Welcome to Depression: Advice to Creative People Suffering from Major Depressive Disorder

Slightly altered from a letter to a friend:

First of all, thank you for looking for help. Asking for help is hardest when we need it most, at least in my experience, so taking that step is a Big Deal.

Depression is not a new thing for me. I’ve lived with it since I was a kid. Some days are better than others, and major crashes do come (way more often than I would like). I can give you advice based on my own depression experience, but like anything, YMMV.

First of all, even if you don’t care or want to, take care of your physical self. Eat meals that are as good as you can make them or buy premade stuff that is good. Shower. Change clothes, and wear stuff that makes you feel good when you aren’t depressed. Get at least ten minutes of sunlight at least once a day; it’s better if you get outside at least four times, even if it’s just standing on the sidewalk. Exercise a bit (this is how my son has just about beaten depression: exercise and sunlight). You won’t want to; do it anyway. If you feel like you are in need of help, get it. There are clinics, and in an emergency, 911 (in the US) will bring you assistance. The world is better with you in it. Treat yourself as though this is true even if you don’t feel like it is right now.

I have found that anger is about the only source of energy when I’m really low, and even that doesn’t come easily, but if you can get it, use it to attack something useful (dishes, a small corner of the bathroom, etc) so you can feel like you’re still useful. Feeling useful is very important.

Even if you don’t want to, pick some small creative project to do that is below your peak skill level. This is vital: you need to NOT be challenged by it. It needs to be something that you could normally just about do in your sleep. Make something for yourself if you can come up with something you want or need, whether it’s cookies or simple embroidery or whatever. I do beaded jewelry to be given as SCA largesse when I feel like crap; it’s how people (if they knew me well, and almost nobody does) could tell if I’m teetering on the edge – I make beads on a string because I feel like I’m incapable of doing anything original. But if I do that, afterward, I can look back and see that I made things that someone can use. Make sure that at least one of the projects you pick is small enough to finish quickly so you get the reward of finishing soon.

If you can, find a nice thing to do for someone else. You don’t have to know them. Largesse serves this purpose for me, but so does making a treat for family, friends, or critters. Writing letters of recommendation for SCA awards for people has also made me feel better.

Cuddle a fluffy critter if you have access to one.

Here are some of the best sites I’ve found for people dealing with depression: Metanoia’s page for people feeling suicidal is the best page of its kind I’ve seen, and the National Institute on Mental Health’s depression page is useful and accurate. Also, if you’re looking for a way to explain depression to others, or just want to see that others ‘get it’, try these 21 comics from Buzzfeed that pretty well sum it up.

And remember, that voice in your head telling you all that negative stuff is a liar and a cheat and an exaggerating jerkface. Tell it to shut up every time it starts in on you. You are valuable, you are skilled, you are talented, and you are loved. Depression is temporary, and even if it comes back, it will go away again. Keep pushing.

This is Not the Post I Should Be Writing; in which mental health is apparently only taken seriously by those who need help

I had all these great plans this morning… yesterday morning, too. I was going to get up, be Super-Mom TaxiDriver as usual, tend the chickens, make awesome art stuff, feed myself at least two proper meals, and end the day(s) feeling satisfied and at least ok, if not happy. I have several arts posts to write, as backup documentation for the classes I am scheduled to teach at Great Western War, and I planned to write those in the evenings and during the hotter part of the day.

Yeah. Not happening. To explain why, I need to go back to 6 am Saturday, when I got back from being Super-Mom TaxiDriver and realized abruptly that the antidepressant which I take three of every day, without fail, because it works, was almost all gone, and needed doctor’s approval to refill. I should point out that said doctor was a student, and graduated, passing me off to a new doctor, who did not renew the prescription, probably by mistake. Also significant is that my new, shiny insurance does not cover the facility these doctors work from, because they’re only available to be seen once a week, and that’s apparently not good enough. My other antidepressant, the one that is being used off-label as a sleeping pill, I have what looks like a 45-day supply in two bottles left. Why don’t they match? Who knows? Probably a mistake with the number of days/pill count for the more important one. Doesn’t matter. The rattling in the bottom of the bottle is mostly desiccant cylinders, not pills, so this is urgent.

To know why this is going to be as bad as it gets, it may help to know that I have run out of another antidepressant before, and was, then, unable to find a doctor who could help me get the medication I needed for over two months, being uninsured and unable to pay the price the County wanted to charge me for a second visit. I spent the next few months a wreck, having all sorts of side-effects from stopping the antidepressant suddenly, including my very favorite: the repeated sensation of being electrocuted, happening 20-150 times a day. Yes, I counted. I stopped at 150. It happened more, but I was tired.

