Anti-depressants

Sleep and depression

Introduction to my new YouTube playlist on depression

Feel free to add any questions you have as a comment and I'll try to get around to answering as soon as I can.

PIP Assessment Hell part 1 - The Letter Arrives

A terrible day among bad days

I think the title of this entry says it all really.  Today is a really terrible day for me as I feel the loss of my beloved cat Merlin even more keenly than the preceding days.

It’s not the inability to remember what he looked like that’s the problem but the fact that he left a gigantic hole in my life and there’s nothing in the world that can fill it.  Waves of tearfulness come crashing down upon me and they are wearing me down as it is in the nature of water to do so.

No one in my life understands just how deeply I am wounded and how hollow and meaningless my life has become.  Losing Merlin came upon a tsunami of misfortunes that have decimated what I laughingly refer to as my life and, whilst I have somewhat overcome some of those misfortunes, there are still enough continuing to damage my fragile psyche.

Oh, I can whack out some humorous memes and make the odd humorous remark but inside I’m dying, pieces of my soul worn away by grief, loneliness and the eternal blackness within which I live.

The light that once shone throughout my life has gone and, piece by piece, it’s killing me.  The most stupid things trigger suicidal thoughts in me and I feel the greatest urge to act upon them so that I can be with my beloved Merlin even though I know that there is nothing beyond this torturous life.  My head feels as though it is numb and filled with cotton wool.

I don’t think I’ll be able to make it through Christmas without something giving.

Extracts from my diary part 1

It’s late and I can’t sleep so I decided to look through my old diaries that I kept over the course of a couple of years beginning in 2008.  I thought that some of the entries might be of interest to people who’d like to get into the mind of a depressive like myself so, for your reading pleasure, here is the first selection of entries covering the period between November 2008 and the end of February 2009.

Note: Dates marked with an asterisk are incomplete diary entries with only the most interesting parts reproduced here.

29^th November 2008

A little voice urged me to stop reading the book on Schopenhauer and start to read “Memories, Dreams, Reflections” by C G Jung.  I’ve been putting off reading it for ages but now I seem to need to read it with the utmost urgency so I bow to the wishes of that little voice.

30^th November 2008

Yesterday I read 103 pages of Jung’s book!

At last I have found someone who understands the duality in my personality!  Despite having died a decade before my birth, I find in Jung a kind of kindred spirit plagued as he was with a duality of personality and our philosophical studies have followed a similar path – Hegel, Schopenhauer and then Kant (which is next on my personal reading list).  I am now a little more at peace with myself and my little voice has told me that I need not read any more today.  As I reflect on my new-found kindred spirit’s words I feel that the start of my journey is not far off.

6^th December 2008

I do not dream in the accepted sense; my midnight movies are more like previews of coming attractions.  Last night I was assailed by two such fragments the first of which I have been plagued by for weeks now.  It involves me in a medieval setting and concerns two necklaces of which I am the owner – one is crystal, the other metal – and being magically attacked for possession of them.  More detail I cannot give as the memory fades almost as soon as I finally wake up, usually in drool.  The other dream involves me finding the mortal remains of five people who have been skinned very expertly, placed in some kind of trunk or holdall (the skins only) and then the receptacles are dumped in a ditch where I find them.  How I miss the nights of dreamless sleep of the days before I started taking happy pills.

7^th December 2008

I hate Sundays.  They are a horrific reminder of the coming working week (not that I’m working at the moment but the sense of dread remains just the same).  As each hour passes, the spectre of Monday gains a tangibility until it materialises like a mugger from the shadows of an alleyway.  It shouldn’t affect me like this as every day feels like a Sunday to me now and I seem to live in a state of constant dread.  We decorated for Christmas today but I felt no sense of happiness and even Christmas music seems hollow to me now.

11^th December 2008

Sitting here listening to jazz and reflecting on events at the Open Arts session.  Surprisingly my poems received a good reaction, even the two I wrote about 1AM this morning.  Maybe I am a poet after all.  Was still hard to read them in front of the attendees but it was a little easier than last week.  I received a massive ego boost when a woman from the group read out a piece she had written and claimed it was due to me that she wrote it.  Can there be greater praise than to be an inspiration to someone?  Another lady told me that I made her cry with my poetry last week – not just once but twice.  It seems as though my poems are able to touch people’s hearts in some inexplicable way.

