We put Trouble to sleep yesterday. I just couldn’t watch him suffer anymore. Now he’s at peace.
My rat Trouble is dying and I feel like I can’t focus on anything.
I’m going to start this post with a little bit of honesty: until recently, I thought that organizations like the NAACP and the National Urban League and some of the other old Civil Rights infrastructure were outdated, irrelevant, and unhelpful in the conversation about race in America. I thought that the idea of sit-ins and protests were good tools for another time, that peace marches and locking arms were something for a time gone by. Quite frankly, I had an attitude of “what have ya’ll done for me lately?”
I never thought that these organizations should disappear… I considered them to be Professors Emeritus in the sphere of race and class conversations in this nation. We see them as an authority, representations of the “old school,” but I thought that it was time for a new vocabulary, because we live in a new world with new needs.
And then Trayvon…
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I’ve been using the Burns Depression Checklist to track my depression symptoms every day for the past month. For anyone who doesn’t know, the Checklist is a list of 25 symptoms, such as: “feeling unhappy or blue,” “loss of motivation,” “feeling tired,” and suicidal thoughts. It’s been about a year since I last used it.
To complete the Checklist, I rate each item on a scale from 0 to 4 – where 0 means I didn’t experience the symptom that day and 4 means it was “extremely” present that day. I find tracking my symptoms daily to be helpful because it’s hard enough to remember everything I felt, experienced, and did in one day – never mind trying to do it for a whole week! I add up my ratings on all 25 items to determine my score, a numerical representation of how depressed I was that day.
My scores (blue line) are usually in the mild (11-25) or moderate (26-50) ranges; my average for the month is 30. Days when I score above a 40 are particularly bad and I notice impairment in my functioning beyond feeling tired and not wanting to do anything. It’s like I can’t do anything.
In contrast, days when I score in the teens or low 20s are my good days, when I feel like I can get my life back on track and I want to do everything. They are days when I’m the most active and social… and (usually) spending time with Banji. Both of the days when I scored below a 10 (July 27th and August 2nd) were days I spent with Banji doing some of our favorite activities.
My scores oscillate wildly from day to day; a change of 10 points or more is not uncommon. I’ve even had the score jump almost 30 points in one day! (August 3-4: I was sick, but pushed myself to spend the weekend with Banji and other friends anyway. I needed the 4th as a day to say “fuck you” to the world and stay in bed. I ended up playing The Sims 3 for most of the day.)
To try and compensate for the oscillations, I had my spreadsheet calculate a 7-day average value for each day, using the scores from that day and the 6 before it. The 7-day average values are marked on the graph above as a dotted green line that never drops below a 16.
Ironically, my low 7-day average score of 16 occurred on the day of my psychiatric evaluation – probably the one day I’d want to exhibit depressive symptoms so they could be observed and evaluated by a professional. It’s been rising since. There are definitely other factors involved (well, mostly visiting Banji), but I think my hope that the advanced practice nurse (APN) would be able to help me reduced my depression leading up to the appointment.
[August 20, 2014 Update: Actually, my low 7-day average score of 16 was 2 days before the psychiatric evaluation – on the day I came home from visiting with Banji.]
In the time since that appointment: I have not been on medication, I’ve been unable to schedule the sleep study the APN requested, I’ve stopped taking the supplements that seem to help but cost more than I’m comfortable spending while I lack income, and I haven’t been doing music therapy with Wakana because she’s on a business trip. Most importantly, I haven’t seen Banji since August 3rd.
a bit stressed out about the summer class I’m taking, which is awesome but requires me to go out into unfamiliar social situations and be professional and on time and do independent research for a paper due in less than 2 weeks. It’s sending my anxiety through the roof! My responses to anxiety tend to be depressive symptoms: feeling hopeless, inadequate, ashamed, and guilty, criticizing myself, avoiding people and activities, eating like crazy, and my sleep cycle is a total wreck. It’s a bit overly simplistic to stay that my anxiety causes my depression, but it definitely contributes to it.
I have noticed a cycle where I start to feel better, start making commitments (applying for jobs, registering for this course, etc.), feel very anxious about keeping the commitments, fail to keep the commitments, feel depressed, don’t do anything for a while because I’m too depressed, rinse and repeat.
Where is this anxiety coming from? Well, our friend David Burns and other cognitive behavioral psychologists would say it (as part of depression) comes from distorted negative thinking, particularly about myself. I hate myself; I think I’m no good and I don’t deserve to live and it’s only a matter of time before other people figure it out. It doesn’t really matter where I got this belief; exploring its causes won’t help me feel better and will only open up an ugly can of worms that’s best thrown out. It’s in the past. I live in the present; in the present what matters is replacing the belief with something more realistic and healthy… at least, that’s my understanding of what cognitive behavioral therapy is about.
I’m ostensibly holding a key to overcoming my depression in my hands as I write this: the book Feeling Good: The New Mood Therapy by David Burns. It’s where I got the Checklist and its scoring chart from and I’ve read parts of it, but I have yet to fully absorb its wisdom – obviously, or else I wouldn’t still hate myself. I’d love to use the excuse that I need to focus on my class so I can’t also read this book, but let’s be realistic. I’ve been wasting time on random things that I could easily divide between schoolwork and doing things that benefit my mental health and have time left over for fun and/or social activities. The number one “random thing” is an online free-to-play “game” that some friends got Fox and me into.
I need to kick my computer addiction, but I don’t even know where to start… especially since I need my computer for things like the class I’m taking! Aarrgghh!!!!!
