Saturday, March 29, 2014

The 7 Steps of Managing My Depression

The one thing that has frustrated me the most this past year is that I have been unable to find any support groups for survivors of suicide attempts. This week, I have found the "Live Through This" project, and hope to soon add my own story. I've also discovered the "Help for Attempt Survivors" section on the National Suicide Prevention Lifeline. Most people hide their suicide attempts (I don't blame them), and am some what fearful that sharing my own story will prevent me from obtaining future employment. I prevail in the hope that my story helps another person to not feel so alone, to grab onto hope, and to seek the help they need to continue to stay afloat. It is one of the most incredibly difficult journeys to travel, but YOUR life is worth it - even if you don't believe it now, think it, recite it, chant it, whatever; YOU DESERVE TO BE HERE ON THIS EARTH. You are loved for YOU.

Note: I highly encourage that this post be shared, as long as you credit it to me (otherwise, I might stick a cranky guinea pig on you ;-) ).

These are the 7 steps of surviving depression that I have found work best for me. Caution: They may not work for you. Take what works for you, and build upon it. If you have not yet found help, I strongly urge you to do so. You can locate a crisis center via the National Suicide Prevention Lifeline. Calling 1-800-273-TALK (8255) routes to the nearest crisis center.

The 7 Steps to Surviving Depression

1.) Lay your anger down. It's okay to feel anger. It's not okay to let it destroy you (or your stuff, especially if you're broke and/or have no income). It's also okay to lay your anger down, and come back to it when you have the mental energy to deal with it. Give yourself permission to walk away from yourself. Take a nap, eat a meal, watch TV. Learn to forgive yourself. Kick yourself in your ass if need be, eat a pint of ice cream, learn from the situation, and move on. My dad taught me this helpful advice that I still use to this day: Anger is wasted energy. You need all the energy you've got to tackle what life throws at you, so why waste it on anger?

2.) It's okay to feel okay and have fun. Laughing and smiling are okay, too. It doesn't mean that you're NOT depressed; it means you're human. Don't worry about putting on an act, or having to act super depressed for the benefit of those around you. Those who will understand, will. Keep these people close to you, because they will be your support and your rock. For those who choose to not understand out of ignorance or cultural experience, tell them that your therapist said that laughter and having fun are the best medicine. Or, tell them nothing. It's your business, not theirs. Don't beat yourself up for smiling, laughing, acting happy, or otherwise having fun. It's a human thing, and doesn't mean your depression is any less real.

Depressed people are not mopey, sad, or isolated ALL the time. If depression were as stereotyped as it is, then we wouldn't have such great works as the Harry Potter series, As I Lay Dying, "The Raven", Old Man and the Sea (Fine. It's the only Hemingway novel I can stand), Carrie, The Great Gatsby, A Street Car Named Desire, or even Huckleberry Finn. All these authors have or have had depression.

For me, laughter helps to ease the pain. I appear functional and happy because that's the method that I have found works the best in helping me to manage my depression. I must caution you: smiles and laughter can and have been used as masks to prevent myself from seeing my own denial. As to most things in life, it is a very thin line between helping ones self and harming ones self.

3.) Get help, identify your Warning Signs, and create a Plan of Action: Depression cannot be willed away, cannot be snapped out of or otherwise made invisible, made to magically disappear, has no threshold, does not mean that you're weak, and is real. You may not cry, wish to die, or crawl away into a cave to escape the misery of human existence. Or, you may prefer to be amongst people. Or, your depression may present as crying non-stop, loudly expressing your wish to die, and as a generic walking commercial for depression medications. Your depression may be like mine, in that you act like a functioning human that's ever-so-slightly unhinged, followed by anger outbursts, bouts of crying, lots of sleeping yet still exhausted, and isolation. One depressed person is one depressed person, and only YOU will know your own personal brand of symptoms, when and what makes them worse, and what helps to ease them.

