You know those episodes of Scooby Doo where Velma would lose her glasses and she would grasp around aimlessly until she grabbed the ghoul's foot? That's what depression is like. You've lost what you need most in order to find what you've lost. It's a paradox.
[From an email with a friend]
>I am too lazy to kill myself.
A lot of the time doctors have to slowly raise people out of depression for just this reason. If they come out of it too quickly, the first thing they're motivated to do is to kill themselves. They have to feel a little better at a time before they get past the nihilism and have the will not just to get out of bed, but to get out of bed and live, not to make a Drano cocktail.
I tried Prozac years and thought I was having a heart attack from the side effects on my GI tract (although they were a bit high up in my case). I literally ran an EKG on myself (I was teaching a lab at the time where I could do it). I had chest pains at 4am, so I ran up to campus and hooked up the equipment. I was clear, thankfully. The medication was just causing (I think) my GI tract to seize up because I started off with a relatively high dose. I've also used Effexor, which has a couple modes of action. However, I used a very low dose of that because of side effects again (though not so dramatic in that case). I pulled the little capsules apart and took small amounts of it every day. It was a lot cheaper that route as well.
I heard this guy on NPR talking about his bouts of mania. His "to do" list had "buy milk" next to "write novel and adapt as screenplay." I do this less now, but I have a million little things I want to do. I'll send you my own "to do" list a little later so you can get a little more insight into the pathology that is "me."
There was a good article I read about male vs. female depression that I wished I would have saved. It talked about how the term "depression" is really a misnomer since it accurately describes the lethargic pattern that you see only among the most severe cases among guys. The rest of us just go from Bruce Banner to The Hulk... only just for a little while at a time. The rest of the time we're thinking, "Don't make me angry. You wouldn't like me if I was angry."
The hardest part of breaking out of depression is initiating behaviors that break a pattern when the pattern was established by the inability to break the cycle to begin with. The opening passage in Phillip K. Dick's Do Androids Dream of Electric Sheep? (the novel that was loosely the basis for the movie Blade Runner) that touches on this bind:A merry little surge of electricity piped by automatic alarm from the mood organ beside his bed awakened Rick Deckard. Surprised - it always surprised him to find himself awake without prior notice - he rose from the bed, stood up in his multicolored pajamas, and stretched. Now, in her bed, his wife Iran opened her gray, unmerry eyes, blinked, then groaned and shut her eyes again.
"You set your Penfield too weak he said to her. "I'll reset it and you'll be awake and - "
"Keep your hand off my settings." Her voice held bitter sharpness. "I don't want to be awake."
He seated himself beside her, bent over her, and explained softly. "If you set the surge up high enough, you'll be glad you're awake; that's the whole point. At setting C it overcomes the threshold barring consciousness, as it does for me." Friendlily, because he felt well-disposed toward the world his setting had been at D - he patted her bare, pate shoulder.
"Get your crude cop's hand away," Iran said.
"I'm not a cop - " He felt irritable, now, although he hadn't dialed for it.
"You're worse," his wife said, her eyes still shut. "You're a murderer hired by the cops.
"I've never killed a human being in my life." His irritability had risen, now; had become outright hostility.
Iran said, "Just those poor andys."
"I notice you've never had any hesitation as to spending the bounty money I bring home on whatever momentarily attracts your attention." He rose, strode to the console of his mood organ. "Instead of saving," he said, "so we could buy a real sheep, to replace that fake electric one upstairs. A mere electric animal, and me earning all that I've worked my way up to through the years." At his console he hesitated between dialing for a thalamic suppressant (which would abolish his mood of rage) or a thalamic stimulant (which would make him irked enough to win the argument).
"If you dial," Iran said, eyes open and watching, "for greater venom, then I'll dial the same. I'll dial the maximum and you'll see a fight that makes every argument we've had up to now seem like nothing. Dial and see; just try me." She rose swiftly, loped to the console of her own mood organ, stood glaring at him, waiting.
