Checking in – Adventures in Depression Medications

I feel like it’s been a long time since I’ve written about myself in any depth. It’s not that I haven’t meant to; I’ve started and abandoned all sorts of things in the last couple of years. There are ghosts of old writing hidden in google keep, google docs, evernote, and probably even on paper somewhere.

So let’s all settle in and get uncomfortable while I gather my thoughts.

Sometime last June, after more than a year of counselling, I took some time to check in with myself. Or more specifically, with my depression. I had a few difficult conversations with myself, coming to far too many conclusions, some right and some completely irrational:

  • I was doing kind of better, but not remarkably so, and was still overwhelmed by daily life – not able to focus, forgetful, and too often incapable of things like brushing my teeth each day, continuing walking in a given direction without stopping, and feeling even a general sense of satisfaction with being alive, let alone happiness.
  • Counselling was supposed to make me better, and if it wasn’t working then it must be because I was doing it wrong.
  • I was, in fact, doing everything wrong and should just give up on [fill in the blank].
  • No one would want to be around me if I was depressed, so if I talked about it or tried to do things about it then I would be utterly abandoned.
  • Antidepressants wouldn’t work for me because I wasn’t really depressed.
  • I am strong and capable and should be able to beat depression based on that, so exploring antidepressant options would be letting everyone who sees me as strong and capable down.
  • As soon as my coworkers or bosses found out I was on medication for depression they would lose faith in my ability to do my job (which only fed into my own lack of faith in my ability to do my job).

After all that thinking I went to see my new doctor. I was a bit of a mess when I told her; giving her the short version of my long-term history (childhood sexual abuse, emotional abuse, various abusive partners in my early relationships, rape, imposter syndrome, depression, cancer, the great flood and subsequent house-hopping… you know, the usual) and the catch-up on what I’d been doing to try and cope (regular counselling and trying – but failing – to think happy thoughts).

There were many tears.

I told her I didn’t know what else I could do, and was considering some kind of medication. We discussed it some and I started on a low dose of Citalopram (aka Celexa). It has minor and manageable side effects that for me went away after a few weeks. I took it for a few months and it helped, but I still didn’t feel like I was there, so we increased the dosage. I did that for a few more months, and I was feeling much better generally, but I still didn’t think I was quite right.

Last week I had another check-in with myself and came to a few more conclusions:

  • Overall I was having far fewer days where I felt totally hopeless and helpless.
  • That said, I also still had far more days where I felt incapable of maintaining normal existence and taking care of myself – the days when I couldn’t find the energy to brush my teeth.
  • Use a phone mood tracker I found I was generally Meh to Good, with more dips into Anxious and Awful than I wanted to see, with no reason to feel either.

Those hard days also bled into work and family and home life – engaging with any single task became impossible. I would instead start something, flip to something else, then do three or four other things before losing track of everything, staring blankly into space wondering what I was trying to do in the first place. Simple things could be insurmountable. Sometimes I left things to the last minute and got them done in a flurry of activity, and it always turned out fine… just like homework and essays back in high school and college.

Some things I simply couldn’t bring myself to finish at all – responsibilities I’d taken on in volunteering, or getting things done around the house that I knew needed doing but couldn’t reach a point of actually doing them.

I still didn’t think I was where I needed to be to  call myself a functional member of my family, let alone work or society. So back to the doctor I went.

Now we’re testing out an additional medication – Mirtazapine (aka Remeron). I’ve been on it since last week, and so far the side effects are noticeable, but hopefully will back off after the initial adjustment period. It’s used for depression, but can also be prescribed for anxiety, insomnia, and as an appetite stimulant for weight gain.

I can attest to the insomnia treatment – this drug puts you to sleep, and in my case so far makes me sleepy and foggy-headed for an additional 7 hours after I wake up. I’m hoping that passes soon.

The appetite stimulant side effect is not enjoyable. For the first few days I couldn’t stop myself from eating, even when I was so full I felt like I was about to explode. I have good self-control with food normally. This is very frustrating. I’m hoping that passes soon too.

I’ve also found it makes me feel constantly thirsty. I haven’t drank this much water in a day for a long time. And I never feel like it’s working.