For myself, crying is a wash. I cry when I'm exhausted, angry, overwhelmed, PMS-ing, in a full on sensory meltdown, when my blood sugar is low, and/or when I'm not feeling well. I tend to isolate for many reasons: sensory, auditory processing disorder, and the fact that I'm an extreme introvert. I am easily irritable, especially if my blood sugar is high or I'm having a bad sensory day. My concentration is usually shot because of my brain's inability to filter out excess sound (sensory processing disorder) and the inability to slow my brain down to a manageable level (ADHD).

 In order to gauge my level of depression, I ask myself the following questions:
  • Have I been sleeping? Is it related to stress, anxiety/worry, or is there something more?
  • Have I showered today? On low energy level days, I do not have the energy to do much else, let alone take a shower.
  • Did I eat? On busy days, it is more common for me to graze than to sit down to an actual meal. On low energy days, I tend to skip one or two meals.
  • Where is my anger level? For me, anger and depression go hand in hand. If I am under a lot of stress, and cannot do anything to solve a situation, and I am on red alert re: frustration, I tend to implode. It's not a choice, but an impulsive reaction. My brain doesn't multitask well and the filters used to stop impulsive actions and slow the input of incoming information (be it sensory, auditory, emotions, or whatever) don't function well (my brain is more like the really cheap AC filters, as opposed to the really expensive allergen filters). My brain enjoys processing one thing at a time so the processing mechanism doesn't get backed up and overwhelmed. This is especially important considering my language doesn't come as readily as I would like it to when I am frustrated, angry, exhausted, not feeling well, and/or upset. Stress and me are a ticking time bomb. Some days, I am better at handling it than others, but it all depends on how well I am feeling from the time I woke up, to the particular circumstances of that moment and day.
  • How do I feel? Did I wake up semi-functional, or am I in a total fog? This one is tricky, because diabetes can fog up your head (especially if you're blood sugars are bouncing up and down due to stress, illness, or PMS), and some medications include brain fog and drug hang overs as a side effect. If I'm still dragging my feet by the third or fourth cup of coffee and have yet to feed the guinea pigs or clean the guinea pigs' cages, then it's definitely depression effecting my mood. If I am beating myself up into a bloody pulp, feeling like a burden, saying negative things about myself ("I am so fucking worthless!"), and other similar things that scream "Warning Sign!", I now force myself to realize it and reach out to others. It's still a work in progress. The most important part is that I have identified my Warning Signs and have some reasonable plan of action other than harming myself.
This is why I've set three rules for myself, even on low energy days: 1.) Shower, 2.) Eat, 3.) Find a way to distract myself, even if it means turning myself into a couch potato and watching Law and Order reruns. It's okay to be lazy sometimes.

4.) Low mood days will happen. It's "normal," and doesn't mean that you necessarily are bipolar. When I was in fifth grade, I was incorrectly diagnosed with bipolar. I remember being a ten year old kid, thinking it meant that I was mad (insane), and would die in the gutters like Edgar Allen Poe and every other depressed poet and author. To this very day, I am still scared that people will mistake me as bipolar because I do have mood swings and the fact that my autism is mostly invisible. It's only once you really get to know me that the autism diagnosis becomes clear.

Depression is similar to autism and ADHD in that life is very much like a roller coaster. Some days, you will be functioning, other days, not quite, and there will be many days in which you will have any number of combinations of roller coasters. It doesn't mean that you're insane, or "bad", or crazy. You simply are a person who just so happens to be dealing with a chemical imbalance in the brain (or, as I sometimes describe it, managing the damn squirrels which have taken up residence in my head).

5.) "Getting better" has more to do with accepting and managing your depression than curing your depression. Depression is a medical disease, just like ADHD, diabetes, high blood pressure, or heart disease. Depression is a mental health disorder, and is a very messy, complex thing that will require research, treating yourself like a guinea pig (re: experimentation with medications and cognitive-behavioral techniques), and patience to figure out what works and what doesn't. It's not a 7-11 quick pit stop for a Pepsi when you're thirsty.