He sighed, defeated by her threat. "I'll dial what's on my schedule for today." Examining the schedule for January 3, 1992, he saw that a businesslike professional attitude was called for. "If I dial by schedule," he said warily, "will you agree to also?" He waited, canny enough not to commit himself until his wife had agreed to follow suit.
"My schedule for today lists a six-hour self-accusatory depression," Iran said.
"What? Why did you schedule that?" It defeated the whole purpose of the mood organ. "I didn't even know you could set it for that," he said gloomily.
"I was sitting here one afternoon," Iran said, "and naturally I had tamed on Buster Friendly and His Friendly Friends and he was talking about a big news item he's about to break and then that awful commercial came on, the one I hate; you know, for Mountibank Lead Codpieces. And so for a minute I shut off the sound. And I heard the building, this building; I heard the - " She gestured.
"Empty apartments," Rick said. Sometimes he heard them at night when he was supposed to be asleep. And yet, for this day and age a one-half occupied conapt building rated high in the scheme of population density; out in what had been before the war the suburbs one could find buildings entirely empty . . . or so he had heard. He had let the information remain secondhand; like most people he did not care to experience it directly.
"At that moment," Iran said, "when I had the TV sound off, I was in a 382 mood; I had just dialed it. So although I heard the emptiness intellectually, I didn't feel it. My first reaction consisted of being grateful that we could afford a Penfield mood organ. But then I read how unhealthy it was, sensing the absence of life, not just in this building but everywhere, and not reacting - do you see? I guess you don't. But that used to be considered a sign of mental illness; they called it 'absence of appropriate affect.' So I left the TV sound off and I sat down at my mood organ and I experimented. And I finally found a setting for despair." Her dark, pert face showed satisfaction, as if she had achieved something of worth. "So I put it on my schedule for twice a month; I think that's a reasonable amount of time to feel hopeless about everything, about staying here on Earth after everybody who's small has emigrated, don't you think?"
"But a mood like that," Rick said, "you're apt to stay in it, not dial your way out. Despair like that, about total reality, is self-perpetuating."
"I program an automatic resetting for three hours later," his wife said sleekly. "A 481. Awareness of the manifold possibilities open to me in the future; new hope that - "
"I know 481," he interrupted. He had dialed out the combination many times; he relied on it greatly. "Listen," he said, seating himself on his bed and taking hold of her hands to draw her down beside him, "even with an automatic cutoff it's dangerous to undergo a depression, any kind. Forget what you've scheduled and I'll forget what I've scheduled; we'll dial a 104 together and both experience it, and then you stay in it while I reset mine for my usual businesslike attitude. That way I'll want to hop up to the roof and check out the sheep and then head for the office; meanwhile I'll know you're not sitting here brooding with no TV." He released her slim, long fingers, passed through the spacious apartment to the living room, which smelled faintly of last night's cigarettes. There he bent to turn on the TV.
From the bedroom Iran's voice came. "I can't stand TV before breakfast."
"Dial 888," Rick said as the set warmed. "The desire to watch TV, no matter what's on it."
"I don't feel like dialing anything at all now," Iran said.
"Then dial 3," he said.
"I can't dial a setting that stimulates my cerebral cortex into wanting to dial! If I don't want to dial, I don't want to dial that most of all, because then I will want to dial, and wanting to dial is right now the most alien drive I can imagine; I just want to sit here on the bed and stare at the floor." Her voice had become sharp with overtones of bleakness as her soul congealed and she ceased to move, as the instinctive, omnipresent film of great weight, of an almost absolute inertia, settled over her.
>Maybe no pill ever will cure depression.
Don't look at it in absolutist terms (You aren't a guy, are you?). Nothing is ever going to be a panacea nor should you view meds as nothing more than a placebo. Here's an analogy: Right now you have a broken leg. You need crutches to get around effectively. The crutches don't fix your leg and they aren't really a replacement for your bum leg. They're something altogether different. You shouldn't expect to be perfect. Like the crutches, meds keep you from aggravating something that was bothering you while you try to get past it.
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