12^th December 2008

For the first time I had a dream with Grandma in it.  She only appeared within moments of me waking up but I woke up feeling happier than usual.  It’s been twenty years and a handful of months since Grandma died and I’ve missed her every day.  In some way it’s like she came back for me because she knows I need help.  It’s been a long time – maybe she stopped for a chat!  I’ve been reflecting on the events since my suicide attempt and I’m getting the impression that I’m heading for a moment of revelation.  I believe that the following few months will be especially important for me.  I am being driven by an irresistible force towards an understanding of myself.  Whether that is good or bad remains to be seen.

14^th December 2008

I had another dream last night and this one seems very important to me.  I was in a huge library filled not only with books but also letters and other pieces of paper.  The books seemed to rearrange themselves on the shelves as though being moved by some invisible librarian.  I picked one of the letters and it seemed to be from Great Uncle Arthur.  All of a sudden I was overcome with sadness as I realised that the letter had been received after his death.  The letter said that Arthur had wanted to see me and that he missed me.  In reality, Great Uncle Arthur and I hardly knew each other but I did like him although I’m not sure that either of us would have missed each other to that degree.  The letter, however, brought a clear picture of Arthur into my mind and that’s the most important part of the dream.  It seems that the library is actually a repository of memories not necessarily representing truly received books or letters but each item affording the dreamer access to a forgotten picture or actual memory of a loved one or forgotten event.  Emotions seem to be represented by items in the library too.  If I can learn to use this dream library, I may be able to access my forgotten past.  Perhaps this dream library is a manifestation of the collective unconscious and a dreamer could access anyone’s memories with correct use of the library.  I must try to dream of the library again.  The question I keep asking myself is “why am I having so many dreams”?  I have had a lot of different dreams in the last two or three weeks and I can’t put it all down to my meds or the books I’ve been reading.  There seems to be a change happening to me, a change within me, but I have no idea what the change is or why it’s happening to me.  I know that I’ve been different since my suicide attempt, angrier at times, even deeper in darkness than I have ever been but I also seem to be at peace at times with myself, with everything.  I know that I have found great strength from the knowledge that Jung found a way of coping with his duality of personality.  I would say that it gives me hope of coping with mine but hope is not something I allow myself anymore as my hopes are always dashed.  When the time is right I shall legally cast off my name and adopt my chosen name.  I will ask people to use my chosen name in the meantime as a courtesy to me and to allow them to get used to using it.

17^th December 2008 *

Finished reading Jung’s autobiography last night and started reading “The Undiscovered Self” before going to Lakeside where, thanks to a headful of thoughts, a slight dizzy spell and a stupid error in spatial awareness, I managed to rip a big hole in my sweatshirt sleeve.  Took the bus home as the dizziness returned.  Have been reading like a man possessed and have, as a result, already finished “The Undiscovered Self”.  A curious thing has occurred to me and that is that I have been listening to jazz music whilst reading.  This is curious to me for reasons unknown to me as I have had music on whilst reading before, it just seems as though it must be important to note it at this moment in time.  Is it important to me to have this type of mellow assault on my auditory system during this particular time of study, reflection and, most importantly for me, creative release?  If so, why is it important?  So many questions, so few answers.  My intuitive little voice is telling me to leave my studying of Jung, to break my current path of study and seek a new avenue for a short time so that I do not overextend myself and become disenchanted with Jung.  I am inclined to trust my little voice as it has proven itself valuable to me in the last couple of weeks and I have decided to turn my attention back towards politics with a view to read a book on anarchism.  Maybe I need the assault on multiple sensory systems to drown out the crushing banality of my existence.

