Another depressed person...
August 21, 2010 3:34 PM   Subscribe

How do you deal with intractable depression?

I just came back from a professional conference. At the end, many people told me how much they admired me and thought I was great and lots of fun. I was shocked. I consider my self a loser. I am full of self loathing, but put on a good show. I am like a dark pit of despair, with a fun sparkly party-girl covering. Who I appear to be is not who I really am. The pain inside me thrums like a constant pulse. I think of killing myself or ways to die frequently all day. Before I go to sleep, I think "i hope i die, i hope i die" like a mantra and it is not consciously done, I realize I am doing it after a few minutes; it just happens. When I wake in the morning, I think, "still here." I go through the movements of living, and I hate it all. It has been like this since I was about 7. So I figured, I must not really want to die, or I would have killed myself awhile back. When I hear of someone my age who died or is terminally ill, I think, "not fair, I am the one who wants to die."

The last thing I need is to be told to be positive or count my blessings, that makes me more miserable. I seem to be terminally and intractably filled with black despair and sorrow, I am so unhappy and sad. There are people in my life who love me and would miss me. It is the one thing that keeps me going, but there are times that I feel that slipping away. I am a talented artist, smart, and well educated. I have a good job and live in a place many consider paradise.

I am not religious or spiritual. I have been involved in religion in the past. It does not help and makes things much worse. I exercise, eat properly, am a normal weight, and I am in good health.

I talked to my GP about this, but I am afraid to make it sound too desperate. I have talked to psychiatrists and therapists, and with them I was very truthful. They usually start with a rather lackadaisical manner ("hohum, another unhappy woman") and then looked completely flipped out and concerned. Only one seemed unconcerned and told me to get over myself, I felt more suicidal after talking to him. I finally stopped seeing him when I realized I was being pushed to the brink and wanted to start cutting myself. In graduate school, they were so concerned I saw a school psychiatrist three times a week for a year (the university is affiliated with a major hospital). This was very helpful, since I was ready to kill myself and had a plan. It is amazing how much planning can go into suicide. There were no SSRIs at the time.

I am on Zoloft. I have talked to my current doctor, but he focuses more on behavior modification, i.e., exercise, meditation, than drugs. These things (behavior) do not help. The only thing that ever really helped was Zoloft (which I currently take). Other doctors I have talked to about this tell me I have nothing to be sad about, completely missing the point. I am hesitant to speak to my doctor again.

Growing up, my sadness and expression of this sadness was treated with disdain by my highly educated parents. My mother was a child psychologist and told me they institutionalize people with my problems, so I should just shut up. My father told me I had nothing to be sad about. So, I shut up and pretended to be happy. I have no close friends, and the friends I do have I would never talk to about these issues. I cannot talk to my family about this.

I am married. I have lived with my husband for 20 years. Over time he has asked me how I felt, mostly I would lie. The few times i would tell him how I felt, he would freak out. About 2 months ago, I told him I was feeling sad. And I explained my black feelings and despair. He was really upset that I shared this with him. I told him in the future, if he doesn't want to know, he should not ask.

If you feel this way, how do you keep going? How do you cope? What should I do? It is odd to ask strangers, but I feel safest this way.
posted by wandering_not_lost to Health & Fitness (29 answers total) 19 users marked this as a favorite
There are a ton of different drugs for depression, and if one doesn't work as well as it should you can try others, or even combinations of drugs. (My husband takes a combo of 4 meds for anxiety.)

But this is the sort of thing that should be managed by a psychiatrist, not a GP.
posted by Serene Empress Dork at 3:39 PM on August 21, 2010

Firstly, get a new GP.

