I upped my medication, so up yours.

Those of you who have just started reading my blog might have missed or glossed over the fact that I struggle with clinical depression.

There’s something I have to get out of the way first, before I can get to the point:

Clinical depression is not the same thing as “feeling depressed” (aka “sad”). Although it can be triggered by a sad event, it can also be triggered by nothing at all. A comment such as, “What do you have to feel sad about? You have a charmed life!” completely misses the point. Depression isn’t about sadness, not really. It’s about:

• A lack of motivation. The lack of motivation in depression isn’t laziness, and it’s very difficult to think your way out of. It’s sort of like losing your appetite: you still need to eat, but you have no inner urges making you do so, so you have to force yourself. When the motivational drive is malfunctioning, absolutely everything becomes an uphill battle: I’ve had to give myself a pep talk just to get up and empty the dishwasher. And lest you say, “hmm, still sounds like laziness,” I’ll tell you that during depressive episodes I’m also unable and unmotivated to get any of my creative projects done.
• Faulty reasoning/attribution of causality. I’m having a hard time thinking of an example, actually, but I know depressive thinking when I find myself doing it. I’ll add a proper example when I have one. The attribution of causality thing has me blaming myself for being unmotivated (“lazy!”) and saying things like, “I’m a terrible mother. A good mother wouldn’t lie in bed staring at the wall while the baby cries his heart out. I don’t deserve my kids. Why am I such a bad mother? I thought I’d be good at parenting, but I hate it. My kids are a burden.”
• Fatigue. Yes, you’re right, everything is blamed for fatigue these days. But now that I’m on the right dosage of the right medication, I see the difference between fatigue from depression and regular old tiredness. When I’m in a depressive episode, fatigue is an emotional and cognitive tiredness in addition to the normal physical need for rest. I need to sleep because I can’t cope. You know how you can be exhausted but happy, like at the end of a great party? Well, depression precludes that kind of tiredness.
• Social avoidance. During a depressive episode, I don’t call my friends. I assume that they don’t want to be with me or help me because I’m such a leech and never help them (see faulty reasoning, above.) At the same time, I need my friends even more. With other people around, I find it easier to get the little things done (dishes, cooking dinner, etc.) Also, having people over forces me to take a shower and get dressed.

Skeptics will say that the above symptoms could just be personality flaws, and if depressed people would just “snap out of it” or “work harder” or “change their thinking” none of those things would be a problem any longer. To them, I say that there is a marked difference in how I feel on the proper medication, even in ways I didn’t anticipate (and therefore couldn’t just be a placebo effect):

• Motivation. I’m able to get things done without having to work myself up for it. I feel like I want the kitchen to be clean, and I get up and clean it. I see a dust bunny on the floor and I get a broom and sweep. I don’t have to overthink these things in order to start doing them. Creative projects come to mind, and I’m able to plan and execute them. There is not enough time in the day for everything I want or need to do (when I’m depressed, the opposite is true – bedtime can’t come soon enough.) When I’m not depressed I have a reduced tolerance for things like aimless web surfing.
• Reasoning, logic, and attribution. Even when I contemplate the possibility of bad things happening, I don’t have a sense of doom about them that would push me to fear the worst. I can correctly attribute negative outcomes, and I don’t resort to attacks on my own personality or value as a human being. For example, I might say, “This table I built is uneven and wobbly. I didn’t have the right tools and decided to go ahead anyway, and I valued quick work over quality work. Next time I’ll get the right tools and give myself enough time to do it well.” Normal thinking, right? Right. But it only happens for me when I’m medicated. No matter how hard I try, I can’t think that way when I’m depressed.
• Higher energy and no fatigue. I wake up in the morning and I’m ready to get up and do things. I may be physically tired, but it’s not a struggle to move myself out of the bed. As the day wears on, I might choose to nap because I’m physically tired, but it’s often a tough choice because there are other things I need and want to do. At bedtime I’m physically exhausted, but I’m still thinking straight and able to cope. Most significantly, I’m able to be tired and happy at the same time. Until several months ago I didn’t realize that was possible.
• Social participation. I get in touch with my friends and initiate plans to see them. I notice when people around me need help and I’m able to offer it. I find it easy to host people for shabbat dinner without getting overwhelmed.

Right. So that’s my take on clinical depression. Back to my intended post for today:

So about two months ago we (my shrink and I) upped my meds. Since then I’ve had all kinds of epiphanies: it’s normal to wake up in the morning and feel somewhat refreshed and ready to start the day! It’s normal to be able to do daily tasks without needing a motivational speech! It’s not normal to assume that everything is my fault and that I’m a bad person!

After five years of either deep or mild depression, these realizations have been so liberating. I finally, finally feel like I’m meeting my potential as a mother, wife, daughter, sister, and friend. I finally am able to do all the things I envisioned myself doing –  preparing breakfast for my family, playing with my kids, creating things with my hands – and truly loving my life, rather than just going through the motions. It’s amazing and wonderful. As I told my shrink at our last appointment, they’re going to have to pry the meds out of my cold, dead hands. There’s no way I would consent to go back to the way things were.

There are naysayers. You might be one of them. There are people who like to tell me that with exercise/cognitive behavioural therapy/nutritional supplements/meditation/yoga I can eliminate my depression without drugs. To those people I say, “read the title of this post.” To the rest of you, a question:

Has this post changed how you think of depression? How? Why? I want to know. Leave comments here please, instead of on Facebook.