Image credit: Glenn Carstens-Peters

 

About a month ago, I was feeling quite depressed. And since my depression had been in remission for a while, I was surprised. Despite knowing from experience that I would eventually feel better and be able to get through my days without feeling that damn hole in my heart, I still felt distraught.

Depression makes you feel like it’s never going to get better, that you will always feel that way. It is the nature of the beast.

And now, I feel better. Much better. So what’s my next step?

SHOULD I DO TMS?

When those feelings of loneliness, hopelessness, and anxiety came back, I decided that it might be time to do TMS treatments again. Only I would have to get started with a new clinic. I couldn’t go back to the one I used to do TMS at – it’s 800 miles away! So I had to find one here in Michigan that does it.

Cue my roommate, Lisa. I was so depressed one day, I could hardly even describe what I was feeling, much less pick up that 50-pound phone and ask a stranger for help. She asked how she could help me, so I went for it: I asked her to find a place online and make the phone call for me. And you know what? She did.

Now that’s a good friend.

She called a clinic near where we live, gave them my basic info, and explained what was going on. Five minutes later, I received an email with some paperwork from the clinic. I went online and filled it out to the best of my ability and sent it back to them. Now I just had to wait for them to contact me.

Turns out, I didn’t fill out the paperwork completely. So here it is, four weeks later, and I haven’t heard from them. Now, if you know me, you know I am almost phobic about talking on the phone, so I put off calling them to find out what my status was.

The first week really sucked – I was still quite depressed – but I did my best to be patient with them. I know that most mental health clinics have more clients than they can reasonably handle and little time to take care of the day-to-day crap.

The second week was also tough. I was going back to Minnesota to pick up some things I inadvertently left behind when I moved. This may sound like a cut-and-dry operation, but it was anything but. I’ll leave out the messy details; suffice to say that I was very, very anxious about the trip. It’s a good thing I have a prescription for Xanax! (My shrink wants to take me off it, but hasn’t yet. He says there’s an antidepressant that does the same thing, but I’m not sure I believe him. Doctors are, understandably, hesitant to prescribe Xanax, but I tried quite a few other meds before this and Xanax is the only thing that actually helps my anxiety.)

I was so relieved that the trip went smoothly! There were no fireworks, no confrontations, and no conflict. The weather was perfect for the 1600-mile roundtrip trek, which Lisa and I did in three days. We left on a Thursday and came home that Saturday. Bonus points for the beautiful fall colors we got to see, too :).

After the trip, my anxiety level went down, which was no surprise. What did surprise me was that my depression also eased. Within another week or so, it was pretty much gone. Or, as gone as it gets with me. (Check out a condition called dysthymia and you’ll know what I mean.)

NOW WHAT?

Two weeks later, I feel pretty damn good. My anxiety is still hanging around a bit, but I’m getting used to that. I have ways to combat it now, thanks to DBT therapy a few years ago. I only take a Xanax if my anxiety is hindering my ability to think or breathe, which is rare.

I don’t know about you, but I’m one of those people who overthinks things. Not just some things, but everything. Right now, I’m doing that with TMS. Should I contact that clinic and get on their radar for when I do need it? Or am I okay now?

Part of me simply doesn’t want to pick up that damn phone and try to explain myself to yet another stranger. But the healthy part of my brain says it’s a good idea to get established with them, so that when I am in need, I’ll already be in their system. I wouldn’t have to waste additional, precious time waiting for them to go over my paperwork, do an intake assessment, etc. while I’m struggling to get through each day alive.

I want to be prepared for my next crisis. So I suppose I should call them.

And isn’t that it? As people with depression and/or anxiety, we need to be on the ball. We don’t want to be caught off-guard or unprepared for the next time we feel like life isn’t worth living.

For many people, Major Depressive Disorder isn’t something that just happens once. It keeps coming back. It’s a very vicious cycle of being active and then being in remission (although if you had told me five years ago that it could go into remission, I wouldn’t have believed you). There is no limit on how long an episode can last (I once had one that lasted six years), just like there’s no way to predict how long it might stay in remission. That’s why it’s SO important that we have plans to beat it back as soon as we notice it’s trying to come back.