Depression is similar to a long-term relationship with the self: you have to be openly honest with yourself and your mental health care providers (which may consist of a therapist, a psychiatrist, and/or nurse practitioner), and willing to keep the lines of communication open between yourself and your mental health care providers. Keep in mind that cognitive-behavioral therapy as a treatment is only one tool, and that medications might be needed at some point. I swear, Big Pharmaceutical is not out to get you and it doesn't mean that you're a failure as a person (or a parent, if you  have a child/children). Yes, trying new medications can be scary, especially with the long list of side effects and whether or not they'll work, which is why it's important to have a trusting relationship with your mental health care providers. The goal is to balance your medications and/or cognitive-behavioral therapy so that it's effective while keeping the side effects and symptoms to a minimum. Yes, it can be tricky - I'm medically sensitive and have developed side effects previously not known to psychiatrists, and group therapy and de-stressing activities do not work for me.

Be willing to compromise and trade off responsibilities on your low energy days (for me, the key is to do as little as possible while still doing something, so I feel like I'm accomplishing something), and to accept the things that you cannot change. Find the support that you need when things are not working out as planned or going poorly so that you can change what you can. As you go through treatment, you will gather many tools and tricks. Some will work, and others won't. Bits and pieces of one treatment option will work and others may not, and that's okay. Discard the tools that don't work for you, and use the ones that do.

Cautionary note: For those of you who do choose to take medications (antidepressants or not) to manage your depression, know that the medications will not automatically make you feel HAPPY, HAPPY, HAPPY!, but that they will take some time for the medication to work (4 to 6 weeks at best). A common myth is that medications for depression will make you instantly happy: medications for depression help by evening out your moods so that you can ultimately function better in your life than before the medication(s). Even after taking medication for a few months, you may not feel happy all the time, and you might feel your emotions dulled. This is "normal" and is okay. What's not okay is if a month has passed and you're still feeling nonfunctional. You might need a different dosage, or another medication all together. It is vital to keep your appointments with your mental health providers, and to continue to find other tools to help you manage your depression. If the side effects bother you too much, speak up and tell your mental health provider. Also, know that there is no shame (or government/pharmaceutical conspiracy) in taking medications. Do what works for YOU, and tell the naysayers thank you for their advice, but all you need from them is an ear to listen without judgement. Speaking of which, I recommend reading "10 Things to Say and 10 Not to Say to Someone with Depression," "How Not to be a Dick to Someone with Depression" by Mia Steinberg, and "How to Deal With a Depressed Person" (as shown in pictures!).

On a side note, ask if it's okay to pray for the person before you bring up God (the guilt! the guilt!), and know that most people do mean well, but are usually clueless when it comes to mental illness because they've never encountered it before.

6.) Create a Mood Journal: Depression has a nasty habit of sneaking up on me, which effectively blinds my ability to perceive my reality at that particular moment in time. Sometimes, I can recognize it, but, for me, depression is mostly a sneaky, conniving ninja that karate chops me from out of no where (bastard!). Figure out what works for YOU and find some one or some way to remind yourself "Hey, if this and this happens and I find myself telling myself "I'm A-okay" and all signs are pointing to the fact that I'm NOT okay, then it's time to haul myself into seeing my mental health provider." Only YOU know the signs of your particular brand of depression, and only YOU possess the solutions (for example, "If I do not feel well, I will lay down on the couch, snuggle with the cat, and watch Netflix", or "If I feel suicidal, I will contact my mom and then go and take a nap"). Have a plan to NOT commit suicide. Make a list and tape it near your computer screen. Hell, make several copies and post them all over the house. Do what it takes for you to stay well and ALIVE.

7.) Educate others: Suicide doesn't always involve making a plan, giving away your most precious items, making a will, or even saying good bye to love ones. Some times, the brain "snaps" or "breaks" (or however you describe it), and the brain takes over and reacts impulsively to the stresser instead of thinking the actions through like most rational brains. The body and mind are in so much mental pain and turmoil, that it hits the "self destruct" button. Unless you've been there, it is difficult for most people to understand how a person can do this to themselves. To the best of my knowledge, there's no treatment or prevention for impulsive suicides, which is why early treatment of YOUR depression symptoms is so important.


