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Dealing With Depression

by Patty E. Fleener M.S.W.

For those of you who are depressed or just plain "not doing well" I want you to know that you are not alone and hopefully I can give you some ideas that have helped me. 

Very recently I began to notice that I wasn't very interested in my chores, even though they are light. Showers were taken less frequently and I have experienced a little more irritability. Every morning I wake up and say to myself, "Should I get up or stay in bed all day?" 

At first I felt guilty feeling I was getting very lazy for some reason. The "symptoms" began to worsen. Showers became more infrequent. I began sleeping in my clothes again, wearing them the next day only to sleep in them the next night. Believe me, there are not too many people I would tell that to. But I think most of you understand. If you are a clinician and you don't understand you should take notes and call it "Depression 101." 

A few days ago I actually sat in my living room crying, "everyone hates me." What was this discussion based on? Nothing. :-) 

The interesting thing about bipolar disorder from what I am learning in my case is that things will go along well and "from nowhere" depression or mania will come. Uninvited as well. 

If you are new to this newsletter, I occasionally have "melt downs" over my 20 year old daughter who has had no contact with me for over a year and a half.

The meltdowns appear to be coming more often and are much worse in intensity. Could be due to the current depression.

What are the meltdowns like? Lots of tears coming from very deep down - "hard crying." I feel as though I cannot survive or go on without my daughter being in my life. I miss her so much my insides physically hurt. When I see someone about her age, I get that ache inside. I feel fear that I have lost her forever or at least that I will not see her for a very long time.

I have racked my brain trying to figure out why my daughter is doing this and I don't have a clue. Nothing has "happened."

First of all, most of us have advantages we are not aware of in dealing with depression. Here are some of mine:

I have endured many, many, many cycles of depression in my life - all the way from mild depression to very severe depression which I describe is next to death and I do not exaggerate when I say that. For those of you who have been there, you understand don't you?

Because I have been through so many cycles of depression, these depressive symptoms are not new to me and thus they do not scare me. We fear the unknown. I will say however that the severe levels of depression do scare me each and every time and I believe that they should scare us. Why? Because that severe of a depression puts us at risk of suicide. Severe depression is extremely difficult to endure and for many people, knowing that death is an option is a comfort as it is a way out of the pain. 

For the sake of this discussion, let us forgo severe depression. That is another subject altogether. If you are severely depressed but are not actively suicidal you are in extreme pain. My advice is to see your Dr. right away, preferably a good psychiatrist. In fact you may need to be evaluated for hospitalization. No need to fear that. Medications can be increased and decreased much more rapidly in a hospital, hopefully leading you out of your pain quicker.

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Ok, so here I sit unshowered and depressed. I have a new medication to add on to my current "drug cocktail." I have no idea whether this new med will work for me or not. I do know that I have been in this exact situation many times in my life. I know also that each and every time I was able to leave my state of depression. I know that there is a beginning, a middle and an end to my depressions. 

I have the advantage of writing to Dr. Paul Markovitz, our Ask the Dr. for both the Bipolar and BPD sites. You all have the same advantage. 

I did in fact write him. I described my depression as accurately as I could, advised him of the meds I was taking, told him what my diagnoses are and asked him his opinion. He wrote back and I gave his thoughts to my nurse practitioner who in fact did take his advice. 

I am fully aware that many of our Drs. have a large ego and will not consider such advice. This has happened to me with previous prescribers. 

If you have a Dr. who is well educated with the BPD or the BP then he/she is already acquainted with who Dr. Markovitz is. However if you have a Dr. who is not so educated you need to educate this Dr. just as to who Dr. Markovitz is. I recommend printing up his C.V. (resume) off of the website and bringing it to your Dr. 

You must remember however, that Dr. Markovitz is not your Dr. He has not seen you, has not seen your chart, is not aware of your history, has not evaluated you personally, etc.

If you are not getting better with your current Dr. and you have given him ample time to assist you, GET A DIFFERENT DR.

I don't want to hear that he is the only Dr. available in your town. This is where saving money and traveling to see a good Dr. comes in. Spending money to see a good Dr. is right up there with your rent/house payment and the electricity bill.

What? You would have to miss your rent to own furniture, tv and freezer? I don't know about you but I would rather be happy, stable and alive. I would gladly give back all those luxuries. "Things" are just that - luxuries. They don't and cannot make us happy. If you are stable and happy you can work well, keep your marriage together, give more to your children, yourself, your parents, etc. Less likely to wind up in the hospital, huh? Get your priorities straightened out. 

I have a relative who is in debt $40,000 as his wife has a spending problem that is out of control. His wife is a wonderful person who admits that she is ill. What would you do in that situation? Could you afford to pay cash to get help if you needed it?? Do you notice I used the word "afford?" Let's reword this sentence. Would you pay cash to get your wife the help that she needs for her sake so the she can be the happiest and best person that she can be and hopefully the end result would be that she will stop using the credit card?

Here is a sentence I hear all the time. "I don't think I am worth taking medicine. The money is best spent elsewhere." You don't think you are worth it because you are probably depressed indicating all the more that you need medication. Whether you feel you are worth it or not, your family probably suffers in some way because you are not getting the medicine you need. How far down are you going to go before you get help? Are you aware that depression can worsen over time? Do you really want to recover? Some people don't. That is a fact. Some people are very comfortable living in misery and get lots of "poor me" attention. 

If you are a family member of a "poor me" person, ask yourself if you are enabling that person in any way. Other than people committing suicide, sometimes we need to let people fall. 

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