Something else about depression. How it is treated. One of the most excellent therapies is talking and sadly talking is not very sexy as far as finding money to fund it goes. There are millions spent on sexy research to develop drugs-based treatment, a much more attractive proposition to governments providing a health service because a) drugs companies can bear the costs and b) drugs companies like making money. A drugs company won’t make a lot of money from promoting talking for 30 minutes a day to pharmacists and GPs.
There are other ways to treat depression. You can, as the euphemism goes, self-medicate. Come on. Self-medicate? That’s taking drugs. Only not ones that drug companies have spent lots of sexy research money on. They don’t have to even be legal drugs if you self-medicate. Plus it doesn’t really treat the depression so much as make you forget, for many hours or even days at a time if you’re really committed to the self-medication, that you are a living, breathing human being with depression. Staying in bed for several days, only getting out to go to the loo, waiting for it to pass (because it will) is a less risky treatment than self-medication, but if you have to leave the house because you will lose your job, or your children need taking to school, or you cannot live with the people you are sharing your home with and have no means of moving elsewhere, then self-medication can be very attractive. Or you can kill yourself. Admittedly, depending on one’s perspective that’s less treatment, more final solution, but at least your own hell is done. And depression has done its job, taken you to the point where you believe its lies and abuse, because it’s your head telling you all that and why would you – you – lie to yourself?
Actual medication is never an easy subject where mental health is concerned. I was never anti-medication. I never believed in medication in isolation either. I urged a very sick friend to consider it when she was adamantly refusing because of fear of turning into a zombified being. I saw others take medication and improve their stability levels just enough to manage coping with basic day-to-day tasks that provided some chinks of light. I had friends who swore by it, and confessed they didn’t know how they’d manage without it. And when it came down to it, when I knew finally that I was ill, I knew I would be prescribed medication. Self-medication hadn’t worked (don’t get excited, I’m really not a risk-taker, so we’re only talking alcohol). Creativity as a distraction had stopped working (but as a therapy, really effective, and another post for another day). Sleep worked but only because it was the only thing I could do that was effective in stopping me doing anything else.
Let’s have a story: How I fell in love with the drugs.
I was prescribed 20mg of citalopram a day. After I picked up the first prescription I read the side-effects. There’s a lot but I know enough to understand that there are several categories and the ones that most people experience were the ones to consider. Not that I didn’t worry about all the others. I didn’t start taking the medication straight away because I had an essay to write and I did not want to be experiencing the side-effects while undertaking intellectual activity of that minor magnitude. Also the advice was that if you were about to do something significant requiring consciousness, you should probably put off starting to take the medication until that was out of the way. It was about 3-4 weeks after first seeing my GP and having the drugs in my hands before I started to take them.
I chose to take them about 10pm at night. I cried every night before I took them, and I cried afterwards. I hated that I was having to take drugs to fix this illness. I hated that my body was being subjected to something that made me nauseous and dehydrated, and that I didn’t even know whether it would work. I was afraid I’d feel nothing if I took the drugs. And then about four months in, I found something out that made me almost run home to take the pill because I was so relieved that I had this way of coping with what would have been unimaginable days of sleeplessness and misery.
The story involves an Acquaintance, and for a change not the Original Acquaintance (although anti-depressants would have been a help there, but that’s a WHOLE other story). So all I will say is that what I felt on that day was betrayed. If I had not been ill, and recovering from that illness, there’s every possibility that it would not have been so impactful. Emotions are slippery things, making us euphoric in one moment, and devastated the next. But what I know is that when I got home that night I did not cry before I took the drugs, nor after, and I haven’t since. What I realised was that although they did make be dehydrated, and although they occasionally still made me nauseous, and they certainly make me forgetful, what they also did was provide emotional stability. Everything that had been in my head before I starting taking the drugs was still there, but the drugs stopped everything rattling around in it ALL THE TIME. They gave my mind some space to stop thinking about everything ALL THE TIME. And they were the sole thing that I knew would enable me to get up the day after that horrid day. And I did.
What that life event has also led to is an incredible amount of work on forgiveness. I like to think I am generally a very forgiving person (I forgave the Original Acquaintance for their behaviour a very long time ago), but it turns out, not so much given the right circumstances. Or circumstance, as it’s only the one that I’ve struggled with over forgiveness. I hope I’m nearly there, because the energy and anger that not forgiving consumes is life-sapping too. And to be clear, I’m talking about me and my circumstance only. I know there are life events after which forgiveness would be a very, very hard thing to do. Margaret Atwood’s The Handmaid’s Tale triggered a lifelong musing on asking for forgiveness and the giving of forgiveness without being asked. Again, another topic, but that book remains one of the most incredible works of (not so much) fiction I’ve ever read, and there are threads throughout it that have stayed with me since I was 17. The act of forgiveness being one.
Upshot: the anti-depressants have worked for me. But not on their own. I have found a fantastic counsellor, I have a tremendously supportive employer, and a family and friendship network who have offered nothing but love and care. And I have worked bloody hard on self-care as not being selfish, and realising that I don’t have to help everyone because I will admit that very occasionally, it’s all right to help yourself…
As always take care, and if you need help, links are in About.