I will only type this once, so please read closely: If you feel unloved, know that I am here, thinking of you, sending you positive vibes, and loving you. If you feel lonely, I am here for you. E-mail me, comment here. If you can't think or breath for another second, or do one more fucking errand, then just stop. STOP. Breath. Step away. (Or, if you're me, just let out a five minute long scream of profanities. I don't care about the looks people give me, they're not in my shoes - and, besides, if they cared at all, they'd bring me espresso chip frozen yogurt and scream obscenities right along side me). If you'd rather, call the National Suicide Prevention Lifeline at 1-800-273-8255. Call your local crisis center or the 24 hour grocery store or pharmacy. If you don't have any in your city, it's still worth the possible roaming charge to program an out of state number it into your cell phone or home phone. Even better, keep a list of emergency numbers on your fridge - family and friends included. Call 911. As a last resort, call 411. Get someone on that damn phone, and reach out. Don't wait until your brain gets so tired that it reaches that breaking point of suicide. Just don't. Love yourself enough to reach out and get help. YOU are worthy and YOU are deserving of love. Write that down on your list of emergency numbers, too, along with a few pictures of whatever makes you happy or cute pets (if you don't have any cute pets, you can use one of mine).

Take care of YOU and do what is best for YOU. Family, friends, pets, work, errands, your to-do list can wait. Without YOU, there is no family, friends, pets, work, errands, or your to-do list. YOU are the most important thing on your to-do list. If you don't take care of YOU and put fuel in your system, you cannot function. A former and dear supervisor once told me "You can't expect a car to run without gasoline." So too goes it with the body. Boundaries are okay. It's equally okay to nicely say "No." I know this isn't always easy, and I'm still working on this part. It's a one step forward, two steps back sort of dance. It is difficult. The journey won't always seem worth the fight, and may seem too damn long and unending. Here I am, offering you the flashlight so that you might see the end of the tunnel. It's there. Hold on to that hope. There is light at the end of the tunnel. YOU can fight your way out of the hole. It may not seem possible today, or even tomorrow or the next week or month or year, but it IS possible. YOU possess the strength - I know YOU can do it! When you read the last sentence, also read that I'm not talking about doing away with your depression all together or "You alone are responsible for solving all of your problems." No! I'm talking about finding a long-term solution that works for YOU.

Also read: YOU will find those happy, sparkly moments, and YOU will hold onto them dearer than life itself. YOU will find the stars even amongst the darkest night. Even though you might stumble, YOU will keep your feet on the path that you are journeying. YOU will promise me, in reading this very sentence, that YOU will seek/find/discover treatment(s) that works for YOU. Don't worry about feeling selfish or mental or any number of excuses. You've read this far. Now go out and do what YOU need to do, whether it's call your psychiatrist, your doctor, your counselor, your preacher or pastor, reaching out to your community, calling your mom AND stepdad four times a day, texting your best friend to let him know that you're still alive, e-mailing me, reaching out to a stranger, putting together "I'm Okay" or a "Feel Good" scrapbook, coloring, posting an angry rant on Facebook, or whatever it takes to get the treatment and services YOU need. As you continue on your path to managing your depression, your opinions, thoughts, and treatments will continue to grow and evolve. Walk that path, knowing that YOU deserve help, YOU have the power to gather the resources and to keep moving forward, and YOU will survive because YOU have a purpose!

I will end this very long post with pictures of my current distractions (not shown are Baby Girl, Tony, and Bella, the cats, and Buffy, the dog. Pictures to come later, promise!):

Sally (ferret), fast asleep in my arms, with tongue slightly hanging out of her mouth, and clearly relaxed. Stay tuned for her own incredible story.

Left to right: the best and adorable bits of fur with teeth (aka guinea pigs) Daisy, Benny, and Zeke.

Sabelle (ferret), curled up to sleep and looking very content. Her best friend, a toy squeaker snake, is shown in the upper right hand corner.


"Let’s Bust Some Myths: Depressed People Are Always Sad or They’re Faking!" by Anna

7 Myths of Depression by John M. Grohol, Psy.D.

Ten Signs You're Depressed But Don't Know It (Forbes) 

"Depression Myths and Facts Demystified" by Margarita Tartakovsky, M.S.

1 comment:

  1. Extremely moving, informational, encouraging and inspiring post Serenity!!