Lots of people find Cognitive Behavioural Therapy to be helpful. There are a few books out there that can give you a grounding in it, such as CBT for Dummies or Feeling Good or the Feeling Good workbook. I found the first to be quite helpful, because it really gave me a grip on why I was thinking the way I was, which was causing me to feel the way I was. Once I realised that I was catastrophising (or whatever), I knew what steps to take to deal with it. You might find it helpful to ask your GP for a referral to a CBT-based therapist.
posted by Solomon at 3:41 PM on August 21, 2010

2nding that you need to be under a psychiatrist's care. I'm horrified that these doctors told you that you have nothing to be sad about. Depression frequently isn't "about" anything. Please find yourself a good psychiatrist who will work with you to find solutions that will actually help you, especially if medication has helped you in the past. GPs aren't really set up to deal with the nuances of this kind of case. (If you need a recommendation in the Los Angeles area, MeMail me.) You might consider writing down your concerns ahead of time and bringing a list with you when you go to talk to a new doctor--it really does make it easier when you're not worried about forgetting or downplaying issues.

I'm sorry you feel so isolated. Hang in there.
posted by corey flood at 3:55 PM on August 21, 2010

I was treated for depression, and my symptoms were similar to yours. I'd be driving down the road and suddenly the thought would pop into my head to drive into a tree or building. I'd fantasize about killing myself throughout the day. When I could take it no longer, I sought therapy. My health insurance had a phone number specifically for mental health issues, and I was put in contact with a therapist in my area and had regular sessions to help me learn how to deal with these feelings. My meds (I took Celexa) were prescribed by my GP at the request of my therapist. Eventually I was able to get off medication when I dealt with the underlying issues causing my depression. That may or may not be the case for you.

It sounds like you've been unlucky with the psychiatrists and therapists you've consulted with if you feel like they weren't taking you seriously. Keep trying.
posted by Roger Dodger at 4:14 PM on August 21, 2010

Your GP is an idiot as to be honest is anyone who says depression such as you describe can be managed with a workout and a think.

The hard part is the first psych visit so I'd prepare by either writing down a long piece and asking them to read it first or as corey flood suggests a list of items. Be very direct too in what you want.

Have you got someone who could go in with you? Or be there when you come out? That would be useful.

And yes it does take a remarkable amount of planning from where you are but you have got so far as to write this so there is hope yet and it can be sorted out.
posted by markx2 at 4:16 PM on August 21, 2010

#1 - You do have a serious problem - no one should be going through life in this kind of misery when help is (or should be) available. Posting here was a really brave first step - it shows that you are not giving up. Now you need to find a team that can help you.

#2 - find yourself a psychiatrist who can help you find the right medication and the right dose.
Most GP will just give you a standard dose of a standard antidepressant. It sounds like you need much more help on the brain chemistry level than your current medication is providing you. I'm not an expert but from what I've seen when people are deeply depressed "for no good reason" the problem has more to do with brain chemistry than maladaptive thinking so that is place to start.

#3 - research shows that the combination of both therapy and medication is more effective in the long term than either one individually. I suspect that you will get the biggest win in the shortest time from fixing your medication so that should be your first priority but once you have that started, it is really worth trying to find a therapist that "gets" you. If they don't take you seriously, don't listen to you or if after a couple session you don't feel like it is making any difference then fire the therapist and find a new one. Don't give up - you just need to find the right chemistry. Your therapist can also help you figure out how to get better support from your husband and friends over time.

In the US, therapists can be a psychologist, MFT, LCSW which is usually less expensive than getting your weekly counseling from a psychiatrist so you probably need one of each - that's why you should think of this as YOUR team. Other people have thrown a lot of garbage at you about what it means to have depression. I can tell that you know it is b*sh*t but you don't what is like to have people who understand depression, professionals that you can count on, helping you find your path to a better life.
posted by metahawk at 4:29 PM on August 21, 2010 [1 favorite]

