Depression. . . for better or worse, is a topic that is with me every day. . . . it’s a daily struggle.
To someone who doesn’t suffer from depression, this may not be of interest (hell, it may not be of interest to those who have and do suffer). These are just my thoughts and impressions, nothing more.
I am 44 years old, but have only been treated for depression for 3-4 years. In hindsight, I find it hard to believe I didn’t recognize the symptoms sooner. That said, I am able now to understand this daily struggle through a much different — much clearer — lens.
I don’t profess, here, to have answers or even a good understanding of the disease process. . . . again, these are just my thoughts and conclusions (right or wrong). Indeed, I believe that I am only just now beginning to understand it.
For the last 44 years, I considered myself shy and quiet. I was often uncomfortable around groups of people — awkward, even. These group situations fostered anxiety. Prior to diagnosis, I considered myself socially inept and lacking confidence in social settings. In many social settings, I am comfortable with solitude and silence. I don’t mind sitting at the back of the room, away from everyone else. When I travel, I looked forward to eating dinner alone. I don’t care whether I interact with those around me. Solitude in social settings is perfectly acceptable, if not preferable. I prefer short interactions, rather than prolonged engagements. All these years, I chalked these “weaknesses” up to personality flaws.
Over the last several years, however, I realize that my perception of my personality was skewed. Not necessarily wrong, just incomplete. You see . . . . I never considered myself “depressed”. How could I be depressed if I didn’t feel “blue”, or “hopeless”. How could I be depressed if I didn’t have suicidal ideations. After all, I didn’t sleep all day because I dreaded facing the day’s challenges. I didn’t hurt or cut myself. If I didn’t experience these things, how could I suffer “depression”. . . right? What a difference 3-4 years has made.
What made this more difficult to accept is that I am completely at ease in other settings. In my profession, for example, I seemingly thrive. There are almost no business settings that bother me, or that make me want to sit in the corner and observe. To the contrary, I enjoy being around co-workers, colleagues, other professionals. This dichotomy between “social” gatherings and “business/social” gatherings made it that much more difficult to accept that I was depressed. It never made sense.
To me, this is a complex disease and I consider it anxiety based. I work in a high stress environment and for the longest time, the anxiety I felt was considered (by me) completely and solely job related. When I was in law school, I considered this reclusiveness to be solely school related. When at the Univ. of Utah, I considered it solely school related. I thought this type of anxiety was created by the circumstance in which I found myself. Now, I don’t dismiss the reality of situational anxiety and depression . . . What I am focused on here, however, is my realization that my depression was more pervasive. I realized that when I am not in high stress periods at work, I am anxious. . . on edge. Nearly all the time. Every day. . . . and sometimes all day, every day. Relaxation was elusive and sleep disruptive.
It’s difficult to describe this anxiety in words. At times, I feel that I am on a precipice. . . that the next step will lead me over an unseen ledge. I felt as if taking that step would only improve my situation (and those around me). It wasn’t that I wanted to die, just that I thought I could escape, that the darkness over the ledge would provide. . . a release.
There is a physical component to it, or so it seems. It’s as if I can’t seem to slow my heart rate . . . that it will beat right out of my chest. I often feel on edge and ready to unload in an angry meltdown (this happens from time to time at work). Shortness of breath. Irritability. A constant knot in my chest. This probably doesn’t make sense, but it’s real. . . I feel it. What makes these symptoms so insidious is that they are often “mild” and this allowed me to ignore the problem.
Prior to diagnosis, sleep was an enormous problem. For the last 20 years, I didn’t really sleep. It’s not that I couldn’t fall asleep, but I found myself waking nearly every night thinking and worrying about what was happening. There were (and still are) times that my dreams are so intensely angry or violent, that I wake up yelling or screaming. When I’m awake, I found myself trying desperately to reel my thoughts back in. I had to assure myself that I had “it” (whatever it was on any given night) under control. If I could not provide myself these assurances, I would lay in bed with uncontrolled thoughts and the anxiety would spin out of control. I often lost 2, 3 and up to 4 hours of sleep when this happened. I couldn’t rein it in, no matter what I did. Of course, for the last 20 years or so, I never once considered that this was symptomatic of a disease process and that it could be controlled.
I finally went to a doctor. He first prescribed Klonopin . . . essentially a tranquilizer . . . . to help me sleep. This has proven effective, but not completely (even now). Interestingly, the combination of Klonopin and Melatonin does the trick most nights. Sleep, however, is only one of many of the manifestations of this disease. Many years later, during a particularly difficult time at work, I went back to the doctor and inquired — for the first time — whether he thought I could be suffering from depression. I nearly cancelled this appointment, though, because, I thought, the current situation would pass and I would be “ok” again.
During this appointment, he explained to me that I might benefit from Prozac. He actually told me that my symptoms were consistent with depression. My initial response was. . . . “Prozac” ?. . . you must be joking and, I don’t need Prozac. Again, I wasn’t feeling “blue”, “depressed”, “suicidal”. . . . so how could I possibly need “Prozac”?
Despite my internal misgivings, I began to take it. Within a few weeks I felt a noticeable difference. I felt better. I was no longer “on edge”. I felt calm and controlled rather than “edgy”. This was the first concrete benefit I saw from the meds. As time went on, I found myself interacting with others in a more meaningful way. I found myself more comfortable around people or groups of people in social settings.
It has now been nearly 4 years since I began taking Prozac (the doctor subsequently added Wellbutrin to the daily regimen). I continue to take the Klonopin/Melatonin mix at night. By no means do I feel that I am “cured” or that I don’t have the same challenges, but I do feel that I can control those challenges. The “knot” in my chest is less pronounced. I do not mind being around groups in social settings. This concoction of drugs will not make my inherent shyness disappear and I realize that; however, this treatment has had an immense impact on my daily life, the way I feel, the way I act, and the I react to situations.
I now understand that I suffer from the disease known as depression. I have come to realize that this disease process is not just situational. I realize that depression is a disease. Like diabetes, depression, requires treatment. I would not ignore diabetes if I had it; similarly, I cannot ignore depression — it requires treatment. I have also come to realize that there is no shame in admitting it.
While I continue to struggle daily with this disease process, I am grateful that those around me steered me to seek medical intervention.
As I travel, I am grateful every day that I am being treated. That knowledge allows me to feel more in control. It is difficult to be on the road, away from my wife and children, but it would be significantly worse if I did not seek medical intervention.
I make this entry as an explanation to my children. . . a written record of what their father struggled with daily.
For better or worse, this is my reality.