The depression that I’m currently dealing with seems to have gotten its start almost a year ago.
When I returned from my visit with Gawan last August, I was (as expected) physically fatigued from the travels and adventures and flights, and given my ongoing difficulties with fatigue, it took a couple of weeks to recover. Wolf recalls that for the first while my mood was better than it had been, but then it slowly and steadily started to tank. Depression didn’t so much “strike” as it sidled up, slipped up onto my shoulders, and then gained mass with aching slowness.
I had been seeing a counsellor regularly a couple of years earlier during a previous depressive episode but as I found my even keel, the sessions were no longer useful.
By December last year I was struggling again, and one day was especially draining. First there was an appointment to get two fillings replaced. The dentist is very good but I have needle phobia, and had a dental dam making me a little claustrophobic and causing my jaw to ache. I was tired. Then later that day I got a call about a health test and the results were not great. Now I was brittle.
I don’t know what set me off the next day, but I had a meltdown and was simply unable to cope. I realised that I needed some help again and called to make an appointment to see my counsellor, but to my dismay she no longer worked for the service that provided my benefits. Dammit. I was going to have to decide who to talk to. It was challenging enough to make a phone call, but making a decision too? Ugh.
So I made a decision, hung up, almost immediately changed my mind, eventually worked up the nerve to call back, and agreed to talk to the first counsellor who was available, that evening.
I wasn’t looking forward to having to start at the beginning again with someone new, and a one-hour appointment hardly seemed long enough for me to tell the story, never mind having a discussion and getting productive feedback. But I tried.
It played out as I’d feared. I was irritated to have to explain that I’d tried all of these suggestions already and I needed some new input. As I talked, he would from time to time flip through a file looking for a sheet that he thought might help. By the end of the session, I was holding four or five pages; I’d been polite and accepted them, mostly out of a desire to get on with it.
At the end of the session, he asked me if I wanted copies of any of the sheets he’d handed me (they were his originals). I declined. By way of conclusion, he asked me whether the session had been helpful, in a sort of “I have a customer satisfaction questionnaire to complete” way. I had gone into the session feeling depressed, anxious, and in need of help and now, on top of that, I was emotionally drained and out of fucks to give. I knew he’d wanted to be a help. But his approach was too simplistic, too conventional, too amateur. I’d read more insightful blog posts than the material he presented to me. I didn’t have the mental energy to be anything other than blunt. Helpful? “No, not really.” He wished me well (sincerely), and I made my escape.
I was disappointed, frustrated, and a bit angry about how little the counsellor seemed to know. My subconscious kept chewing over the session and I’d intermittently fume to Wolf, “And another thing about the session…”
But the utter uselessness of the session had, improbably, brought me clarity. All of the counsellor’s suggestions were based on an assumption that I was thinking incorrectly: that I was dwelling on negative things (gratitude journal!), that work stress was taking its toll (do activities you enjoy!), that I was unintentionally ignoring certain needs (work-life balance!), that I was bottling things up (find a creative outlet!). I know all this. I’m doing all this. It’s not working. Or it’s not working enough.
Maybe I had finally reached the point of needing medication.
The next day I made an appointment with my doctor. In the week that I had to wait (this was over Christmas, of course), I compiled the following list of symptoms (omitting the perennial fatigue issue that he already knew about):
- having trouble coping
- feeling of moving backwards
- difficulty retaining new info, memory
- feeling like abilities are shrinking
- every task feels difficult
- indecisive, then second-guessing
- anxiety? depression?
- brain not working well
- sleeping 9+ hours a night
- frustration that it’s so hard
- lack of resilience, brittle
When I met with him, I rattled off the items.
“Yep, you’re depressed,” he said with a compassionate smile.
It was interfering with work, my ability to enjoy life, and even do the simplest things around the house. Unlike the previous depression, Wolf was with me, and my work situation was pretty decent, all things considered. In other words, it wasn’t situational.
So just before New Year’s, I got a prescription for citalopram (aka Celexa), starting out at 10 mg for 10 days, and then increasing to 20 mg indefinitely. I noticed an improvement in mood quite quickly, but it plateaued well before “good”. The day after I got home from my Europe trip with Gawan in March, my dosage was increased to 30 mg. In the middle of May it was upped to 40 mg.
For me, the most frequent symptoms of depression are lack of motivation and indecision, although there are other reasons why I might feel unmotivated or indecisive, such as fatigue, so as symptoms go they’re more subtle than I’d like. Also, things that are at best a bit challenging for me, like calling someone on the phone or starting on a new work project, become excruciatingly difficult. I could focus for 20 minutes, willing myself to start, and still not be able to. I might as well be practicing my telekinesis.
After the Europe trip I had a week of downtime before a work trip, during which time I’d expected to be tired and planned to be taking it easy, but in my travels I’d picked up a seriously nasty cold and a week was nowhere near enough time to recover. (I ended up being sick for another almost two months.) After the work trip I was utterly wrecked. It was only when I looked back at the pattern of fatigue and changes to the dosage of anti-depressants that I put two and two together and concluded that at least some of the fatigue was likely attributable to the increase in dosage of the anti-depressants.
But how would they affect my sex life?