An eloquent, sensitive, touching and troubling portrait of chronic depression. I am glad you have chosen to hang in there--but it can be tiring to live in two worlds. Maybe it is my background or my essentially optimistic slant on things but I would think a significant portion of "the pain inside me (you) thrums like a constant pulse" could be tempered by a well thought out medication plan. As I have said in previous posts--it is usually a matter of the right drug, at the right dose sometimes in combination with the other right drug. There is an incredibly array of drugs, drug combination(s) and dosages available that were not available 10-15 years ago. It takes patience, a skilled an patient psychiatrist and some medication failures. I hope someday you will wake up and it is 11:30 before you realize that you had not even thought about feeling bad. Since you have only recently joined askmefi and do not specify a location please feel free to email me (either directly or through mefi) and let me know where you live. I will make a serious effort to find a regional center of excellence for treating depression or other legitimate and credible treatment resource. BTW, if the depression is moderated I can almost absolutely promise you that you will not lose the parts of you that you value.
posted by rmhsinc at 4:34 PM on August 21, 2010 [1 favorite]

You have a chronic debilitating illness that makes you want to die. You need a specialist in this sort of disease - a psychiatrist, not a GP. There are newer, stronger and more effective drugs to treat your illness. Point your husband (and/or other family and friends) to this thread and tell him you need help fighting this disease - finding treatment, sticking to the treatment, fighting side effects if any, and generally just getting through it. It sucks that the first thing this disease attacks is your will to defeat it, but you (and the people who love you) need to know that this is what is happening - and that it can be treated more effectively. Best of luck.
posted by judith at 4:43 PM on August 21, 2010 [1 favorite]

I find hope in your user name - I assumes it comes from Tolkein quote:

“All that is gold does not glitter, not all those who wander are lost; the old that is strong does not wither, deep roots are not reached by the frost."

The fact that you are still struggling and haven't given up completely says that you still have deep, undamaged roots.

The quote goes on to say: "From the ashes a fire shall be woken, a light from the shadows shall spring; renenwed shall be blade that was broken, the crownless again shall be king.” Hold on to this - from the ashes of depression, your new life will spring.
posted by metahawk at 4:45 PM on August 21, 2010 [8 favorites]

I've had a similar experience to yours, people seeing a bright and cheerful demeanor, not really believing when I mention depression (even therapists, ferchrissake), while inside it's black churning misery and the reason I don't talk about it much is because I would just end up talking about it all the fucking time and interacting with me would constantly make people upset and anxious about my well-being.

Therapy hasn't helped me much either. I'm on a couple of SSRIs that have minor effect. One thing that does help is the stimulant mixed amphetamine salts (MAS, brand name Adderall) which I am prescribed as a treatment for ADD, but it has a very temporary effect and you build up a tolerance for it, so every six months or so I have to go off it for about a month which is a month of hell.

(Still, it is nice to have an hour or two every day during the peak effect which doesn't suck so much. But I should mention that occasionally I get a "rebound" effect where I have a temporary period of unusually intense depression as it wears off. Also, I have seen in some medication manuals that MAS are sometimes prescribed for treatment-resistant depression, so it makes sense that I find it helpful.)

My psychiatrist and I have been experimenting with a variety of antipsychotics over the years and recently one of them, Risperidal, has had a little positive effect, so maybe that will be more promising as we increase the dosage.

My physician has also suggested electro-convulsive therapy (ECT) which evidently is less scary than it was in past decades (much less as scary as in horror movies where they're locked in an abandoned insane asylum with crazy ghosts) and has proven very effective in certain cases of treatment-resistant depression. But there are potential side effects including memory loss and because they don't really know how it works it seems to me kind of like hitting a malfunctioning electronic device with a hammer to see if the problem clears up. So I've refrained from pursuing that so far.

There is a newer experimental treatment I've read about with interest called magnetic seizure therapy (MST) which works on the same principle as ECT by inducing electrical currents in the brain but it does so with powerful magnetic fields that are much more focused and localized on the areas of the brain that seem to be effective in ECT, yet it has more mild side effects compared to ECT. But because it's experimental insurance doesn't cover it (I'm in the U.S.), hence I've been looking for a nearby clinical trial. Hopefully I'll find one soon.