It’s only been less than a week, so these side effects aren’t necessarily going to last forever. The tricky part is figuring out if the drug itself is helping, and if it’s worth the side effects. If I start gaining weight it won’t be good, so I’m hoping my ability to regulate food comes back.

The other aspect that I’ve started to wonder about but haven’t yet discussed with my doctor is wondering if I have ADHD or some form of executive function disorder. In my mind, ADHD means high-energy hyperactive, and I’m not that. But executive function issues? Now that’s starting to sound familiar. I don’t know, of course. It’s only my own brain I’m dealing with.

And the very loud voice in the back of my head is telling me that I’m wrong, that what’s wrong with me is just me, and I should stop trying to label myself to sound super cool with disorders and such.

That voice is a jerk and doesn’t want me to be better than I am now.

Invisible in Victory Square

Dawn in Vancouver, midwinter, after a cold, clear night. The sun is rising, but it’s hidden behind buildings. Early morning light is soft and I am walking through Victory Square, finally taking a moment to pause and look at the things I usually see in passing as I rush by.

A man is walking his dog. I’ve seen the dog before, though I don’t remember the man. He lives nearby, I suppose.

Flocks of crows pass overhead on their morning flight. None of them stop in the park. I wonder where they’re heading. I take pictures of them flying above electric bus cables; blurred black bird-shapes against the deep blue cut by black wires.

I stop to take a picture of steam rising from a pipe in the ground and admire the deep blue of the dawn sky, slowly lightening.

There’s a dusting of white from the day before, when the city collectively panicked as the temperature dropped below zero and the pouring rain crystallized into snowflakes.

The lamps that line the paths of the park used to be invisible to me. I remember the day I noticed they were helmets – like those worn by soldiers a hundred years ago. I can’t imagine how I didn’t see it for so long.

The cenotaph that stands in the northeast corner of the park still has wreaths that were laid there on Remembrance day. Their name liveth forevermore.

The mosaic stonework beside the path catches my eye. Pender. Hamilton. Victoria. I take a few more pictures but can’t capture what I see, or what I feel.

I’m not alone. People walk by on their way to somewhere. Cars, trucks, buses are all speeding along the streets that surround me. But I don’t hear them. I feel like I’m standing outside of time, watching everything go by, waiting for the sun to light up the winter sky with golden rays of morning. They don’t see me. Things move around me but I am still. I am invisible.

I turn away from the mosaic and walk along the path, enjoying the contrast and reflections of morning light on the buildings against the blue-grey sky. I stop for one last picture, hoping I can catch the perfect light as I see it, but knowing my phone isn’t really up to the challenge.

I notice the cold again. Crisp, frosty, I can see my breath.

I take a photo.

I am not the only invisible person in Victory Square. But I am invisible by choice, knowing that I can step back into the city around me and back into my normal life.

I am not the only invisible person in Victory Square.

I step away and head to work. I forget. By my photo remembers.

There are always invisible people in Victory Square.

 

 

Familiar Complexity

Complex things can be subjective or objective. Complexity itself describes a state of something’s existence, so in a way it seems always measurable, always definable. But when you get to know something more intimately, when it has become a part of your everyday life, understanding makes it less complex.

A huge grocery store, when first experienced, is overwhelming. Aisles stacked high with different versions of the same items, bright colours and bizarre images on boxed products in some places and inedible ingredients waiting to be cooked in others only add to the confusion. It can be too much choice, too many unknown elements, too many options, and the overwhelming complexity can make a person want to flee towards the familiar.

That feeling of wanting to run away can be a hard one to fight. It’s easy to stay within our comfort zone. It’s easy to avoid trying something unfamiliar. Most of us seem to harbour an underlying fear of doing things wrong, and most of us find comfort in the familiar. It’s harder to make a mistake when you’ve done something a hundred times before.

The reward we get from taking a risk, even a tiny one, can be great. Trying something new and failing seems like a frightening outcome, but familiarity can be worse. Not because we shouldn’t take comfort in the things we know and love, but because we don’t know what we’re missing when we don’t spend time exploring complexities.

