I have depression. For as long as I can remember, life has always been just a little bit sad. It’s a chronic, low-level hum that’s in my brain pretty much all the time. It’s not always obvious to most. I can step it up because I have to. I have to work. I have to maintain relationships with people. Life requires a certain number of Oscar worthy performances in order to survive. I’ve always thought I was just pessimistic. I thought it was a character flaw.
There is a stigma in this world against people with mental health issues. People say they understand, they recite the usual script that they know it’s just like any other illness and they wouldn’t get mad at a cancer patient would they? Actually, they would if the cancer patient got grouchy or showed any sort of negative emotion that made people uncomfortable. Not all people. There are people who do understand. I’ve just discovered that a lot of people are really uncomfortable with people who are depressed. They actually do think it’s a character flaw. Apparently, if I wasn’t feeling so sorry for myself, if I wasn’t so “comfortable” with my sad self, if I wasn’t looking for attention, I would just stop “acting” this way. Everyone has experienced a hard time or two in their lives. Maybe this is why some people can’t relate to someone who is depressed. They assume that because they got through their hard time that everyone else should be able to do the same. It’s understandable to some degree and I certainly don’t mean to shame anyone (I mean you don’t know if you don’t know), but if you have depression and you’ve ever experienced someone pulling away because they’ve just decided you are a negative or toxic person, you don’t really give a shit how understandable it is. It just hurts. A lot.
While I’m angry at the stigma, I also know it must be incredibly difficult to be around a person who is depressed and eventually, compassion fatigue can make even the most empathetic human being turn away for their own survival. Depression doesn’t just affect the person who is depressed. It damages everything in its path.
I am a high functioning depressed person. I can hold down a job. I can pull myself together and act “normal.” Exercise helps, as does eating a healthy diet and connecting with friends. Helping others and getting out of my own head is good medicine. The problem with persistent depressive disorder is that these things do not cure anything. Also, if life stress gets too high, there is risk of going into a major depressive episode, which happens occasionally. Then there are crying spells, suicidal thoughts, extreme fatigue, worsened insomnia, isolation, etc. In addition, relationships are difficult to maintain and life just becomes a slog because there is always a gray film all over everything.
I have made attempts to treat my depression. I’ve taken just about every medication available and endured numerous unpleasant side effects without much of a payoff. I’ve treated it myself with food and alcohol. Needless to say, those solutions created problems all their own. I’ve been in therapy for years and seen a handful of psychiatrists. I have bought dozens of pairs of shoes. I mean I have a massive number of shoes and you’d think that would cure just about anything, but no.
Some treatments have worked more than others and I’ve had periods that were on the higher end of the spectrum so it’s not as though my life has been just some sort of vale of tears.
I won’t go into all of the details because that’s just dull, but through a series of events, I ended up in a downward spiral.
My doctor moved away so I saw a new doctor and tried numerous medications without much success. Stimulants helped keep me awake during the day, but they weren’t a permanent solution. I began to feel my life was not worth living. Sure I could put on the happy and professional persona (because no one likes a whiny baby) and I don’t suppose many people knew what was happening except my husband and close friends, but slowly I was becoming undone.
I switched to another new doctor when things were not improving after a couple of years. The new doctor wanted to start ECT (electro convulsive therapy) right away. I went for a consultation and was convinced this was the right response. In my mind, I felt I wasn’t going to last much longer. I ran it by a doctor friend with lots of experience and she felt certain ECT was too intensive a place to start. She recommended TMS (transcranial magnetic stimulation) and gave me a number to call. She also referred me to another new psychiatrist with much more experience. I went for a TMS consultation and with it having a 70% success rate, I felt hopeful. Antidepressants generally only have a 30% success rate and I had tried so many that it was likely that I was treatment resistant to most or all medications. I loved the new psychiatrist and she also helped me feel hopeful. She supported the TMS and had ideas about really scaling down my medications.
I went to my first TMS appointment on Tuesday, October 29, 2019, and met with their clinical director. He reviewed my whole history and felt TMS was a viable treatment option. I tried to feel hopeful, but I really felt sad having reviewed my entire life and seeing how much my depression had limited me in so many ways. They showed me the TMS machine and did something called “mapping” so they would know where on the skull to put the magnet. They tap on certain spots on your head to see if it causes the reflexes in your fingers to move. Very weird.