I wish it were as simple as deciding that this other stuff is more important and doing it, but if that were the case I wouldn’t have depression. I need some kind of support; I feel like a broken record because I don’t even know how many times I’ve said it since I started this blog. I’m having trouble focusing, deciding what to do (which causes me overwhelming anxiety), mustering the energy to go do it… I don’t know. I’m stuck. I’m just going to stop writing now.
So it’s been a few days since I began taking the full 300mg dose of the bupropion. And so far, the patterns that seemed to be emerging before are consistent:
- Increased irritability. It’s stuck around, but I think I’m starting to get the hang of handling it.
- Much lower scores on the Burns check list: the highest this week has been a 12, with four different instances of a 9 representing the low. In fact, my weekly average dropped from a 14 to a 10 (technically a 9.8, but close enough).
- An easier time actually getting going. Four days in a row of paid work (all successfully done) is a good testament to that.
The only difference I have noticed is something I was warned about: if I take the second dose too late, the 6 hour jolt of energy is enough to make it difficult for me to get to sleep. Mostly, this is a problem when I wake up late (ie, 1 or 2pm), rather than the drug acting in some weird way. The other thing I have noticed has been an increase in headaches; but that could simply be attributed to general lack of sleep. In fact, that’s probably what it is; headaches are a fairly common result when I get less than four hours of sleep in a night.
All told, I’m mostly liking the bupropion so far. I’m thinking of doing one more part to this series after a few weeks on the full dose when I’ve gotten a better picture of how it’s affecting me.
After hearing the sad news of Robin Williams and his suspected suicide, I am really tired of hearing some people refer to depression as a ‘disease’. It is not a disease, but more chemical and emotional imbalance of the brain, normally affected by long-term stress, deep trauma or grief, for some it is difficult to diagnose the root cause. Here is a good article written by Dr John Grohol on defining Depression for those of you that are insistent on calling it a ”disease”.
Furthermore, should it really be referred to as a ‘mental illness’ either? Through my research and personal experiences, depression is an understandable psychological reaction to the stress and violent deformities of the modern world.
I have tried a number of conventional and non-conventional methods to treat my own depression and I feel the most valuable activities are spending time in…
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Following in Ziya’s lead, I also recently had a psychiatric appointment. I made it the same date as zir appointment, and it was supposed to be for the day after zir appointment. But of course, things happen, and five days later (the 5th), I had an appointment with the same psychiatrist that Ziya had so many problems with the last time.
My appointment thankfully went much smoother, and since I’ve been doing the Burns depression checklist every night for the past three weeks or so, I had a pretty good sense of what my symptoms really are. This made his choice of medication easy: the generic of Wellbutrin (bupropion). This post (and the next few parts) will consequently track how I’m feeling on the medicine as I ramp up to the full dose and beyond.
So far, I’m a little more than halfway through the ramp up period; I have two more days of just one 150mg pill a day, then I progress onto two. And so far, it seems to be helping with my main symptom: the incredibly low energy (as well as the motivational problems that follow from that). Prior to starting it on Wednesday, my typical score on the Burns was in the 17-26 range; basically, the upper end of mild with the occasional break into low moderate. Since I’ve been taking the bupropion, the highest I’ve gone is a 13, and I’ve seen my second 9 in several weeks. So while I may still hit the low end of mild, I’m seeming to stay more towards normal but unhappy.
I feel significantly more energized and capable of actually getting things done. This is a huge improvement.
But I’m also finding myself more susceptible to distractions (for example, people talking near me or Ziya humming a song or thinking aloud). And those distractions are definitely hurting my ability to focus. I’m also finding that, so far, I’ve been becoming more prone to irritability. Little things that didn’t use to bother me are starting to and with an ease I haven’t felt in awhile. It is possible that the latter issue is (at least in part) due to having the energy to actually feel those emotions again. But I’m not sure if the bupropion is the cause of the former, and I’m hesitant to look at the side-effects; I don’t want my brain to get any ideas. I’m hoping that the former will become easier to deal with; I like this new energy far too much to want to try some other random drug.
Maybe things will shift when I start taking the full dose next Tuesday. Part two will probably go up after a few days on that dose.
I felt very tired and sad all day today; it took all my energy to do anything. I felt like I was trying to interact with the world from the bottom of a pool.
We went to talk to the representative at the venue where we’re having our wedding celebration; I felt like he was being very curt, talking down to us, lecturing us, and trying to get us out of there as quickly as possible. It had to be at least partially depression goggles; I can’t imagine he would still have a job if he treated everyone the way I felt like he was treating us. We accomplished most of what we wanted while we were there – I think, the whole thing felt very disorganized – but I left feeling as dissatisfied as if we’d missed our appointment or something.
We went grocery shopping on the way home. We kept to the list, found everything we needed, and headed home tired but satisfied. At one point I even found myself dancing to the music playing in the store. When we got home I just sat in the car for a couple of minutes, then got stuck holding the same weird position for a while as I was trying to get out of the car. I was sitting sideways in the seat, one or both of my feet on the ground, leaning against the door frame and staring at a spot about 5 feet away. My limbs felt too heavy to move.
I’m kind of amazed that I managed to stay awake for about 13 hours today. If my body had its way, I think I would’ve spent the whole time drifting in and out of sleep. Should I be proud that I accomplished things even though I was feeling so miserable?
I’m moving ahead with wedding planning and the summer course I signed up for begins on Monday and I have a job interview over the phone tomorrow morning (which I already postponed twice because I was sick). Maybe this lethargy is a sign that I’m not ready to pick up my life again just yet… or at least that I’m trying to do too much at once.