My friend asks me why I don't take medication for depression. I don't have a good answer.
I don't like medication in general; don't like adding things to my body, especially when I am not convinced it will have any impact. Yet the evidence for the role of medication in improving depression is persuasive. It can change lives, provide a break in the cycle. It can save lives.
I have known people it has helped. I have known people it has helped not at all. Is it worth it to try? That is up to the individual.
I have tried Prozac and Wellbutrin in the past and both seemed to work for a while to improve mood - until they didn't. The most consistent and dramatic improvements I have seen regarding mood are when I'm able to run regularly and boost my endorphins and serotonin naturally (while also relieving stress), but my schedule does not always allow it. Even then, the dark moods can come.
As I consider the ups and downs I routinely experience, I understand why I have never sought out medication.
When I'm feeling better it seems unnecessary, just something to fuss about. I don't need it, don't want it. The dark moods feel much further away, and not so bad. I know I survived them, can survive them again, and when they come back, I just need to wait it out.
From that perspective in never seems worth it to find a psychiatrist, consult with the psychiatrist ("well, it all started when I was small... how much time do you have, doc?"), get on medication, adjust to the medication, etcetera... it all seems like too much. Plus, when I am feeling good, I have too many other things to do... like running! Reading! Playing with the kids! Relaxing! Anything other than going to the doctor... bleugh.
But when the bad times come, it is hard to get much done at all, least of all find a doctor. On those days I am frantic, would rather cover my head and trudge through, trying like hell to appear normal. I cannot look for a doctor, I am too exhausted from fighting. The fight is for my mind, for my day. I put off tasks that are not critical and focus on getting through the afternoon.
Logistics aside, there are other reasons why I resist the idea of medication. One pressing concern is it will make me feel ways I don't want to feel.
What if it makes me sleepy? Dopey? Unable to think creatively? I have a lot of thoughts I don't like, but the rest of the time I like my brain. I like how it goes off on tangents, sees different perspectives. I feel like I can hear one tiny piece of something and spin a million thoughts off that one idea, and even if it goes no further than my little brain, I like the way it spins. I like the way it furls and unfurls. I like the pathways... but then, there are times that I do not.
Will medication change all of that?
My friend assures me it will not. You will still have plenty of thoughts, she says, believe me. That is not going to be a problem. But it is my down periods that concern her more - she wants to talk about these, as they are what worry her the most. The bad place, she calls it. You don't want to go there. You don't want to be in that place.
I think about that place. I remember a time last year that was not unique, but I recall it specifically as I had just returned home from a trip to a mountain I had always wanted to climb. An opportunity came so I seized it, and went and climbed it not once, but twice in one weekend. And I did it all by myself.
Yet after I finished and came back to my apartment, I felt really alone. I remember lying on the bed and racking my brain for one thing, any one thing I could think of that made life seem worth living.
I had been unable to think of a single thing.
Somehow worse, I had not even been able to see the point when I was on the mountain. I felt so alone, my kids felt so far away. There has got to be more to life that this, I remember thinking, yet as I stood there on the mountain and later lay down on the bed I could not think of one single hopeful thing.
And that scared the crap out of me.
I knew enough at that time not to make anything of it, to just focus on getting through the day, but in the meantime, lying there unable to think of one single thing was awful. It felt so horribly hopeless, and eternal.
When I am in the bad place, I understand things I wish I didn't. I can be driving home and look over at the person in the truck next to me and suddenly understand why people have affairs, why people have random sex with strangers, let people use them. I don't want to do it, but I understand it. I don't want to understand it.
I understand why people drink every evening, take pills at work, eat sugar and other crap all day, then gorge themselves at night. It's all to stop from feeling, or because they are unable to feel enough.
I understand why people cut themselves, why they shoot up. Why they steal. I understand why they speed, act reckless, make dangerous choices. Go places where they shouldn't go at night. I understand why they hurt themselves, why they kill. I understand why they die.
I understand all of this. I don't want to understand any of this.
I get a reference from my friend and contact the shrink. I set up an appointment for an upcoming Saturday.
There are things I am missing when I choose not to get help for the periods when I am depressed. I am not a martyr for getting through them, and I deserve help in learning to survive them.
I deserve better than this, and my friends and family members do as well.