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Having Depression is NOT a Choice – This is Why

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I saw this on Twitter and read it about a dozen times. I thought, “this is me, this is what it’s been like during too many major depressive episodes over the past 5 years.” I shared it on Facebook and realized that simply sharing it only reaches a very small group of people. This scares people. This is honest and open. This is scary. But the part that is missing are the answers. I want to share my answers, my experience, my reality. Personal experiences are the missing link in order to gain understanding about those suffering with what can be a debilitating illness.

1. How would it feel to wake up and not having the emotional strength to face people?
I’ll tell you how it feels. I have felt it on and off over the past 5 years. It is daunting, sometimes an insurmountable goal that you know you can’t reach. I would get myself going on certain days, like days I would see my therapist and the days I work. It is not easy. I have worked in retail for the past 2 1/2 years and people is what it’s about. My mask is sometimes put up and while it has slid off at times, I have always done my best. At times, I choose not to go to synagogue with my husband and our daughter. It’s sometimes been too scary to bring my daughter to a friend’s birthday party. It can be exhausting.

2. To think that time is passing by with no reason?
I felt that strongly today. I had a session with my therapist where I felt misunderstood. While she meant well, it felt as if she were trying to convince me to see things realistically in order to not beat up on myself. I felt my feelings were not being heard. After that, the rest of the day felt odd and I am not even sure how time has actually passed.

3. To feel so alone even when you are sitting in a room full of people?

This is why I have stayed away from people when I have been depressed. Feeling alone when you are alone is one thing, but feeling alone while in a room full of people, even close friends, does not always make a difference. It is a terrible feeling.

4. To have to put on a face and hide your feelings because in your mind you think no one would care anyway?

This is almost automatic for me when I am in a depressive episode, unfortunately. I think to myself that I don’t want to burden my friends any more than I already have. There have been times I have asked my past 2 therapists over these past years, why do people care about me? Their responses were the same: a list of my attributes, reasons why people like me, love me, care about me. Sometimes I believed them, but others I didn’t.

5. To lose friends because you can’t find the strength to go out and you can’t physically be ‘happy’?

Fortunately, I have not lost one friend due to my illness. I don’t know what the odds are of that, but I am aware that it is not necessarily usual. I have heard from others, very sad stories of dear friends who literally disappeared on them because of their mental illness. 

6. To cry yourself to sleep, hoping that tomorrow will be a better day, then when you do try you are exhausted from the night before, and it all starts again?

This may sadden many, but there have been many nights I have cried just as I fall asleep over the past 5 years at the times I have been depressed. I pray for a better day, that I will wake up a bit refreshed and feel better able to tackle whatever the new day brings. The fatigue that my depression causes is the enemy of this hope on some days. It has taunted and paralyzed me. This cycle is more than exhausting, in terms of physically feeling tired, it is emotionally draining as well. This combination can be depleting and debilitating.

7. You try to hide your feelings hoping no one would notice, and more.

This is also a challenge, yet something I can do well, at times. When I am anxious, I can talk a lot. People then believe I am feeling better or well, when what is really happening is that I am not feeling great but masking it with my anxiety. I am actually not always aware I am doing it until I feel my heart beating a bit faster than usual.

8. Now tell me why someone would choose that?

This is truly the million dollar question. Would any of you choose any of this, as well as all of the treatments I have endure(d): therapy 3x per week, medication trials, ECT (Electroconvulsive Therapy), TMS (Transcranial Magnetic Stimulation), ketamine infusions and psychiatric hospitalizations? Any aspect of my experience mentioned above? I can’t imagine so.

Depression is an illness, not a choice.

Saying it is a choice is the largest form of stigma I can think of. It’s cruel. I would move mountains and do anything possible to be rid of my depression, anxiety and OCD. I have tried and will continue to try. To say I would choose to have these illnesses is shortsighted and ludicrous.

I have said this before:

My mental illness is treatment resistant, but erasing stigma doesn’t have to be.

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7th Inning Stretch

Here we are. It has been seven months since I began my recovery from my fourth back to back severe and treatment resistant depression. It is the longest span of time of relative health I have had in 4 ½ years. I never intended to count the time like this but it is so significant after what I have been through these past years. When you have been to hell and back and tried medication after medication, endured 4 psychiatric hospitalizations, intensive medical treatments which included ECT (electroconvulsive therapy), TMS (transcranial magnetic stimulation) and ketamine infusions, you do need to take a step back and recognize where you were and how far you have come. Time is important in this process. Seven months is significant. I have learned quite a bit in these past seven months and it doesn’t include thinking that all is better.

The process of recovery from major depression differs from person to person. During my briefer periods of recovery in between these past episodes, I was thankful and always felt that each one was the last. I felt too well to imagine anything obstructing that feeling. With this last episode, which was long, painful and haunting, I was cautiously optimistic. I tried a new medication from a class of drugs that I had never tried before. I had to stop my previous anti-depressant and wait two weeks before starting this new medication and began this process while hospitalized in July.

Once I began to feel better, think more clearly and feel more connected to people, I was hopeful but, again, cautious. With each month I have been able to really be “with” people, work and enjoy my life. At the same time, I do have struggles. If I do not sleep well for a couple of nights I become irritable and it can play out in a way that is certainly not fair to my husband and daughter. If I do not eat regularly I will not only get headaches but I will start to feel sad. I still have memory issues as a side effect of the ECT and sometimes I can laugh it off and others it is extremely frustrating and makes me feel angry. I am slightly traumatized by the experiences I had with ECT, TMS and the ketamine infusions. The ECT and TMS certainly helped and unfortunately the ketamine didn’t but the act of going through it all still frightens me when I think of it. It was terrifying and it was upsetting to be with and see so many other people struggling urgently with mental illness as these treatments are seen as the “last ditch” effort to ease someone’s symptoms and pain.

I have bad days as everyone else does and I have days that are “bad” but in a different way where my symptoms make themselves known. There is no cure for depression or anxiety. It is always there inside of me. I am working hard in therapy with a new therapist and this process brings up a lot of topics I have worked on in the past. It aggravates my anxiety and provokes in me anger, sadness and a bit of humility. It is hard. It is difficult. It is humbling. The positive of this experience has reminded me that I can feel better, even much better than when I was in a severe depression but there is always work to be done on myself. I’m not out of the woods and I have realized in the past seven months that I never will be. It is simply who I am and I am learning to accept it. I suffer from depression and anxiety and I own that. They will always be there in some form. I am not cured and I pray I do not have to endure another severe episode but I am doing everything in my power to care for myself. These past 7 months have provided me not only with better mental health but with more knowledge and understanding about myself. I will take this opportunity to stand up, raise my arms above my head and take that stretch.  Time is meaningful.

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Huffington Post: Ketamine Infusions for Depression: Beware Pop-Up (Private) Clinics?

https://www.huffingtonpost.com/entry/ketamine-infusions-for-depression-beware-pop-up-private_us_59f90fd2e4b0b7f0915f62cb