Feel the Burn(s Depression Checklist)

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.

Ziya's scores on the Burns Depression Checklist from July 16, 2014 to August 17, 2014

Ziya’s scores on the Burns Depression Checklist July 16, 2014 to August 17, 2014

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.

I’m also 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.

My Thoughts on Menstrual Products

I drove for 5 hours to visit Banji, then realized I was due to  menstruate soon – but I had forgotten my menstrual cup at home. I have to use tampons for the first time in years, and I’m not happy about it. I’ll admit I’m not in love with my cup or menstruating in general: my cramps are mild but can still be annoying, and emptying the cup can get a bit messy. I’ll be the first to admit that menstrual cups are not for everyone. But I’d gotten used to mine; using tampons again is just weird.

For anyone who doesn’t know, a menstrual cup is a small, flexible, medical-grade silicone cup that one inserts into one’s vagina to collect menstrual fluids. Five huge advantages of a cup over tampons are:

1. The cup only needs to be emptied once every 12 hours (as opposed to every 8)
2. Menstrual cup use is NOT associated with Toxic Shock Syndrome
3. It is reusable, and therefore better for the environment
4. It is reusable, and therefore saves one money
5. It is safe to insert before menstruation begins, protecting clothes from stains

There is an added advantage I hadn’t really thought about until I was forced to use tampons again: a menstrual cup allows one to be more in touch with one’s body. I’m finding the plastic applicator and convenient pull string of the tampons to be just a little bit too sanitary. All this pushing and pulling and fibers rubbing against my mucus membranes just doesn’t feel right; the silicone cup was much gentler. I actually kind of miss getting some blood on my hands, seeing how much had collected, even smelling it. I miss using the muscles around my vagina to push the cup out just far enough to grab the bottom with my fingers. It was a process; I had to be slow, gentle, and deliberate. I had to feel and respond. I had to touch myself *gasp* down there!

I’m finding that, for me, staying clean is not the be all and end all of this part of my cycle. It’s important, especially because I still need to participate fully in society. But it’s not enough on its own, not for me.

Menstruation is a potent, messy reminder of my creative potential – both biologically speaking and otherwise. My ability to create, nourish, and nurture a new life. That raw, primal power that rushes through my veins, filling every part of me. My connection with the generative forces of the Universe. The Muse that guides my artistic endeavors. It is an inescapable part of being alive. I want the product I use to reflect my acceptance of it.

I want to take this time – when I’m continually reminded of it by cramps, cravings, and an added process in the restroom anyway – to honor this sacred cycle, without which humans would cease to exist. I send positive energy to all people who menstruate, will menstruate, or have ever menstruated. May you be safe, healthy, and free to use (or not use) your creative energies as you see fit.

Blessed be.