The more time I’ve spent learning the complexities of a grocery store and the foods and ingredients found within, the better I’ve become at cooking, and the more amazing food I’ve discovered that I enjoy. My love of flavour is enriched by this complexity. And the more I explore this complexity the easier it becomes to understand it without feeling overwhelmed.

I’m not actually talking about grocery stores, though.

I take Lyra shopping sometimes. I like to spend time talking about her thoughts and listening to her ideas. As she gets older, the complex flavours of her personality are showing themselves.

Her complexity is fascinating and beautiful and unfamiliar. Sometimes I get overwhelmed. It would be easier to back away and treat her like a superficial being – like a child – when I’m feeling that way.

Instead I try my best to understand her by exploring her complexity. My life is enriched by her, both objectively and subjectively. I look forward to learning more.

Five and a half

I think those might be eyes like mine, but I’m not sure. I don’t look into my own eyes nearly as often as she demands I look into hers.

Bold, loud, rambunctious. Adjectives I’ve never used to describe myself. She is a mystery to me sometimes.

She uses my name as an excuse to avoid things she’d rather not do, invoking me like a charm against her perceived enemies… Going to bed, taking responsibility for things, being told to eat food she’s not interested in.

Her opinions are strong and her voice carries across a crowded room. She feels things deeply, passionately, and often fleetingly. She flares up with rage like the dragon for whom she’s named, but is known as a peacemaker to many.

Five and a half, and already more herself than I was at thirty. She takes the things she learns to heart. I hope that she will never be broken.

Repeat

Unable to sleep, Lyra, who is nine, tells me tonight about how she sees time.

“It’s a rectangle,” she said, “but with round corners. The seasons go around each corner, four seasons and four corners of the rectangle. But they’re not square. And that’s how time works; it keeps going around and around, but some sides are longer and some are shorter, and the corners are curved.

“How does it work for you, mom?”

She’s awake well past her bedtime, which has become the norm. She, like me at her age and for my whole life since then, does not go to sleep early. The earlier she goes to bed, the more anxiety and frustration it creates when she can’t sleep, so she stays up late.

And now she has me thinking about the movement of time.

“I experience it more like a spiral – a kind of erratic orbit,” I tell her. “It’s like I’m always moving in circles through time and space, but it’s never exactly the same as the last time around. Things repeat and change and we go around the seasons and the days and the years and there are places, people, and things that happen to change the path I take; but the base orbit is basically the same.”

She thinks about that for a moment.

“Well, for me it’s a rectangle with rounded edges.”

I nod, and we talk for a few minutes before I say good night and leave her to try and fall asleep. I think about how I wanted to write about repetition tonight, about how when we do the same things over and over they can go from exciting adventures we occasionally get to have to mundane, everyday experiences. I catch the ferry home, and I am bored. Whenever I need a snack I get fries and gravy from the cafeteria. Always the same, but time keeps moving, and the weather has changed, so it’s not truly the same.

Like a round-edged rectangle. Like an erratic, spiralling orbit.

Traditions

What makes a tradition stick? We have so many old traditions that we repeat year after year without thinking about where they come from and why we do them in the first place. Sometimes we talk about them, share origins with our children, and pass them on to others. They mean something to us so we keep them alive.

Sometimes we allow old traditions to fade away, forgotten, no longer relevant or so lost in the concept of themselves that they’ve become a thing we do just because we always have. Some of them lose their meaning, origins and stories that disappear with time.

Sometimes we realize that an action we’ve traditionally done doesn’t fit our world view anymore – when we realize that our values don’t match the meaning behind a tradition, or when we find that something we once thought of as harmless fun actually causes pain to others that we never used to see.

A tradition shouldn’t be maintained just because it’s always been so. We change, we grow, we learn and adapt. This is who we are. It can be hard to let things we’ve always done stop, but it can be healing.

As we remove the old, worn traditions that no longer serve our world view, we make room for building new ones, or adapting the old to fit who we are as individuals, as families, as people.

Let us carry on with the old traditions that bring us together and help us connect and give us a way to see across time into our past. But let us also move ahead, start new traditions, find new paths for connecting not only with those we always have, but also with those we haven’t. Let us learn to make our own traditions that stick.