2^nd January 2009

I have decided to get another pre-pay internet card next week as, apart from a couple of occasions, I haven’t been on the internet for over a month now.  Part of me is looking forward to rejoining the internet community with the few friends I have made online, however, a part of me is almost frightened to go back online and possibly bump into some of the people responsible for my suicide attempt.  I don’t want to get dragged into that false existence again – not after the gains I have made in the last few weeks.  I can hardly deny the attractiveness of my cyber-life though.  I have gained a level of acceptance on the internet that I haven’t had in my real life but is that because I am a different person when I’m online?  Or are people online just a bit more accepting of people?  Another reason for my fear of going back online is that there are a number of ghosts that refuse to be put to rest awaiting my return to the internet and I’m not sure that I’m up to facing them just yet – the emotions surrounding them are just too overpowering or that’s how they seem now at least.  Perhaps I should get a card and give myself a trial period before committing myself to a long-term permanent return to cyber-life – it would seem to be the wisest course of action and it would allow me the opportunity to find more study material, particularly on meditative practices which I am keen on making a part of my on-going course of self-improvement and healing.

I’m a little worried that my little voice has been rather quiet lately except for the urge it gave me to go for that quick night-time stroll by the river.  I could do with some creative impulse to kick start some more poetry writing or some other creative output but I also know that trying to force myself is just going to end in me feeling depressed at my failure to produce anything so I must just wait for the time to be right.  My little voice has been extremely helpful up ‘til now so I must believe that it is being silent for a good reason and that waiting is the right thing to do at the moment.

13^th January 2009 *

I wrote another one of my experimental poems.  It is in much the same vein as my previous one and I’m fairly sure that I was able to keep to the same rules; however, I will be checking it again in the most minute detail.  Details of another poem have also made their way to the surface of my consciousness; lines that have been in my mind for quite a while are now just waiting for the rest of the poem to join them so that they may be written down and forgotten.

People tend to see me as a bit of a waste of space really.  They don’t want to see or are unable to see that I am a reasonably intelligent man who thinks quite deep thoughts at times.  In a way, that is why I write poetry and why I’m trying my hand at art.  It is my way of communicating my thoughtful side to people who would otherwise not listen to me.

In a way I’m still haunted by my suicide attempt because I know now that it would be so easy for me to let it happen again.  The painting that I’m doing kind of represents how I’m feeling at the moment – trapped in a living darkness, completely at its mercy, and having bits of my hidden self revealed to me in fragmentary moments of reflective clarity.  It’s an uncomfortable feeling to be living with.

20^th January 2009

I’m not really someone who constantly reads the stuff I write but today I took the opportunity to re-read all my finished poems and found myself pleasantly surprised by what I read.  Some of the poems are very well written with good descriptive language whilst others seem to cut through the bullshit and get right to the point.  They may not be great literature but my poems do present the reader something worth reading, something thought provoking.  The darker poems are certainly written from the heart, painting a picture of depression that is both accurate for the reader to put themselves in the mind of a depressive and difficult to deny for sufferers.  That is not to say that all depressives suffer in the same way but that there are similarities in how all depressives feel.  My poems might actually strike a chord with other people and may prove to be a comfort to them when they realise that they are not alone in feeling the way they do.  I know that I felt a little better when I found out that Jung had a similar duality of personality as I do even if we handle it in totally different ways.

1^st February 2009 *

I woke up today with the greatest sense of personal insignificance.  It is not the first time I have had such thoughts but it is the first time that they have been my first thoughts of the day.  I have always known that when I die I will not leave even the slightest imprint on history; there will be no Myles-shaped hole in the lives of the people I have known.  The only legacy I will leave is a few mediocre poems and a single piece of art.  I have no children and I have a suspicion that I never will have.  All these thoughts were with me upon awakening followed closely by the questions that have haunted me for as long as I can remember – who are you and what do you want?

2^nd February 2009 *

Whilst I was reading my book on the sofa I had an incredible feeling come over me.  I can only describe it as a ‘eureka’ moment, a moment of supreme revelation like two pieces of a mental jigsaw suddenly falling into place.  The only problem is that I have absolutely no idea what the revelation was about apart from the fact that it had nothing to do with the subject of the book I was reading.  The fact that I consciously acknowledged and recorded the fact that a revelation had occurred must mean that it is somehow important to me so I must try to figure out what it was.

14^th February 2009

I wish I knew what is wrong with me.  I just can’t pull myself together and I’m at a complete loss to work out why.  I really need something to ease this growing feeling of being cast adrift again.  For a while I really thought I was getting somewhere and now I seem to be going backwards again.  I seem to be losing interest in stuff I like and I’m becoming increasingly bored with just about everything.  What’s wrong with me?