MY PLAN OF ATTACK

I didn’t used to have a plan. For more than 30 years, depression was the driving force in my life to one degree or another. My only plan was to do whatever I needed to stay alive. But in the last five years or so, I have learned, created, and otherwise picked up various tools and strategies to take care of my mental health so that, the next time my depression hits, it’s not as bad as it used to be and/or it doesn’t last very long.

Here are some of the ways I stay mentally well:

• I have a Safety Plan that reminds me of what I can do in times of distress. It also contains reminders of things I can do to stay well and not drop into the abyss. This is a very important and useful document for me. It’s taped to the wall in my home office, in which I spend time every day – so I see it often.
• I am plugged into mental health services, meaning I see a therapist and a psychiatrist on a regular basis, not just when things are going badly. My therapist is for talk and cognitive behavioral therapy and the psychiatrist is for medication management. I’ve been on psych meds since 2001, and it took more than 20 different med changes over about twelve years to find a combination that worked for me. Therapy and medication management are both vital to my recovery and stability.
• As I stated above, I will be plugging into a local clinic that performs TMS treatments within the next couple of weeks. This is a proactive measure; I don’t need it right now, but I may well need it in the future, and I want to be able to just get in line when I’m desperately depressed, instead of having to wait. (If you’ve never heard of TMS, you’re not alone. Most shrinks and therapists have never heard of it, either, which is incredibly frustrating. I get tired of educating mental health professionals on what is a very effective treatment. It’s definitely worth looking into and bringing up to your caregivers if you think it might help you. It’s the ONLY kind of treatment that has been able to make me feel “normal” and takes away the daily pain of living.
• I get to purge myself of negativity, doubt, and self-deprecation (which Jacqueline always call me out on) during therapy, but I also have a couple of close friends I can talk to. It can be hard to do, but I really try not to be embarrassed about the way I’m feeling or about my illogical, self-defeating thoughts.
• Something new I’m doing is keeping track of the things I’ve done each day. It’s not a To-Do list – I’m way too hard on myself for those. Rather, I write down every little thing I do over the course of the day that makes me feel better and maybe even productive – like writing, or making one of those dreaded phone calls, or vacuuming, or even taking a shower and brushing my teeth. Then I go to ­­­­a website called Simplenote, which is exactly what it sounds like – a very simple note app – and enter my activities there. I also write down whatever I’m feeling and thinking at the moment. This allows me to keep a journal of my productivity, which helps me feel better about myself. And it’s 100% free.
• I use another app to check in with myself and to help make sense of my moods. Moodscope is a simple, easy-to-use desktop app that asks 20 very simple questions about how you’re feeling. It calculates a score on a scale of 0-100 and graphs it so you can see the trajectory of your mood and any patterns that may emerge. You can also write a short note to yourself if you want, and you can choose to share your scores with “Buddies” (anyone interested in your mental health status). There’s a free version and two paid versions; I use the free version. It says it’s also available as a “mobile web app” but I can’t find it in the Google Play store. Maybe you’ll have better luck than me.

YOU, TOO, CAN STOP YOUR DEPRESSION IN ITS TRACKS

But it takes hard work and persistence. A lot of it.

I’ve been involved with the mental health system for more than 35 years, on and off (mostly on), and it’s taken me almost that whole time to figure myself out on a very basic level. Of course, there’s more to know – there always will be – and that’s okay. I realize that talk therapy can really help in that respect. I can read all the self-help books I want (and I do), but that’s not enough for me. I need to hash things out, ask lots of questions, roll my sleeves up, and get dirty in order to know myself.

How about you?

Are you in therapy? Do you take psych meds? (I know that family physicians can prescribe psych meds, but in my humble opinion, this is better left for a psychiatric professional. Most general practitioners I know of will only prescribe them if you’re in a pinch and then they require you to see a psychiatrist for medication management.)

Do you have friends or family or, hell, even strangers you can talk to? Do you have a Safety Plan to help guide you through the days where you can’t seem to make a single decision?

I know you don’t want your depression to get any worse, and it’s hard enough to stay alive some days. The tips I listed above should help you either get through or even avoid the rough times. I know they help me.

I wish you the best and remind you that sometimes all you can do is take things one day, one hour, even five minutes at a time. If you can find something positive about your day and keep yourself distracted long enough for the negative, soul-sucking thoughts to go away, you’ll make it.

Promise.

As always, thanks for reading. YOU are a true Warrior! 🙂