Here's a good place to look for clinical trials of all sorts:
posted by XMLicious at 5:05 PM on August 21, 2010 [1 favorite]

From your parents denying your sadness to your husband who is unable to hear it, it sounds like you need someone to talk to. Someone you can talk to honestly. Someone you can be yourself around. You need a release valve.

This is usually the role of the psychiatrist, but it is hard to find one who is actually understanding of chronic depression. Surprisingly hard. I could tell you how many mental health professionals have told me I have nothing to be sad about, but you know all about that already.

I've been depressed since I was a child. It's just how I was built. I am sad. The joy of living? What are you crazy people talking about? My savior has been that I have friends that I can be honest with. I am not totally sure how I found them because I'm pretty shy but, I think we just felt each other out, gradually sharing more and more darker and darker thoughts. This sounds weird, but I have friends that I can just go be sad with. And we have an amazingly good time together. You would never even know that we're depressed.

I wish my advice was more than just "find friends" but really, I can't think of anything greater than just being with people who understand you.
posted by bobobox at 5:15 PM on August 21, 2010

For your husband I should also mention that my loved ones, feeling a bit helpless in the face of my problems, have found the National Association of Mental Illness (NAMI,, a U.S. organization) to be helpful. They actually took some informal classes designed for people close to those with mental illness. Plus they've worked on fundraising and some legislative things which I think made them feel less helpless, that they were doing something.
posted by XMLicious at 5:20 PM on August 21, 2010

I've really struggled with this myself considering I am very successful and admired professionally. It's hard for people to believe that I struggle with serious depression sometimes. I had one asshole therapist tell me he didn't think I had depression, but that I was just a "nervous" girl. My GP didn't think I had a problem either until I was hospitalized because of an issue probably caused by depression.

It's hilarious because many here and IRL told me I should seek all these treatments that involve large amounts of money and shopping around. Kind of tough for a person who struggles to get out of bed and to work to make that kind of effort. I'm in significant amount of debt now because of therapists that didn't even help me.

My advice is not to fall for methods that have limited science behind them like psychoanalysis. I think for people like us psychoanalysis can make things much worse. The most I've wanted to die happened when I was under the treatment of such therapists.

Go to a good scientific CBT and psychiatrist. INSIST to your GP that you need to see a psychiatrist and that you are worried about dying.

But realize that even many scientific professionals are complete idiots and you have to keep trying to find the right solution. I try to view the whole endeavor as finding strategies to minimize the down feelings, since I think they are mostly biological, rather than examining my past for causes. Some dietary changes: increased DHA, Mg, and Zinc, seem to also have helped a little.
posted by idle at 5:21 PM on August 21, 2010 [1 favorite]

One more thing - another method that gets applied to treatment-resistant depression, which I think is covered by many insurance companies and provided by some national health systems, is vagus nerve stimulation. When I looked into it the success stories didn't seem to match my case but it might be a fit for you.

And idle - yeah, srsly with the asshole therapists: "It's just dysthymia..."
posted by XMLicious at 5:29 PM on August 21, 2010

Oh holy hell-get thee to a new doctor. This sounds very much like something that is biochemical in origin and I'd like to give a swift kick to anyone who has told you "you have nothing to be sad about."

This is actually a medical emergency and while your coping skills are more than admirable, you really need to let down the mask (while you can do so voluntarily) and tell a good psychiatrist exactly what you have told us. And if she or he recommends hospital, believe them and do it.

My own psychiatrist (the one I had when I was sick) told me that typically a person is able to hide this sort of thing for years but once you hit your forties your ability to do this starts to slide (hence my own first visit with him during that time frame.) I am concerned that if you don't find proper treatment soon that you could find yourself in a world of hurt. OR worse.

There are tons of new meds out there. There are tons of therapies out there. For that matter, in my case, there was actual competent spiritual help out there (I know that as a Christian I couldn't take that for granted. I hit the jackpot with wonderful folks who understood the biochemical component.) What I am trying to say is that NO ONE SHOULD BE FORCED TO GUT THIS KIND OF PAIN OUT. Please, please, please, pursue help. And if one doctor is an idiot, toss him or her and get one that isn't. Good help is out there. For that matter, an anonymous post asking for recommendations in your area might not hurt, if you choose that option.

