Thursday, February 23, 2012

Moderate to Severe

The following is brought to you by the 60 Minutes piece I saw last Sunday about how antidepressants do not, according to science, actually work. It rocked my world, I must admit. And while I am not one to argue with science in most cases, I felt compelled to voice my dissent. Not because I believe their studies are patently false, but because I feel it's dangerous to attach more stigma than there already is to the diagnosis and treatment of depression. Telling someone it's all in their head and that getting better after a few months on Paxil is all a placebo effect may discourage young Kentucky co-eds from giving it a try, and that could actually be a fatal for those young Kentucky co-eds. I should know. I was one once.

Of course. Of course this is happening to me. Why wouldn't it?

I had come there for help. And instead I found myself being mildly assaulted in the waiting room by a very large resident who would not relax his vise grip on my hand and who kept telling me, in the way the serial killers in movies tell their victims, that I was so, so pretty. The kind, soft-voiced receptionist looked my way and nodded, picking up the phone. I hoped she got help before my unknown almost-assailant (I called him Lennie in my head, and pictured him asking about the rabbits) decided to put me in a choke hold, lest my first-ever therapy session begin with me dead. Oh, the irony.

It was easy to forget, in the brilliant pre-spring sunlight that I had been enjoying as it filtered into the powder-blue waiting room, how just a week before I had gone for a two-hour walk in a heavy, cold rain, wanting to die.

I was not adjusting to my new collegiate life very well. I had thought it was just homesickness when, after arriving back on campus after Christmas break, I had holed myself up in my dorm room and cried until I was sick. I had fought my parents for three months to be able to go away to school. Why then was I so sad to be living my own dream?

Things got worse. As the cold, snowy winter passed, I found myself sleeping as much as I could, sometimes 12 hours a day. I had made new friends, but I had little interest in seeing them when class was out. I couldn't stand to see them laughing and happy when I was so deeply sad that my heart hurt. I tried exercise, going to the little gym on campus and lifting weights when it was too cold to walk my favorite route, to the old cemetery on the edge of town. Some days this helped and I felt the gloom lift. Other days it dragged me deeper into my black state of mind and I found myself wanting to lie down on top of a grave and fall asleep on the cold earth, uncaring whether or not I woke.

Please, God, just let me go to sleep and not wake up.

The lowest point came one Sunday night when winter fought with spring. Snow had mixed with rain and the rain won, falling down from a cold, cold sky. I couldn't sit still in my room. The walls were closing in. I felt trapped, lost, alone. I did not want to go home in defeat, just another student who had tried going away from home but who couldn't take it. And yet I did not want to stay. I did not even want to go on. So I left, without even a coat, and walked. I wanted to feel something, anything, out there in the rain. I did not feel cold. I did not feel scared. I came back numb and wondered how many Tylenol, the only drug I had at hand, I could take to not wake up in the morning.

The thought made me cry. Then it made me laugh. Tylenol? Really? That's the best you can do?  And then I woke up from whatever nightmare I had been in. I called Comp Care the next morning and felt empowered by my choice. Strong. Brave.

Until Lennie came along.

My captor began to rub the back of my hand in a way that reminded me of how we used to try to give each other indian burns as kids.

"You got a bo-friend?"

"Yes. Yes, I do. BIG bo-friend. Very tall." The receptionist was still on the phone, smiling assuredly at me, as if this sort of thing happened every day. Maybe it did. Our little drama had gotten the attention of the other patients in the waiting room, who were looking up from their People magazines. So much for trying to go unnoticed.

A door opened and a nurse called out to "David" to come back to see the doctor. David let go of me, and the nurse whispered that he was an inpatient at the attached "facility." I had no idea what that meant, but I was sobered by the thought that I might actually get committed here. I began to panic. I had seen One Few Over the Cuckoo's Nest and knew what happened at inpatient facilities. I was suddenly afraid I'd see a lot more of David.

Eventually they called my name. I was led into a room lit by soft lamp light where a small gray-haired woman shook my hand.

"What brings you here today?"

