On the other side of madness (Part 2, Depression)

I'll admit it: I'm nuts. There are times when I absolutely cannot sync my view of reality with what is actually going on. I get a soul-crushing depression that tells me I am of no value, that I am actually a detriment to those around me, and I'm completely doomed. When it's going on, I'm a sobbing, inconsolable mess. If you approach me with an attitude that's overly enthusiastic, I'll even get mad at you for being too optimistic! How dare you not see how terrible everything is!! I'll plan out my suicide, short of taking any action, and each step I need to take for my desired outcome (fantasies about letters of explanation that this is my own stupid will, and no one's fault). I'll argue with myself in my head with myself about what I'm thinking, because I know this is a temporary lapse of reason that will eventually pass... I know I'm being irrational while it's happening. The voices in my head yell back and forth at one another like some debate on the floor of the House of Commons... Yeah... that's nuts.

I don't mind it so much once I get to the other side of it. It could be a lot worse. I could not have that little voice of reason in there that's able to step back and see, and argue for holding on. I could actually believe the doom and gloom in my head. I could believe I was justified in spreading my misery around. I could have the possibility of not reaching an 'other side.' Oh, yes... things could be much worse. When I do get to the other side, it's like a storm has passed. The calm is deafening. The stillness is eerie. Weren't we just holding on for our lives a few moments ago, hoping the house didn't fall down around our ears? Now it's blue skies and chirping birds... how did that happen??? Ah, the joys of faulty neurotransmitters.

There are a couple of things about this, beyond my own suffering, that bother me. One, why isn't there a medication for the treatment of acute severe depression? Long-term antidepressants help raise the day-to-day functioning, but they do nothing for acute episodes. The best we have is tranquilizers to make people so blotto we don't hurt ourselves or someone else. But that's not a treatment. That's a last-ditch effort! Two, how do I seek treatment for acute episodes without getting the stigma that I am irrational and incompetent---someone not to be trusted? I'm not nuts all the time. Just every once in a while. I'm aware that it's happening. I'm not completely delusional. I can be reasoned with. I'm just really, really sad. Take care of the sad and I'll be right as rain again.

We've separated the medical from the psychological. My mental health counselors love me. I'm a great communicator. I'm self-analytical. They know I've got a better handle on this than most. I'm a big girl. I know that feelings aren't facts, and I want to be responsible in my behavior. I have self-care practices that keep me safe for the most part. But sometimes, what I can do at home just isn't enough. I need the help of a professional. I don't need a psych ward. I'm not out of control. I just need something to turn off the stupid, destructive voices in my head. I know they'll go away eventually on their own. But I've got to be able to hang in there until then. That's difficult sometimes. We don't have anything available for that in our medical arsenal, and our doctors don't get training in how to deal with episodes like this. Once it's a mental health case, they'll wash their hands of the patient entirely, even if there are underlying biological problems. Doctors don't do wackos. That's the head shrinker's job.

So instead, I sit and sob at home, one side of my brain lamenting that everything is awful, and the other side of my brain going, "We've been the most successful recently than we have been since this started! Your doctors are listening and helping. You're to the point where you can do some physical therapy! People love your words! Come on, girl... things aren't that bad!" Meanwhile the other side of my brain cries, "But we've lost everything we loved in life! We can't do anything that brings us joy like before! It's all ruined!! I'm ruined!!! No one's ever going to love me! I'm broken and should be left out for the wolves!" (I'm spectacularly good at beating myself up....) Once the storm passes, I can sit and calmly say, "Yeah, $#!+ sucks... But we've done more with less. This is going to be difficult, but it's not impossible..." I am fully aware that the bad voices in my head are not truthful. They can still incapacitate me, however. That I don't like.

How do I help the storm pass? Sleep. Lots of sleep, showers, and not doing anything that requires making a decision. When my brain is out to get me, I will sabotage myself in a heartbeat. I will do something to make the situation worse, because I feel that life should be awful. And that's crazy! I know it. So I don't allow myself to do anything important. It's just a bad idea. It's better to just hermit for a while and try not to do anything (especially interacting with others!).

I'm lucky in that these episodes only last a few days at most, then I can pull it back together. If they were longer, I'd have to do some serious re-evaluation of my mental health care. Right now it's the equivalent of PMS, and that's something I can manage on my own. Still... it would be terribly nice to have a treatment instead of just coping mechanisms. It would be nice to be able to just brush off my shoulders and keep going. Sadly, that's not an option yet. In the meantime, I'll ride these Moments out as best I can, and just get back to business on the other side.

(Part 1)