Depression

What does it feel like to be depressed? I decided to draw a little picture to help me explain my personal experience:

A dull ache. There’s a hole inside of you that just feels empty. But it’s so full of emptiness that it just hurts. It feels like the emptiness is just pressing in the cavity of your chest. You’re chained to your past and your problems, as you drag them and the weight of the world behind you. Your shadow is three-dimensional and is just looming behind you, ready to collapse upon you at any time. You just want to sleep to numb this life. You don’t want to exist anymore.

There are specific criteria for diagnosing clinical depression. A great site which gives the American and European diagnostic criteria is Mental Health.com. You only have to have had symptoms for 2 weeks to ‘qualify’.

In late 1999 I was diagnosed with Dysthymic Disorder by an American psychiatrist. This is a different disorder to Major Depression and Bipolar Disorder / Manic Depression. Dysthymia is a depressed mood for most of the day for at least two years. During this two-year period, the person has never been without the symptoms of depression for more than 2 months at a time.

I was prescribed Paxil, a anti-depressant that increases the amount of seratonin in your brain. I had really bad side effects with Paxil. My whole body was shaking so much that I couldn’t attend college classes. It was very noticable. I was unable to type normally. It came ooooouuuuttttttt llllliiiiiiikkkkkeeeeee ttttthhhhiiiiiiiiiissss. :P I found that walking down steps made my shakiness worse. I even started to obsess about death a little more.

So then I was prescribed Zoloft, another SSRI (selective seratonin reuptake inhibitor). My favourite thing about Zoloft is their cute cartoon commercial with the little bean. Personally, it made me feel more anxious, so I also took BuSpar to calm the anxiety. I couldn’t really tell if it was helping me very much, so when I returned to the UK (I was an exchange student) I tried Effexor.

It’s hard to remember the effect that Effexor had on me. My life became kind of hazy around this point. I didn’t have as dramatic side effects, however. I still didn’t think it was helping me too much. At one point I was prescribed Mellaril – an anti psychotic medication – for a couple of weeks. My doctor said it would calm me down. Unfortunately I don’t remember how this effected me either.

The final antidepressant I tried was an older kind – lofepramine, a tri-cyclic drug. I was on this for a few months and it seemed quite effective. I came off it when my GP (general practitioner) retired and I no longer wanted to see a Dr. The really important thing to remember is to reduce your dose very gradually. Otherwise you can get some very severe side effects. I really recommend talking to your Dr if you want to come off medication. Don't attempt it on your own.

So what are my general opinions of antidepressants? I think that if you are clinically depressed and your doctor suggests antidepressants then it is worth trying them. Remember that everyone is an individual - how well a medication works or doesn't work for a friend, does not reflect how it may affect you. Antidepressants won’t make you super happy. But if you find the correct medication & dosage, it will give you a bit of a break from the overwhelming feelings of depression. This allows you to work on the underlying problems. I really think it is important to combine medication with therapy. Otherwise you may become depressed whenever you go off the medication.

I also recommend talking to a mental health professional, preferably a psychiatrist if possible. Someone specializing in the medical field of depression will be more able to help you. When I was in the UK I saw a general family doctor – he prescribed medication – and a university counselor. I didn’t feel that the GP really knew much about how I was feeling. He was a lot less thorough than the psychiatrist I saw in the USA. There was also no one to follow up on what happened to me when he retired. I feel that a psychiatrist would have recommended another professional before he retired. The university counselor was also quite unhelpful. I never discussed medication with him, as that wasn’t his area of speciality. He was also very passive and un-opinionated. I saw him for a year and we never really discussed my self harm. He never suggested formulating a plan; he didn’t show concern when I was feeling suicidal and he didn’t bring up alternatives to self harm. That’s what you get when you’re talking to someone for free. But hey, it was still better than having no-one at all.

In 2003, I read some of a book: ‘Prozac Backlash’ by Joseph Glenmullen. It’s about the dangers of SSRIs (Prozac, Paxil, Zoloft & Luvox). Drug companies don’t really study withdrawal effects of medication. You may develop tics, fatigue, muscle spasms or neurologically driven agitation. This is because your brain adapts to being on the medication – you can even develop brain damage. When I get anxious or ‘bad feeling’ I still have twitches in my neck, arms and legs. My legs are still shaky when I walk down steps slowly. I think these are left over side effects from the Paxil & Zoloft I took in 1999. :( Just be sure you ask your doctor about the possible negative effects of medication. Also ask for another medication, if you can't handle the side effects of your current pills. If your Dr doesn't repsond to your concerns - find another Dr. I switched Drs, after one GP decided that I didn't need anti-depressants anymore. I felt that I did, so I found another Dr who would prescribe them to me.

Helpful Links

Drug Index - A-Z List - look up articles about antidepressants.

Depression - great, well organised pages from About.com

RX List - you can look up drug names or general mental health information.