Also, my mother, who has a large number of ailments, any one of which is potentially lethal, has gone rapidly downhill due to dementia and various heart ailments. I just signed the paperwork to put her on hospice care at the skilled nursing facility where she now lives. I’m in the process of getting a job, finally, but it’s temporary and comes with no benefits, and is less than half the pay of my previous profession (teaching, so really, you have to take into account the time I’ll be getting back, as well as the end of my need to buy thousands of dollars in school supplies each year). Anyway, I have some extra stress. And every single person in our household suffers from depression. I’m the ‘good’ one… I’m getting taken care of. Allegedly.

So, back to Saturday at 6 am. Call in the refill, knowing it won’t be looked at until Monday. That’s OK, they can call me or the doctor or look at my records then and surely they’ll be able to refill it. I hope. Until then, take one pill (not three) a day and hope that keeps my head above water. Go back to sleep for a couple of hours. I’ll be fine.

I’m not fine.

I can’t get myself together to make a single thing (except pot roast on Monday night). Monday morning, after taxi-time and chicken-tending, I deal with paperwork at my mom’s facility, pick up her laundry, and marvel at how much better she is able to talk now that they took her off so many of the medications she was on. Then I feel horribly guilty, because she should be home, except she’d probably fall and break a hip or burn the place to the ground, not knowing what she was doing… then I feel even more guilty, because those pills she’s not on anymore were supposed to prolong her life… then get mad at myself because what’s the use of a long, miserable life? Then I run one errand, then it’s taxi-time again, then I get home and just want to cry myself to sleep, but instead I make pot roast from a recipe that used to make me laugh until I couldn’t breathe. I don’t even smile. It tastes good, but I eat only a little and pack away the leftovers, making a small plate up for my mom for the next day, when I plan to bring the kids to visit her. No calls from doctors or pharmacy.

Tuesday morning (that’s today): taxi, chickens, and then a call to the pharmacy. No luck, no refill. Panic starts to build. I call my new primary care doctor’s office, but they have no appointments for a week, and besides, they don’t renew prescriptions for psychiatric medications. (Um, what?) OK. Deep breath. Brief meditation to push down the shrieking panic that’s welling up. By the way, anxiety is not part of my diagnosis. It’s just depression. Severe, recurring, and with suicidal ideation. Please, people, these drugs are not recreational. They’re not fun. They keep me capable of being a responsible mother and partner, a decent member of society, not a danger to myself or others. Deep breath.

I call the insurance company. Hold. Hold. Finally a human being answers, and it’s explanation time, all over again, with a shake to my voice and too much nervous laughter. She asks me the same stupid questions they always ask, am I thinking of harming myself or others, am I injuring myself, am I able to go through my daily routine? I’m sitting on the edge of the bed in yesterday’s clothes, I still haven’t eaten breakfast, what do you think? No sarcasm aloud, just the same answers, not seriously, no, no, I can’t. Great, she can refer me to a psychiatrist’s office, but remember that’s not normally OK, this is just an emergency, so she’s going to put me on hold and transfer me to mental health, whose helpful operator gives me three phone numbers and directions for what to do once I get an appointment. Hang up, breathe, call the first. Explain. No appointments available until next week, or maybe later. Second number same as the first. Last number even worse: a month from now.

If a butterfly had landed on my chest, the scream would have come out. If a breeze had come up, it would have been over. But there is no breeze, no touch to press the scream to the surface, so I breathe again, hoping for the patience and strength to make it through the rest of the phone calls. There is one pill left in the bottle.

I call the old doctor’s office and talk with the receptionist there, who asks the right questions and finds the one way I might be able to get this thing taken care of… no promises, but it might work… I get the information, call the pharmacy and tell them, my son and I talk awhile about everything and nothing as I try to pull myself together, and then it’s taxi-time again.

I was going to do so much, and I have nothing left to do it with. My doctor told me I will probably be on these pills for life. My first major depression was in childhood. It went unnoticed because it started while my father was in his own terrible depression. Nobody saw the cuts on my arms and legs, nobody cared that I hid in the woods all day, all summer. Nobody knew that a $3 pet lizard was the only reason I lived through it, because I knew nobody else liked the animal and so if I weren’t there, he would never be handled again, and might not even be fed. I’ve had them again and again through my life, usually triggered by something stressful and difficult: a death, a breakup, a miscarriage, losing a job. If I keep taking the medication, I should be better able to weather these shocks, she said, and it’s been true. I have had some really tough things happen in the past months, and I have made it through.

So here’s my question: if I am on a medication that works, is at an appropriate dose, and is needed to keep me functional and prevent a catastrophic breakdown, why does the prescription invariably run out in 3 months at the most? And why would a doctor refuse to renew it, knowing that a psychiatric referral can take a month or longer to get a patient treated?

I have never been admitted to any psychiatric facility, but if I didn’t have my family to care for, the taxi to drive, a job and classes I am supposed to be doing, I would walk in and admit myself. It’s the fastest way to get the care I need, and the only way to get it in time.