The first actual treatment was on Wednesday. The protocol was to go five times a week for six weeks and then taper off. They said I would not notice much change for about four weeks. So I sat in a big chair and they placed the magnet on my head. I had not considered what it would be like and I was a little surprised. It was like someone annoyingly tapping really hard on your skull really, really fast with a ball peen hammer for 20 minutes. I didn’t love it.
The theory behind TMS is that in depressed people, there are certain inactive nerve cells in the region of the prefrontal cortex that controls mood. The action of the magnet’s impulses is supposed to get these nerve cells moving, which should boost mood. FYI…the use of TMS for the treatment of depression was approved by the FDA in 2008 and it is covered by most insurance plans. On a side note, I understand that they can slow down the tapping to treat anxiety, but I don’t know very much about that type of treatment.
Weeks one and two were uneventful. I had headaches, but that’s about all I noticed. I cried all of week three. I don’t know if I was disappointed that I didn’t feel better or if my emotions were less dampened by the depression, but it was a horrible week. I felt hopeless and suicidal, which I hadn’t felt so strongly in a long time. I wasn’t sleeping and it was hard to get up and do anything. If I could exercise, things were better for a short time. Week four was not a lot better, but I didn’t feel suicidal. I was still exhausted and not sleeping, but I did seem to want to get out and do more. Not that I did very much. The last day of week four, I was extremely disappointed with not feeling better. It occurred to me how low I had gotten and how much work it would take to get back up and I didn’t think I could do it. It was obvious that this was not going to be the miracle I had hoped for and I really wanted a miracle.
The Saturday, Sunday, and Monday following Thanksgiving were awful. Monday especially. I hardly slept at all Sunday night. I could recall the things in my life that were good and why it mattered that I was alive, but I could not really connect to those feelings. I was not the wife I wanted to be. Bill had said he had seen that things were getting better, but if I could not feel that, was that really as good as this was going to get?
I finished the TMS treatments about mid-December. On the last day, I did not believe that it had worked at all. I was so tired that I hardly had the energy to be too disappointed. We decided to go to Colorado for New Year’s so we packed up the dogs and hit the road. Traveling with two willful Golden Retrievers a relaxing vacation does not make. There were a few stressors here and there. I don’t even remember noticing it at the time, but I was really handling every difficulty with a lot of patience and grace. I wasn’t having any meltdowns and while I had trouble recognizing happiness, I think the trip was a pretty big success. When we got back, I really started to notice more and more that I was not feeling depressed. There were times that weren’t happy and I still had a ways to go in regards to picking up the pieces, but I was not depressed.
The TMS had worked! I couldn’t believe it. My whole life, there had always been at least an undercurrent of depression and it was just gone. Gone! I actually had gotten a miracle after all. It took a while for it to sink in. I didn’t even know who I was without the depression. I still don’t know for sure. I’m a work in progress.
I had a lot of life to start living and I was really looking forward to meeting new people and trying new things. Unfortunately...pandemic. Talk about shitty timing. It’s definitely been a challenge to differentiate between being totally bummed about because of Covid and being depressed. But there are definitely differences. I started gardening. I’ve been drawing. I learned to sew. My whole life, I always wanted to have hobbies, but I never felt like I enjoyed anything. Now I have a whole list. That’s huge to me. I have meltdowns and I get sad, but it’s just not the same as being depressed. I get out of bed every morning and I may not look forward to its being Groundhog Day yet again, but I still get things done and there is a modicum of joy somewhere in the day. I know that doesn’t sound like a spectacular success, but we are in the middle of the craziest period in recent history and I am not hiding under the covers (or worse) on a daily basis.
Doctors know so much more now than they did just 10 or 20 years ago about mental health treatment. They are learning more every day. There are treatments that work, whether it’s TMS or something else. I’m writing this because I felt hopeless and I had run out of solutions, but something finally worked. The depression may come back, and I will have to try TMS again or something else. I get to live the life I was meant to live. If you are depressed or anxious, keep trying things. Depression and anxiety are not parts of life that you have to just accept. You are worth better than just “as good as it gets.”
