Dealing with and understanding post-depression changes

August 12, 2011 5:39 AM

How to deal with post-depression goal changes (or aimlessness)?

Hi all,

it may seem like a silly question, but it is one I have not found much discussed...what do you do when you crawl out of a depression?

This may be a long story...

As for myself, many factors led to my depression. Unsatisfaction with my PhD, conflicting goals (teaching? travel? and a sudden realization of the vastness of academic pursuits), existential angst, confusing breakup, being away from home, etc.

Using marijuana to self-medicate/feel better mostly led to manic-like episodes where I would be infatuated with philosophical ideas and run them into the ground realizing they were probably either silly and meaningless, or out of my reach. I would also be interested with topics related to my PhD (brainy things). In any case, I have been away from marijuana for almost two months and I feel much better.

During my depression I was convinced I was broken -- that I had Asperger's, or ADD, or OCD, or all of them at once. I eventually mustered the courage to see a doctor, who suspected depression (surprise!) and referred me to a psychiatrist who prescribed me citalopram (celexa). I am seeing a therapist/life coach who told me that I should not take the meds, so I followed her advice (she is of the "listen to and accept your feelings" type). Eventually I caved in and took the meds -- I can definitely see a change, at least in terms of crying spells (almost none now!) and suicidal thoughts (mostly gone).

Another detail to mention: when the depression took hold back in March, I basically stopped going to the office for three months. At first I was ashamed of my performance, then ashamed of my mental state, then afraid of what people would think, etc. I sent a long email to my supervisor explaining my angst and asking to meet him, which he never replied to. When I finally mustered up the courage to go see him (unannounced) after three months, he simply said he was sorry for not replying, and within the conversation (which was nonetheless amiable) he said "well, we all have problems, but we don't all talk about it". I think I need a supervisor who would be more supportive, but maybe I am asking too much -- who else can I talk to about academic career confusion? I didn't come back to the office again, as there were interesting classes, then I went back home, and then upon coming back felt even more confused (and that is when I finally started the meds). This is about a month ago.

I asked for academic leave back in March (I could see something was wrong) and that was deemed impossible. Seeing the clock tick made me even more anxious and depressed about my performance and I probably sunk even lower. Last week, I went to another city visiting my master's supervisor and other academics, with whom I am writing a paper on my old topic. I felt much more accepted and welcomed, much more at ease, and basically got offered a PhD position with my old supervisor (who said he wouldn't do this to anyone but for me, absolutely). It would sound great, except it would start in a year, giving me a year of I don't know what (during which my goal will most probably change again)

I also feel the shame of taking up this program's resources and not following through with the research I am here for. In any case, I am thoroughly confused and quitting seems like the only option. I went to see another therapist who told me that quitting now is "forbidden", as I may still be unstable and prone to brash decisions. The life coach previously mentioned has told me it is clear I should quit and travel or experience something else, and so has a school counselor.

I feel I am mostly new to this whole "this is my life and I can do what I want with it" idea. Thus I am still struggling with understanding what it is that I want, and a PhD in a foreign country puts too much pressure on me during this confusion. But, this may all be very normal and I am just making a big fuss for nothing.

I guess my main point is that I do not feel the depressive symptoms anymore, except for, well, lack of motivation, anhedonia, and general existential confusion. I also feel quite anxious -- I almost constantly feel my heartbeat, for instance. Maybe this is how we all live our lives -- or maybe I have still much more work to do. It just feels like I've crawled out of a bad dream which began when I decided to come here, which was itself a very brash decision taken under a depressive spell...

Well, anyway. Maybe this is chatfilter, but I need tricks to understand this new self which appears to have emerged. Maybe some book recommendations?

Thanks.

posted by StoneSpace to human relations (8 answers total)

So wait, you saw a doctor, which led you to see. . . "a psychiatrist who prescribed me citalopram (celexa). "

But then you saw "a therapist/life coach who told me that I should not take the meds"

Do you not think this is crazy? You were (and it sounds like you still are to some extent) in a state of malaise. The last thing you need is people telling you to do and not do the same thing. I suggest you would benefit from having it so your team all pull in the same direction. I'll defer to others who have more experience of this type of situation as to which of your professionals you should change.

You have my sympathy. A lot of people have gone through what you are/have go(ing/ne) through -- and worse! You will pull through this.
posted by davidjohnfox at 6:30 AM on August 12, 2011 [2 favorites]

I agree with davidjohnfox that the professionals you're seeing need to be working in the same direction. They may all be working toward the same goal, but the conflicting paths don't seem to be helping.

Is it possible that you weren't aware of the extent of the anxiety until after the depression has lessened? Anxiety can be crippling, even without depression, and it sounds like that's where you might be now. Many depression meds curb anxiety as well - it's a matter of finding the one that's right for you and your symptoms.