19^th February 2009

So much for getting caught up with my sleep.  I spent most of last night in a state of restlessness, tossing and turning yet again.  I’ve got a headache through lack of proper sleep and my brain is becoming so sluggish it’s getting hard to think.

Saw the psychiatrist today to review my medication.  I told him about my anger problem and that I’m tending to become angry at the slightest provocation and that the anger seems to be bordering more towards rage.  I’m not sure but I think that he believes that my current anti-depression meds may be responsible for the rage problem.  He offered me three options for my medication – 1) increase my current meds to the maximum dose of 45mg, 2) stay at the current dosage of my current meds but supplement it with another anti-depressant to be taken in the morning, or 3) stop the anti-depressants altogether and start taking a mood stabiliser instead.  Each option has its own share of difficulties – 1) would make me drowsy and increase my appetite, 2) could add extra side effects to the ones I already have because of the new drug and 3) could affect my ability to write my poems or any other means of artistic expression even though he was suggesting a mood stabiliser a little less drastic than Lithium.  We eventually settled on option 2 as he didn’t want to risk increasing the problems I’ve had with my current meds or risk me losing my creative ability even if there was only a small chance of that happening so I now have even more expense to look forward to and another pill to add to the collection I have to take every day.

The psychiatrist also said that he was going to put me forward for more therapy.  Oh joy!

21^st February 2009

Another day, another headache.  I’m feeling so low now I can barely build up the enthusiasm to breathe.  Little things are really getting to me and causing me to explode with anger.  I need to find a way to sort myself out and quickly before I do myself or someone else some serious damage.

Sometimes I think I’m going mad because my mind gets so muddled due to boredom and depression or because someone does something that defies sense or logic and the rest of the world accepts what the person did without batting an eyelash.  What I’d like to know is – who makes up the rules?  Who decides that the world should accept vile, talentless and intellectually stunted people as celebrities just because they spent a few weeks in the equivalent of a human rat’s maze, a shallow human peep show?  Suddenly we are asked to ignore any bad behaviour they have ever done and probably still do and consider them role models.  We are supposed to feel happy for them when something good happens to them despite the fact that their celebrity status makes them extraordinarily better off than the public that put them where they are.  We are supposed to gloss over how vile they are and forget their disgusting behaviour when something bad happens to them.  We have to feel sorry for them and praise them for their courage in the face of their tragedy despite the fact that hundreds or thousands have to face similar tragedies in their own lives without the support the “celebrities” can get from being in the media all the time.  The people with true courage in the face of personal tragedy are the ordinary people who have to face their tragedy with little or no support.

28^th February 2009 *

Today I was reminded of why I fell in love with Diana in the first place and, although we’ve had a period of troubles during the last year, I hope we can get at least a little of what we had back.  We had something special and I mucked it all up like I tend to muck everything up but I hope we can patch things up.

That last entry was written at a time when I was taking sole responsibility for the breakdown of my marriage and letting Diana get away with denying any part in the troubles we were having.

I’ll post some more archive diary entries later.

Symptoms I have known

I think that people underestimate the range of symptoms thrown up by depressive illnesses, not just the usual diagnostic criteria but the strange symptoms and behaviours that can afflict one on the dark path.  I mention behaviours in this as, unlike some people, I actually consider some of my odd behaviours not as separate things or indications of other mental health problems but as symptoms that I would not have if not for my depressive illness.  I don’t deny that I have been recently diagnosed with a personality disorder but some of my behaviours are definitely related solely with my depression.

So, very much in the same vein as my previous article on side effects of my medications, I have decided to write about the symptoms I suffer from in the hopes that it might make someone suffering the same symptoms feel less alone in their pain.