I wanted to impress this woman with my bravery. I had been thinking of some jokes on the walk there, just a few starters to show how smart and witty and self-aware I was about my own depression. I did everything shy of writing a script down on note cards to try to play the role of a tragically depressed college student convincingly and show that I could handle that label with grace and humor. I was even ready to improvise in regards to my mishap with David out in the waiting room. But before I could answer, I started to cry.

I told a complete stranger how I had been so sad that it physically hurt. How I couldn't imagine going on any longer if it didn't get better. How I had been feeling, if not suicidal, then definitely ambivalent about the whole living thing.

And when it was over, when this person I had only known for five minutes finally found an opening to speak, she simply handed me a tissue and said one of the most wonderful phrases in the English language, when spoken honestly and with sincerity:

"You're going to be okay. I'm here to help you."

I met with an honest-to-goodness shrink that day, a psychiatrist who evaluated my need for medication and sent me back to campus with sample packs of an antidepressant. I noticed he was wearing a gold Mickey Mouse watch and wondered if I should really take him seriously. I was given the phone number of a suicide prevention hotline just in case, and I almost let loose with a line I had heard Rodney Dangerfield say: I called suicide prevention, but they put me on hold! But it was neither the time nor the place, despite the Mickey Mouse watch.

I used my six free collegeiate Comp Care visits by the end of my freshman year. And used all six visits the next. I had to confess my need for medication to my mother, as once the free samples ran out I had to get my prescription filled with our insurance card. I thought she would be devastated; instead she was relieved. Apparently, I was the last to know that I had been moderately to severely depressed.

A wonderful thing happened. Two weeks after my eventful first visit with David and Dr. Mickey Mouse, lights suddenly seemed brighter. I smiled more. Food tasted better and I gained back some of the weight I hadn't even realized I had lost. When I went for a walk, it was because I wanted to enjoy the weather, not because I was running from something. The weight I had felt in my chest for ever so long lifted. I understood why "the light at the end of the tunnel" is such a popular expression.

I've been on antidepressants several times in my life since weaning myself off of them once the immediate danger of my own self-demolition passed. Sometimes, they have worked for me. Sometimes, they have not. When I freaked my doctors out with my persistent gloom following Ainsley's birth, the drugs did nothing for me; I had a colicky infant and a little cancer thing going on that we didn't yet know about, all mixed up with some crazy post-partum hormone withdrawal, and I needed a 12-hour nap, not Zoloft. But when I felt myself starting to derail in the months following my father's death, when I could not sleep at night for an entire summer because I was convinced Death was outside just waiting for me to let my guard down, I turned again to a doctor who told me I would be okay and sent me out the door with a paper bag full of free samples. And I got better. And I've done well since without the help of any medications. But I know that depression is a war and there will be more battles.

I know people in my life who have struggled with it since I did the first time so long ago. If they choose to talk to me about it (and it can be so hard to talk about) I tell them there's no shame in medication, no shame in seeing someone, no shame in asking for help. No shame in admitting you're struggling. In fact, the only thing I find shameful is that there is still a stigma attached to it. That there are those who think we choose to be depressed and if we could just flip that switch with diet and exercise and prayer and ridding our bodies of Xenu that we could fix ourselves.

If only it were that easy.

So this goes out to anyone who has ever fought depression. Just know you are not alone. And you will get better, if you ask for help.

And I will be here, holding your hand. Gently, and not like David.


Robert K. said...

I think I remember you sleeping a lot freshman year, but I guess I was too oblivious to realize you were having such a difficult time. I admire you for having the courage to ask for help.

Library Lady said...

Thanks, Rob. You weren't oblivious; I was really, really good at hiding it. Remember how I did plays on occasion? My flair for the dramatic extended beyond the stage, and the role of "Completely Normal College Student #2" was my best-known part.

DRoss said...

"Depression is a war and there will be more battles." Damn, Cranky, you have a way with words! I was dx'ed once with dysthymia, "depression lite." I told the shrink that I would really hate to see depression heavy. But, he's a thug that haunts the periphera of my life, to such an extent that I always hesitate to really groove on being happy when I am happy. I fear that to do so would Tempt Fate. And dare that thug to come out of the shadows and make himself Known - aggressively holding his wet blanket over my soul. I'm a coward at heart, I guess.