I'd encourage you to work with your doctor or psychiatrist to find a medication that fits both depression and anxiety, and then a counselor or life coach that won't tell you to drop the meds. Although medication isn't necessary for everone, it is a crutial step for a lot of people. Listening to and accepting your feelings sometimes just doesn't work.
posted by youngergirl44 at 7:02 AM on August 12, 2011 [1 favorite]

My first year of my PhD, I got deathly iil with a heart condition, broke up with a long term, serious boyfriend, and became deeply depressed. I did not think a PhD was for me. While I did not disappear from schoolwork, I did avoid my advisor at all costs. Then when I came to see him and May to say I wanted a leave, his reaction was about like your advisors. I took a year off. I was convinced I was never coming back to academia though. I threw myself into another career aspiration, as a public school teacher. And was still depressed. I got over the sickness and the boyfriend (slowly) but I never shook the depression. If anything, it became worse with a stressful job as a school teacher in a poverty stricken area. Looking back now, I realized I just ran away from my problems. I ended up returning to my PhD program because I decided it was the lesser of two evils..and a phd was kind of what I expected of myself. My advisor and I had a heart to heart (I don't know if that sounds feasible with yours). I got on medicine that worked for me (combo of prozac and adhd meds). I still today don't really think a PhD is necessarily for me (or for anyone) and I don't know what I'm doing after this. But I'm glad I came back to my program and am finishing. I think you might be glad to go back and finish with a new program.

Anyway - all this said, my real advice is don't decide against the PhD/program until you get the depression under control. And please don't feel like you are the only one going through this. Your experience of depression/anxiety is unfortunately very common among phd students.
posted by quodlibet at 7:07 AM on August 12, 2011

Oh, youngergirl44 just stole my thunder, so I'll just sign on to everything she wrote.

Anxiety and depression kind of go hand in hand and medication can help with both. Meds are tricky though, so you really do need to work with your doctor and psychiatrist to figure something out that works--some depression meds can make you more anxious, some anxiety meds and mimic the symptoms of depression. It's complicated stuff!

I would also fire any therapist/life coach who categorically says no to drugs. We all go through rough patches in life, and for sure you don't need a pill for every bad feeling you have, but when something goes on for months and years and no amount of personal effort is working to shake it, medication should at least be investigated as an option, even if it is just to rule it out.

As for your academic dilemmas, yeah, to some extent it sounds like grad school hell, which probably can't be changed, but what can be changed is your capacity to deal with it. If going back to your old supervisor/programme can't happen for a year, one way to look at that is that there is no pressure to decide immediately what you want to do (unless you have to tell them right away?). Put aside your guilt about the programme you are in now; it doesn't sound like they are being very supportive, and anyway there is no shame in realizing that something isn't right for you. I would also consider asking for medical leave, with notes from your doctor and psychologist saying you are being treated for depression and anxiety--these are illnesses that can make intellectual work impossible!
posted by looli at 7:16 AM on August 12, 2011

It sounds to me, someone who has recently (very recently) pulled out of deep, deep clinical depression with the help of medication and an incredibly supportive medical team and family, that you haven't found your way out of your depression.

I think you need to step away from the life coach and see someone else; either the psychiatrist who prescribed medication (and yes, keep taking it!) or a different therapist because your statement that the "suicidal thoughts" are "mostly gone" makes me think you need some additional help beyond the medication.

Once you get the depression under control, I promise you that things will look entirely different. Like, so different that you'll wonder why you made the decisions you did while you were depressed. HUGE life decisions should not be made under the influence of depressive episodes.
posted by cooker girl at 7:18 AM on August 12, 2011

Richard O'Connor's work deals with life after depression.
posted by gnomeloaf at 7:55 AM on August 12, 2011 [2 favorites]

If you've decided to take the drugs, you need a life coach who is supportive of this. You can't have different people saying different things - IMO it's unprofessional. It's not their job to impose their personal preferences on your life. You've taken the drugs so you need to work with someone who goes, okay, how do we manage this situation as you're being medicated?

Your supervisor is also not your therapist/life coach - these need to be separate as they have different roles/functions.

Life changes frequently for many, many reasons - so don't feel shame about using up resources and not wanting to continue with it. You can't see into the future so you don't know what's going to happen. You're not using anything you're not entitled to.

However, it sounds like the new PhD position would work better for you and possibly provide you with the fresh start that you seem to need. So if you need to find something to do in the mean time - travel, non-stressful work, taking the time to focus on you and developing your well-being so that you're fighting fit for your new PhD.

I would give the life coach the flick and find someone who is more supportive of your current situation - depression and anxiety are difficult enough because of the internal messed-up messages without having the same thing occur with the health professionals in your life. Everyone needs to be on your team, helping you to get better.
posted by mleigh at 4:33 PM on August 12, 2011

I would throw in that if this life coach has ANY professional license, which sadly, I'm almost sure she does not, you should report her/him to the relevant professional board - telling a suicidal patient to get off meds is criminal. This is why these f'n people should be banned, or at least widely understood to have zero training.

It seems like taking a leave from a stressful situation to sort your thoughts out, at least while you're reporting your suicidal thoughts are only 'mostly gone,' is a good idea. Your state still seems a bit unstable. I'm sorry you're going through all this.
posted by namesarehard at 5:31 PM on August 12, 2011