And let the traditions that can no longer serve us fade into memory. Someday ours will do the same.

 

December-busy

There hasn’t been much rain so far this winter. November had its moments, but December has been largely a mix of sun and fog – but no rain. But we’ve been December-busy, the kind of busy that happens around the holidays, so it feels like we’ve barely been able to recognize the weather we’ve had, let alone get outside and enjoy it.

Summer the dog has noticed. Stir-crazy and anxious, she’s been non-stop for weeks. When we go to the door she watches and waits expectantly, like a coiled spring, looking for a sign that we’re off to do something fun. She’s the sort of dog that is always prepared to leap into action – always looking for something that lets her run and gets her outside and gives her purpose.

When we take her outside, it’s never for long enough. She runs laps around the yard at top speed, tearing up the damp grass and looking for something or someone to chase. She doesn’t usually find what she’s looking for.

Today before sunset we went outside, the dog and I. She ran her laps of the yard while I pulled bindweed off the Rhododendron bushes. She was happy that I was staying out for a change, taking a few minutes to breathe and weed and not be at my desk working. Lyra followed us out, wondering why I wasn’t at my desk.

After a good five minutes of Summer running in a circle through the yard, the neighbour’s dog Sophie – who likes to escape and go on adventures from time to time – appeared. Summer froze, stared at Sophie, and leapt into action – prancing and barking and wrestling and inviting Sophie to chase her.

We gave them some time to play, then Lyra and I started to walk Sophie back home. When we got to the street, however, Sophie sped off with Summer in tow – thrilled that she had something to chase, finally.

I was almost sad to call her back. Lyra was sad that she couldn’t get Sophie home. Summer was sad to go back inside. There was too much sadness all around. Sophie found her way home on her own after her adventures. I doubt she was sad.

I think it would be easier to be December-busy if it was pouring rain.

Eyes

The eyes are not to be trusted.

The focus is off. The lighting is imbalanced. It’s too dark in some spots, too light in others, and indistinctly blurry, tricking the eyes and the brain into believing that there’s something wrong with me, making me blink to clear my vision.

An image made of imperfections is one that I want to hide. I can do better, I should prove that I can do better by only and always doing better. I have to halt my thoughts. I open the image, I force myself to look at the imperfections, to see past them.

I start to find things I like in spite of them.

I notice that I like some of the imperfections, the errors, the blur, as part of the whole. This imperfect photo I’d rather not show to anyone. The only one I can focus on.

Looking through the uncomfortable feelings that come from examining a flawed image I’ve unintentionally created – in my mind’s eye it wanted to be more – I see the pieces of myself. Those are my ornaments, chosen over the years, each one with its own history. Those are multi-coloured lights – the ones that my children prefer, bright and colourful and irrational. I would have limited it to one, at most two complementary colours, but they want them all. This is our tree. My tree.

Snowflakes appear in the light – an illusion created by a toy filter held in front of the lens. It only works on a few; the rest turn into blurry brightness. Imperfect. Unworthy. Meaningless.

The brain is not to be trusted.

Butter Tarts

“I’m craving butter tarts this morning,” he wrote in a chat window we shared with a friend. We ignored him and continued pasting links to things we found interesting or amusing, without acknowledging his comment.

“None of this has anything to do with butter tarts.”

He was right.

Later, across the street on a morning search for coffee, I saw it. Pastry, folded in on itself at the edges, coming together at the base to form a cup. Contained within, a baked blend of sugar, eggs, butter, poured over dried grapes. Golden brown, nearly overflowing with flavour and sweetness.

I handed over my coffee mug and ordered what I always do. I asked for a butter tart. Into the white paper bag it went, and then back across the street, up seven floors to the office.

I didn’t say anything about butter tarts in our chat.

The butter tart went back into its white paper bag and was stashed away somewhere I wouldn’t forget it.

Time passed. There was no further mention of butter tarts. I worked, I traveled the long way home, I forgot. Late in the evening, I remembered.

I pulled the white paper bag out of my knapsack and handed it over without ceremony. “This is for you.”

“Is this… a butter tart??”

I smiled.

“I love you,” he said.

“I know.”

I don’t like butter tarts.