Clinically Depressed? You can get well. I did.

My son and I at his wedding 2017 after I survived a 6 month depression.

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― William Styron, Darkness Visible: A Memoir of Madness

I have had three major depressive episodes in my life, and several mild to moderate episodes.  Perhaps I’m writing this for me, but I hope that now, while I’m in remission, I’m writing this for you or someone you love.

First, the darker side.  When many hear the term depression, they may think about a person who is in grief, who suffers a chronic illness, someone who may be sad over a loss.  And indeed, some of those people will, under those circumstances, understandably,  be depressed or enter into an episode of major depression.

But what I have is different. It’s an illness. This is  a depression not only in the mind, but a depression that lives in the delicate chemistry that makes up our complicated human bodies. It’s real, it’s not imagined, and it’s serious.

It can recede and remit, but there is no cure, only treatment. When treatment works, I’ve been able to go years between episodes. But it must be treated.

This is  a depression not only in the mind, but a depression that lives in the delicate chemistry that makes up our complicated human bodies. It’s real, it’s not imagined, and it’s serious. It kills approximately 45,000 per year, and I think that figure is low.

There are many theories as to how depression occurs. One interpretation is that neurotransmitters in the brain are out of balance, and this results in feelings of worthlessness and despair. Magnetic resonance imaging shows that brains of people who have depression look different than the brains of people not exhibiting signs of depression.

First, here’s just a wiki version of what this is:

A major depressive episode is a period characterized by the symptoms of  Major Depressive Disorder: primarily depressed mood for 2 weeks or more, and a loss of interest or pleasure in everyday activities, accompanied by other symptoms such as feelings of emptiness, hopelessness, anxiety, worthlessness, guilt and/or irritability, changes in appetite, problems concentrating, remembering details or making decisions, and thoughts of or attempts at suicide. Insomnia or hypersomnia, aches, pains, or digestive problems that are resistant to treatment may also be present. 

Treatments for a major depressive episode include

Psychotherapy. It helps along with other treatments. For me, it’s an add on.

Some nutritional supplements can help. Talk to your doctor.

Anti depressants, although this can take time and many get trapped into what we call “Medication roulette”

In more serious cases, hospitalization or intensive outpatient treatment may be required.

There are new treatments that I have tried, with some success. I elaborate below.

First and foremost, treat the depression with the help of a professional. This is imperative. Your doctor, a psychiatrist, or therapist can help. If necessary, and it usually is, try an anti depressant. It can be maddening to find the right one, but eventually some can land on relief.  If not, do the research.  There are new methods available where a doctor can match your body chemistry to a drug that show which drugs you may metabolize better than others. My first two major episodes were assisted by the right medication. My third required another method.

1. Read up on everything, when you can concentrate, and that may be hard.  If not, have family members or friends research anything that may be of benefit.
2. If you are feeling suicidal, you need immediate help.  Don’t keep that to yourself.  Reach out.
3. While you are in the difficult process of waiting for the fog to lift, you may choose a number of options to get through it.  Some people literally try to sleep through it. I get that. I walk through it the best I can, while knowing that life as usual has altered.
4. If you can, move your body. I swim twice a week, and walk three times a week.  There are days when I force myself, but research shows that exercise can alter your brain chemistry and in a good way.
5. Spend time in nature and get natural sunlight every day, when and where possible.
6. Talk to friends, family, and a therapist.  It can help to just express yourself and have someone telling you they love you and know you’ll get well.  For those friends who feel a party or social event might help, set them straight.  At least for me, my time is best spent one on one.  Large groups can make it worse for me.  Even three to four people together can be stressful because maybe for the first time in your life, you don’t care what they are saying.  When you find family or friends who don’t understand what you are feeling, perhaps share the opening quote above. It’s the darkest, toughest, but best quote I’ve ever read on depression by acclaimed author William Styron.You won’t always feel this way, the pain will end, but until you dig out, that’s how it can look.
7. Try to do the smallest things that seem normal. Just a trip to the grocery store, doing a few simple emails, cleaning the house.  For some, it’s impossible or seems impossible. But give something a try daily.
8. Don’t drink.  I enjoy a glass of wine or so while I’m cooking or when out to dinner.  When this episode hit, I do what I’ve done the other two times I’ve experienced this.  I just don’t do it. If you choose, and things are stable, and you do it very moderately, there could be time for that when recovery happens and when stability comes back into your life. That depends on each person,their illness, and their history.
9. Try something creative.  You may enjoy a bit of art, making a new garden space, re arranging a room.  I try to keep busy. It makes the days go by quicker, and believe me, when you are in this, you want the day to fly by.  If you can’t though, don’t beat yourself up.  You didn’t create this illness.
10.  As I’ve experienced before and many do, the appetite can be gone.  I stopped cooking. I love to cook normally and I’m a “live to eat” kind of person.  First, eat what you can get down, even if it’s forcing yourself.  Later, do some reading on foods that can help lift the mood.
11. Know that your gut bacteria can be related to mood.  In this case, in this episode, I was given a strong antibiotic for a condition it turns out I don’t have. It was a guess on the doctors part. But in the best scenarios, anti biotics can destroy not only the bad stuff, but the good as well.  You might need a strong prescription strength probiotic if you have to go on antibiotics for any reason. Know that there’s a link with these.
12. I went a bit beyond my medical community here in Iowa. If you can’t find the right treatment close by, go elsewhere if at all possible. 
13. Remember, it’s hard to describe this to someone who has never had it.  The strongest quote I ever found on the depths of this is above, from author William Styron. It’s dark but brilliant. Have others read that so they just might get a glimpse of how the darkest parts can look to the person suffering.
14. Know that it WILL lift.  There are treatment resistant depressions, but there are other methods that can be used that go beyond traditional antidepressants.  Look into Ketamine and TMS treatment. Though not without some complications, both Ketamine and TMS (Transcranial Magnetic Stimulation) for me have helped tremendously.
15. You may notice that after a period of terrible psychic pain, you may awaken to more clarity, a better day.  Take that as a sign that you are getting better, even if the days go a bit up and down.

You aren’t alone.  At one time, in any day, in this country, approximately 20% of us can be experiencing a mental illness. The term brain illness is a better one.

 You aren’t a bad person, you didn’t make this happen to you, and that fact that you’re alive and still moving forward is a testament to your strength.

For times of recovery, I choose to look at brighter themes, more clear cut, not perfect, but hopeful like an early spring.  I return to Styron, who ended “Sophie’s Choice” this way.  He said and I end with this,  “This was not judgment day – only morning. Morning: excellent and fair.”

For you…to the morning and the light…you are a precious soul and you can survive.