Wednesday, October 14, 2015

In defense of antidepressants

The other day I was on a preschool class field trip to the pumpkin patch with Jovie, my nieces Pea and Hazel in tow. While learning about corn and apples and pollination and pumpkins, I watched one of Jovie's classmates who came with her grandfather. He was quiet and had the kindest eyes. He hung back when she raced ahead to walk with her friends, but held her hand when she looked tired or unsure of her surroundings. Every once and a while, a small smile played on his face as he observed the all the children or shepherded his granddaughter around the straw maze. 

The joy he soaked in from this shared time with this small person was evident. Though not loud. Not bells ringing or a tree full of songbirds. It was serene and enveloping – a blanket of snow or the sun on your face in a sweet-smelling field. 

As I pulled away from the orchard, the two of them walking hand in hand in the distance (that tender and steady love) my throat tightened. My eyes burned. I missed my grandfather. My dad. Being little and loved in such a simple way. 

This physical reaction to some unreachable emotional ache was unexpected. 

Two months ago, this was every day. Every day something would happen that would flatten me. Sometimes multiple things would happen. A passive-aggressive comment from a neighbor or that song on the radio or another story about the awful nature of humans. Two months ago I was convinced that the world was the sum total of its ugliness. 

But I've been coming away from that perspective. Slow and steady. 

Last week as the bittersweet tears started forming in my eyes, I was frantic. For a minute anyway. Not again, I thought to myself. I can't be feeling this way again. The fraying of nerves. The fragility. 

I found myself careening down the winding path into the dark woods of my psyche. I would never get out of this place. It was foolish to ever believe I could ever outrun that melancholy.

Then I realized I hadn't taken my antidepressant in a couple days.

And that's when I knew they were working. 

I took a deep breath. And another. I was OK. I am OK.

I am so grateful for this moment. 

Months ago, I knew I was depressed. It was obvious – I'd been there often enough to know. But I was in denial of it. For so long. I kept waiting for it to lift, as my low spells had in years past. They'd hang out for a few days, maybe a week. And then I'd feel more like myself.

This was different though. The longer the fog stayed, the thicker it got. I now understand why it is that people "sink into depression." That's what it feels like. The horse dying in the swamp in "The Never-ending Story." The longer you stay, the longer you'll stay.

In July or August, several months after I realized my mental health was shaky, I was on the phone with my sister and I lost it. I don't even remember what was going on that day, it didn't really matter probably. She heard it in my voice though and suggested it might be time to take care of myself. Go on an antidepressant, talk to a therapist. 

I don't want to go to the doctor, I told her. I don't want to have to call to schedule the appointment and tell the receptionist that I'm seeking treatment for depression. I don't want to have to  explain to the nurse who takes my blood pressure and temperature that the reason I'm in is depression. I don't want to have a conversation with the doctor where I tell them I'm sad and that I've been sad and that I really don't know why. I don't want to cry in front of strangers. Because I know I'll cry.

What's more. I didn't want to be on an antidepressant. Years ago, when I'd taken them they left me drowsy and made me feel slightly removed and disaffected. Like I was living above my life somehow. Not really having an authentic experience.

Laura, of course, understood. But gently pointed out that if I was at the point where I was bawling at the doctor's office. Well, it was definitely time to do something.

She was right. 

Because my depression wasn't just affecting me. I wasn't the only one who was sad because of it. I at wasn't my best for my girls or for Brad. I wasn't even at my mediocre. A family flounders or flourishes depending on their weakest link. I couldn't be the weakest link anymore.

So I made the appointment. And I went to it. And I cried in front of the doctor. Some youngish guy I'd never met before (I'd just switched practices last year). He told me he wanted me to stay on the medication for a year. That sounded like an eternity to me. In the past I lasted a month, maybe, Before I took myself off of them. 

Yeah. Yeah. I know. You're not supposed to do that.

This time I made the commitment to be responsible and give the medication a chance to work like it's supposed to. Not only that, but I was going to go back to yoga and look for off-screen activities that brought me joy – like helping at the farm.

And it's working. I feel more like myself. I laugh more than I cry. My patience has returned. My mood swings are fewer. There's more of an equilibrium between light and dark. The scales more balanced.

I think there is a sense among creative sorts – or anyone who struggles with depression, really – that medication will dampen their creativity or make them less of themselves. Will prevent them from accessing the wells of emotion so critical to art. But the biggest killer to my interest and willingness to engage in right-brained pursuits has been depression. That wall constructed in my psyche. 

Antidepressants have chipped away at that wall. 

I'm not writing fiction again yet. But I'm writing. I'm showing up here, which had been almost painful in previous months. This feels right, so this is where I am. The rest will come in turn.

I'm not immune to feeling as I always worried I would be. I still get goosebumps listening to "Girl in the War" by Josh Ritter. 

In depression all you see is gray and tar black. The colors are returning. 

