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.