I suppose we should start with the regular stuff first, the most common symptoms or the ones you’ll find in most books on the subject:

• Persistent low mood (for at least two weeks) plus
• At least five of the following:

1.    Poor appetite or weight loss/increased appetite or weight gain

2.    Sleep difficulty or sleeping too much

3.    Loss of energy, fatigue or tiredness

4.    Body slowed down or agitated

5.    Loss of interest or pleasure in usual activities

6.    Feelings of self-reproach, excessive or inappropriate guilt

7.    Complaints or evidence of diminished ability to think or concentrate (slowed thinking or indecisiveness)

8.    Recurrent thoughts of death or suicide or any suicidal behaviour

The above symptoms are self-explanatory and aren’t really worth discussing in too much detail, however, I do have a problem with the persistent low mood one because it could be said to be entirely subjective.  In my case, I have had persistent low mood for 35 years yet my consultant psychiatrist has been of the opinion that I don’t actually suffer with a diagnosable depression even in the presence of at least five of the other symptoms.  It’s hard enough living with depression as it is without being told that your persistent low mood isn’t technically low enough to count as depression.  But a sufferer knows how low they are feeling and how long for, by what right can a psychiatrist, who knows nothing about your usual level of happiness, dictate what is or is not low mood for an individual?  A bit of a side issue, but I think something the profession needs to think about before writing someone off as not depressed.

The trouble with this list is that some of the symptoms can be made worse by the medications you take.  Items 1, 2, 3, 5 and 7 on the list are common side effects of anti-depressants so once you’re on medication for depression, you may not know if the symptoms are genuinely hanging around or if they are, in fact, side effects of the meds.  The only real way to find out is to ‘take a holiday’ from your meds (under supervision of a mental health professional) and see what symptoms remain.

Now we need to look at the other symptoms, the weird and wonderful problems that can crop up with depressive illnesses.  To do this I will take myself as an example.

Anxiety is quite a common co-morbid problem with depressive illnesses but mine comes with sometimes quite severe feelings of paranoia, the feeling that people are looking at you in a strange accusatory way whether they know you or not.  In some ways, my paranoia can be traced to life events but there are also times when paranoia just hits with no provocation.  There are many times that I have questioned people’s motives simply because my paranoia has kicked in.

My depression has also made me quite susceptible to obsessions and compulsions.  One of my over-riding obsessions is the need to find the perfect (or nearest to perfect as possible) instance of any item I purchase.  I take a terribly long time to buy magazines because I have to make sure that there are no imperfections in or on the paper – no dog-ears on the pages, no bends on the spine, no bad printing – and it doesn’t matter how small the imperfection is because once I’ve seen it, I can’t forget it’s there.  In fact, any imperfections tend to draw my eye like a magnet.

I’m also compelled to collect things – partworks, magazines, series of books, anything collectable.  I suppose I should count myself lucky in that I limit my compulsion for collecting things to only things that actually interest me.  I don’t collect, for instance, every copy of a particular newspaper or every piece of junk mail that comes through my door but if there’s a set of books and I have the money I will attempt to buy the entire collection.  For a while, I was compelled to buy the “Very Short Introduction” series of books until I no longer had the money to buy them.  I started out by buying one that I liked the look of and suddenly my compulsion hit and I ended up buying about 55 of them.  I managed to keep myself in check by prioritising the books with subjects that really interested me but I would pick up one even if it didn’t interest me to make up the numbers because, I may be obsessive and compelled to buy the books, but I would only get them on a deal for financial reasons.  Most of the books and magazines I have collected have remained unread because, although I may be interested in the subject matter, I tend to lose interest in actually reading them when I’ve got them home.

This kind of leads me onto the other aspect of my collecting – the need to buy things to feel ‘normal’.  It’s an offshoot of the obsessions and compulsions I suffer from but also has a ‘feel’ of its own.  The more unwell I feel, the more I will seek out things to buy because for the brief time it takes to look for and purchase an item, I feel calm and just like any other person because buying stuff is a ‘normal’ thing to do and I need that normality.  Unfortunately, almost immediately after I leave the store, I am hit by a wave of self-hatred.

Due to certain events during the teacher training course I was on, I was compelled to go to the local ‘pound’ store where everything costs £1 and I would routinely go to class with a bag with five DVDs in it that I felt compelled to buy.  Thankfully, they were all films I was interested in watching but it was still a problem.  I have, however, become quite the connoisseur of the lesser known distribution companies output and there are some great foreign films amongst them, let me tell you.

