Changing Meds Makes for Difficult Days

My patterns of depression are so familiar now, I may as well copy and paste my last blog post into this one.

Major Depression struck again a couple weeks ago. And it was pure hell. I missed one day's work and struggled like crazy to make myself keep moving for several days afterwards.

My doctor and I decided we needed to be aggressive in trying to stop it, so he changed my meds. I'm now taking Effexor along with Abilify.

The change from Cymbalta to Effexor proved to be a cautionary tale. I had been taking 60 mg of Cymbalta, which I had some success with after a mental health meltdown last summer. To transition to the new drug (Effexor), I was instructed to drop down to 30 mg of Cymbalta for three days before starting out on a small dose of Effexor. 

Only I didn't do that. My Cymbalta pills weren't the kind you can split in half, and I never got new 30 mg pills for the three-day transition period. So I just stopped the Cymbalta cold turkey. I won't do that again.

Wrenching anxiety, stomach aches and feelings of utter hopelessness soon came. 

It was a brutal stretch, probably ranking in my all-time Top 10 list of major depressive episodes.

I'm not exactly copacetic now, but I'm much better. The suicidal ideations that haunted me have subsided. I feel more hopeful than I did even a week ago.

I've now ramped up the dosage of Effexor as the doctor prescribed, and I think it's beginning to pay off.

Those who suffer from depression can relate to the difficulty of changing meds. We often get worse before we get better. And that's really frustrating.

I haven't figured this thing out yet, but I'm trying to remain optimistic about the future. It generally takes 2 to 4 weeks for a new antidepressant to really help. My doctor says it takes much longer—maybe six months—to get the full payoff.

So I wait patiently, doing the other things I know help (exercise, eating less junk, etc.)

I only wish Punxsutawney Phil hadn't seen his shadow. I hate darkness and winter and am ready for it to end.

My guess is many of my fellow depression sufferers feel the same way.

P.S. I hope the few of you who know me understand the difference between the sort of fleeting suicidal ideations I occasionally have and the more serious suicidal thoughts that others experience that involve plans, etc. I've never gotten that far before and don't plan to. I have too much to live for and a burning to desire to defeat depression. I share the brutal realities of depression only so others who feel them like I do don't feel so alone.

The sun is shining after days of dark skies

Last week I slipped back into a pretty serious episode of depression and anxiety. And I don't know why.

I'd been taking my meds and staying fairly active, at least getting on a treadmill for 30 minutes a couple times a week. Not intense exercise, but at least I was doing something.

This week, lo and behold, I feel much better. Could it be the sunshine after days of dreary skies brightened my mood? Or my intentional effort to eat better? Praying for relief more fervently? Going for a sweat-inducing run on an unseasonably warm afternoon yesterday? The long-awaited debut of "American Idol"?

I'm not certain, but it's probably all of the above. 

One frustrating aspect of depression is it's easier to deconstruct good days than bad days. Let me explain. I just laid out a bunch of reasons that probably explain why I feel better this week. Only I have no idea how I got to that bad, dark place last week. Did irrational anxiety about things I can't control start me down the slippery slope to depression? Was it the new drug I was taking as a replacement for Valium, which I usually take as needed when my anxiety gets really bad? Was it those ghastly gray skies, day after day?

I don't know for sure, and neither does my therapist. She flipped back through her records during our bi-weekly session today and noticed that two weeks ago I reported feeling flat. Walking me through last week, we figured out one difficult and stressful task at work—in which I had no clue what I was doing but was too ashamed to admit I was confused and needed help—may have been the final shove toward despair and depression.

So what did I learn from this experience? My psychiatrist took me off that new drug that just made me miserably drowsy. (I'm back to Valium as needed). My therapist coached me to be more self-aware and to look for "cues" that I'm slipping, because if you know you're slipping, it's easier to stop the slide.

A cue might be "all or nothing," irrational thinking, i.e., "I stink at this project and I'm going to lose my job." Had I stopped those inevitable racing thoughts, I could have just slowed down and asked for help.

Only that's not easy for me to do. My sagging self-confidence, which I wrote about in my last blog, sometimes leads me to believe that I can't make mistakes. My ruminating mind tricks me into believing that if I ask for help, I'll come across looking like a dope. How messed up is that?

I feel pretty good today. The sun is still shining and I'm able to focus better. And I know winter, the hardest time for me every year, is one day closer to turning into that hopeful time of spring, when the days are longer and less depressing.

Tomorrow, I leave for a three-day spiritual retreat. I won't get into the details just yet, but it's 72 hours without cell phones, emails or even watches. I look forward to sharing about that experience when I get back—and hopefully how it changed me for the better.

Depression stole my swagger

There are a lot of miserable symptoms of major depression. Despair. Fatigue. Loss of interest in things we once enjoyed. Stomach-churning anxiety. Real, physical pain. Those are just a few.

Worst of all, this soul-sapping brain disease can steal our self-confidence.

At least that’s what my wife noticed recently.

After a tough six months of on-again, off-again depression, I’ve come to realize she is exactly right. Depression stole my swagger.

I was once brimming with self-confidence. Not arrogance, but confidence in my ability to accomplish anything I set my mind to do. Then I crashed and burned with my first major battle with Major Depression.

Sadly, I can’t remember the last time I felt truly confident.

My current meds and time with my therapist are helping me survive each day, but I’m sick of just hoping to survive. I want to start really living again.

Is that too much to ask? I don’t think so.

So what am I going to do about it?

I’m going to be more intentional about setting modest goals that I can achieve, whether it’s at work or at home. Achieving those goals will surely help build my self-confidence back. I am keenly aware that such cognitive behavioral therapy works, but it is difficult to be diligent about using those tools when you feel depressed and mentally exhausted.

I blogged earlier about the need to “fake it til you make it,” and I still believe that. I just wish it wasn’t so darn hard.