. The point I’m trying to make is that I feel well then; I can do all that I need to do and I feel happy.

The problem is that psychiatric drugs are not able to keep one’s mood to a strict numerical scale, something which is both disappointing and a relief. Disappointing is obvious; relief because I don’t really want to be set like a clock. I mean, I suppose if it were possible, then no-one would need to be depressed – but would it be right to take everyone’s sorrow away? There are times when we need to be sad, and the ongoing question as to when depression is an illness and when it is a response to life might complicate things.

But I do feel rather controlled by psychiatric drugs. Lithium is the least of my worries – no side effects, just annoying blood tests. Quetiapine – where do I start? For me, the main things is that it makes me sleep, and if I didn’t I am confident I would be ill. That’s one thing I will admit. It’s always made me fat before, and I am sticking very carefully to a boring diet to avoid this. Never before have I had no chocolate at Easter, and it was hard watching my family chomping away. I don’t like taking it during the day because I don’t feel as alive. And the newcomer – lamotrigine. It makes me less depressed, I think.

Sometimes I feel as though I’m walking on a tightrope, balancing one against another. Yet I never really know what’s actually helping, and that in itself is irritating.

The thing that twists my thoughts and frightens me most, though, is the fear of becoming depressed again. Sometimes I don’t know how I survived either depression or the treatment. As a doctor, I say to myself – ‘well, worst case scenario you can be treated again, and you’ll get well again. What’s the problem?’ As a patient, I simply can’t imagine going through it again. I’ve put a lot of thought into how I could recognise any deterioration sooner, and hopefully avert disaster by earlier treatment, but I don’t have much faith in this. And because of it, I feel that I simply can’t risk anything, anything at all, that might make my mood lower. And it’s not just for me, I can’t put my family through this again.

I don’t really know how much control I have over all of this. I lead a fairly healthy (boring!) life, with my boring diet and my feeble attempts at exercise. I don’t smoke and I don’t drink much, and sometimes I wonder whether my fears and guilt about life actually make things worse at times. Perhaps that is why I prefer a slightly elevated mood (6.5), as fear and guilt simply vanish, replaced by pleasure.

I realise that I am often the last to recognise my mood shifts, and I am making a concerted effort to change this. I do think one of the big problems is the binary approach of others – you’re ill or you’re not. I do understand this, and if I was seeing someone who’d been ill, who had improved, I would declare my happiness that they were so much better. And I think this is my own fault, as I am probably over-sensitive to others’ comments – so if I am feeling less well, someone saying ‘you seem fine to me’ makes me doubt myself. It is easy to hide mood changes – indeed, when they are mild, they are likely the same as what others experience, but the problem is that for some they can herald something worse.

So – I am much better, if a little bit irritable, managing to do the things I love, though perhaps not concentrating quite as well as usual. I will continue the nasty triad of medication, and possibly take more if I need. I am just an ordinary person with a mood disorder, and I will get on with it as best I can. I will try not to listen to what people say – they are kind, but they don’t know what it’s like being me, and most of them don’t balance their moods with a fistful of unpleasant pills. I’m just very happy to be here.

5 thoughts on “Farewell depression?

  1. Migraine is a bit like this. After a time you learn to spot warning signs though you don’t always take notice of yourself. Sudden elevated mood is one..a day of feeling cheerful & energetic but unrelated to any actual life event,means a bad migraine is imminent. If you can jump on the meds then …

    1. I’m fascinated by the link between bipolar and migraine. Bipolar people experience migraine more commonly than general population. Valproate treats bipolar and migraine. What’s the link?

  2. Hi Rebecca – on your fears of becoming depressed again, I wondered if you’d ever come across Mindfulness-based Cognitive Therapy, which makes much of the idea that attempts to avoid low mood themselves can be what drives relapse. The advice – strongly influenced I think by Buddhism, is that practising acceptance of the low mood makes it more likely to be transient: “if you resist, it will persist”. No idea whether it might be helpful to you, but The Mindful Way Through Depression by Mark Williams et al sets out the thinking/framework pretty well.
    All best

    1. This, I think, is very true. Essentially fear of what could happen again pulling one’s mood down – very unhelpful. I definitely fear being depressed, in fact much more so in the recovery phase, which is long, than at any other time. I’ve done CBT with little benefit personally, but will have a read of this. Thank you! R

  3. Yes, it’s not really like CBT as I’m familiar with it – much more like meditation adapted to those at risk of relapse in depression. Hope you find it interesting.

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