The obsessive compulsion to collect things and the compulsion to buy things stem from the feelings of emptiness I feel at the very heart of my soul which in turn causes feelings of self-hatred.  Self-hatred builds with every purchase and with every new collection I start but is also added to with every insult, every bit of unwarranted criticism, every putdown that adds to my negative self image and need to punish myself for my perceived weakness.  I know in my heart that I am actually quite an emotionally strong person and possess an equally strong will but depression weakens even the strongest person as it makes you emotionally raw like having a whole in a tooth that leads straight to the nerve.  Every negative comment, every insult, every putdown is like having a toothpick rammed into the hole in your tooth and deep into the nerve.  To have endured that for almost 36 years is proof enough that having depression may be disabling but also makes you resilient...for a time, however, there will always come a time when your resilience is so low that you succumb to darker, self-destructive urges or simply breakdown.

Depression breeds a lack of motivation and a corresponding lack of interest in one’s personal safety.  Why bother doing anything if everything always seems to turn out bad?  And why bother worrying about personal safety when all you can think about is wanting your misery to end?

I don’t know about other sufferers but I have terrible mood swings.  They aren’t bad enough to warrant a diagnosis of bipolar but they can be quite severe and the duration of each swing of the emotional pendulum can vary wildly.  I have had such severe mood swings that I have gone from happy to sad to angry to back to happy in the space of less than an hour.  And mood swings, especially the emotionally violent and rapid ones can be so emotionally draining that the following depressive phase is worse than any previous phases and self-hatred and the inability to motivate yourself to do anything become almost paralysing.

I exhibit many aspects of a persecution complex which is tied not only to my paranoia but to events in my early life that left their indelible mark on my psyche.  I tend to keep stopping still when walking anywhere and turning around to make sure that no one is coming up behind me to attack me and I am almost constantly haunted by the idea that people are looking at me, talking about me, judging me.

I suffer with a very bad memory, sometimes even forgetting things that happened only minutes beforehand.  I have always put this down to my brain’s need to block out as many bad memories as possible but losing the ability to discriminate between the good and the bad memories thus deciding to repress everything to protect me.

Depression can make you feel so worthless and emotionally drained that you start to lose interest in your personal appearance even to the point that your personal hygiene becomes less of an issue for you and you end up bathing less frequently.  There have been times during my worst depressive episodes when I have gone without bathing for a week and only bathing then because my body has become too itchy to ignore.

A depressive tends to become very needy in terms of requiring almost constant external validation from those around them if only to try to counteract the almost constant droning of the voices of self-hatred running around in one’s head – not literal voices though, just the kind of thoughts you have when left with no other distractions.  It was this need for external validation that made me send in draft after draft of my various essays for the various courses I have taken to my tutors.  I knew that the work I was producing was good but my mind rejected those thoughts until I received confirmation from my tutors; even then the depression refuses to let me believe in the good things that are told to me as they conflict with my negative self-image.

It is so hard for a depressive to believe anything good about themselves because of the deep self-hatred built up over the duration of the depression and the longer the duration spent on the dark path the harder it is to ever believe anything good about oneself.  It takes ten good things to register a good thought in a depressive’s mind and only one bad thing to wipe it out so it is no wonder that depressives end up almost entirely mired in self-loathing, denying anything good within them.

With all this going on in a depressive’s mind, it is no wonder that they resort to self-harming behaviours and there are so many to choose from – cutting oneself, taking overdoses, over-eating, starving oneself, buying stuff to fill the empty void within, isolating oneself from the rest of society, binge drinking, taking illegal drugs and engaging in hazardous activities to name just a few.

I, myself, have succumbed to suicidal acts – taking overdoses and trying to hang myself – and, as I’ve mentioned before, I tend to feel compelled to purchase things to feel normal.  I tend to comfort eat and regularly isolate myself from people both in the ‘real’ world and online.  When I was younger, I over indulged with alcohol but not to the extent of binge drinking as it is currently defined; in fact, as it was at a time when I was still undiagnosed as a depressive, it could be put down as an attempt to self-medicate with alcohol to cope with my depression.

All of the symptoms and behaviours I have mentioned above I have, to one degree or another, exhibited.  Some of the behaviours, such as taking illegal drugs, have not been part of my repertoire but have been included as further examples of behaviours exhibited by people walking the dark path.

It is my hope that by being honest about the symptoms and behaviours I have suffered from myself or that have been reported by others, sufferers of depression will be able to feel less alone in their darkness, that somewhere out there someone else is going through similar experiences and having similar thoughts and in that knowledge they may find some measure of hope.