There was this wonderful post on the On Being blog this week. Sharon Salzberg explores the buddhist concept of dukkha:
"One of the traditional Buddhist illustrations of the term dukkha shows a chariot with an axle that simply doesn’t fit quite right. If the chariot were to move, there would be a rub, a jolt. Maybe nothing dramatic happens as a result; maybe the wheel stays put on the chariot, and all that results from a ride is a bit of discomfort. But the rider’s presumable awareness of the not-quite-rightness shades the experience with a level of discomfort. That is duke...
"...Through my own meditation practice and through teaching, I now know that dukkha, suffering, the sense of dis-ease in our lives — no matter what you want to call it — arrives most achingly not from uncomfortable circumstances but from our reactions to them. Culturally, we are all taught to turn away from pain, to disguise it as if it were disgraceful. Or, if we don’t disguise it, we label it or judge ourselves for feeling it and become the person in the chariot worrying about the effects of the ill-fitting wheel. We feel isolated rather than seeing our pain as part of the human experience." 
Reading this helped me understand that depression begets more depression. I was depressed and so focused on my depression and the pain it was causing that the rest of my life was muted. And I couldn't really define that outlines of the depression and why it was there. What's more, I was ashamed of it. Ashamed that it made me a weaker, indulgent person. But it doesn't really matter about appearances. This is my life. My one life. So I can't spend it like this.

I won't be defined by my ill-fitting wheel. 

A while back I heard this TED Talk by Andrew Solomon on depression – it's a pretty popular one, but worth sharing to understand this ... illness? Disorder? He defends medication (why is it that no matter how many people are on antidepressants right now, it still feels like it needs to be defended? It still feels embarrassing, right? To talk about it? But it shouldn't be.) 

In it, he sums up well this new perspective I'm developing:
"The opposite of depression is not happiness, but vitality, and these days, my life is vital, even on the days when I'm sad. I felt that funeral in my brain, and I sat next to the colossus at the edge of the world, and I have discovered something inside of myself that I would have to call a soul that I had never formulated until that day 20 years ago when hell came to pay me a surprise visit. 
28:37"I think that while I hated being depressed and would hate to be depressed again, I've found a way to love my depression. I love it because it has forced me to find and cling to joy. I love it because each day I decide, sometimes gamely, and sometimes against the moment's reason, to cleave to the reasons for living. And that, I think, is a highly privileged rapture."
In yoga you sink into your poses, allowing your breath and gravity to help you give in and so find more strength. I sunk into depression, and now as I work on standing up up again, I too, feel grateful for the lessons it's taught me as well.


  1. I saw a therapist about two or three years ago when I didn't know what was wrong with me but I knew I couldn't live every day feeling that way - sobbing each night after work or the aching feeling that it wasn't going to get better.

    No one ever said I was depressed. The therapist never diagnosed me (that he told me of). I never went on medication. But I knew what it was. My mother's side of the family struggles with anxiety - my grandmother having to excuse herself after we say grace before a meal because she can't stop crying. My mother and aunts often grasping at hysteria for what most people can see as no reason at all.

    My grandfather on my father's side struggled with depression his whole life but it wasn't until the last two years of his life - when the combination of mental anguish, chain smoking and excessive weight gain would cause his heart to burst in his chest. I don't know what the medical term is for that, but it's how it was explained to me as a teenager.

    So when I felt that way two years ago I didn't know if someone should say, 'OK, this is a family thing and you know you need help.' Maybe I didn't tell anyone how bad it was because I didn't actually get help for about six months. And I don't think I felt relief until several months after starting therapy (and quitting my job, which the therapist recommended).

    I have not felt that way since. I hope I never feel that way again. But I truly believe I might never have gotten better if I didn't see what depression did to other people and see how not getting help just left them sinking deeper. Until it suddenly killed what life was left in my grandfather.

    No one ever labeled what I felt as depression, but I don't know how else to describe what was going on with me at the time. I also don't know what exactly made me feel better, or that there was a day when I said, 'I'm finally happy again.' It was a process. A lot of things had to happen to make me feel the way I do today. I'd like to think if I ever got back to feeling that darkness that I would take the steps to get better. I'm so proud of you for making that decision for yourself.

  2. Wow Rebecca - thank you for sharing your story. I'm am so glad to hear you found your way out of the woods. What you describe certainly sounds like depression to me. It's so helpful to be aware about your family history as it relates to anxiety and depression and the ailments of that spectrum. If it weren't for conversations with my sisters about these issues over the years that I would still feel unsure about what exactly was wrong with me. It opened the door for me to deal with it – to even know that it was something that needed to be dealt with. And it it's allowed for an ongoing conversation about our mental health – we're well-versed in the language of depression and look out for each other because of it.

    I'm so sorry you lost your grandfather to the side-effects of depression – I absolutely agree that it allows someone to give up – even though it's not suicide, it's like a slower version somehow.

    I hope that you never struggle with these feelings again. And that if the fog does descend that you're able to use what you learned in therapy and your own history to seek help early. How wonderful to be in a place where you feel happy – it probably doesn't matter really how you got there, only that you got there. That you made thoughtful changes and your brain healed and life moved on. Anyway, thank you again for being so open and honest. More conversations like this! That's what will make it easier for the next person, right?