But please, do something. Kill that dragon before it drags you away. Please.
posted by St. Alia of the Bunnies at 5:41 PM on August 21, 2010 [1 favorite]

Other doctors I have talked to about this tell me I have nothing to be sad about, completely missing the point.
I think CBT can come across this way, as dismissive or invalidating. If so, I suppose it's an indication of a lack of rapport with the therapist, or lack of skill, or something like that. But if you look at what actually helps people, CBT is near the top of the list, especially combined with other things.
In graduate school, […] I saw a school psychiatrist three times a week for a year […] This was very helpful
Can you think about what made it helpful? About what made it different from the other therapies you describe that were not helpful? Can you try to replicate what was good about it?
If you feel this way, how do you keep going? How do you cope?
TBH, and I hope you don't take it amiss, it sounds like you're coping pretty well. You're in deep deep pain but you're able to function in society, you have some human relationships, you're able to have goals and pursue them. You can keep on as you have been, but I think you should try to do something about the actual depression while you still have the emotional resources to do so.

If I were you I'd do two things: one is keep looking for a therapist you feel you can trust, even if they tell you things you don't want to hear, because if a therapist is doing their job they will do that from time to time. The other is find a psychiatrist who'll help you try out different drugs: the drugs act idiosyncratically on different people, finding the right one seems to involve a bit of guesswork and trial-and-error, and everyone I know who's had life-changing beneficial effects from psych meds has had to try a number of them before finding the one that worked for them. (Trying new drugs can be horribly unpleasant, though, unfortunately.) The therapist and psychiatrist can be the same person, or two people who work together.
posted by hattifattener at 8:17 PM on August 21, 2010

Have you had your thyroid completely checked out? I knew a woman many years ago that suffered from crippling depression and eventually tried to commit suicide. While in the hospital after the suicide attempt, they checked her thyroid and it had completely failed. I know that you said that you are in good health, but often the thyroid isn't checked unless there are other symptoms. It's worth a try.
posted by The Light Fantastic at 9:11 PM on August 21, 2010

When you go see the new GP and psychiatrist that everybody else in this thread has told you to find, print out a copy of the post you made here (verbatim), and show it to him/her.

Some people have a hard time vocalizing their problems and issues, but find it very easy to express them in writing. I suspect you are one of the latter types of people, and that this will help them help you get better!

Also, your GP doesn't exist to judge you. You can be honest with him/her, as GPs have pretty much "heard it all." If your GP *is* judging you or making disparaging remarks, it's time to find a new one -- you are under absolutely no obligation to continue to see the same doctor for any reason.
posted by schmod at 11:38 PM on August 21, 2010

Oh, sweetie, you sound just like me 4 years ago. I'm so sorry that you've been through this for so long and with such poor treatment.

Drop any doctors that tell you you have "nothing to be sad about". Being sad without reason is basically your entire problem.

A medication switch might help-- I'm on my third medication since my diagnosis, and having to try a lot of different medications is quite common. The Zoloft obviously isn't working, and the suicidal feelings-- or the wishing for death-- that you are experiencing might be related to that medication.

Therapy works for a lot of people-- for me, all I needed to get out of my depression was medication and some loving friends. For you, it might be something different. But there is help-- medical help-- that will help with the real problem you have that is caused by bad chemicals in your brain.

You're not the only person that's gone through this, and there are tried and true medical techniques that can make you feel better. Good luck.
posted by NoraReed at 2:25 AM on August 22, 2010

There are a bunch of drugs that are really effective against refractory clinical depression. Unfortunately, they make people happier even if they weren't depressed in the first place, so those drugs are all illegal. Except alcohol, the worst of them all, of course.

That said, I agree with the above recommendations of trying new doctors, and new (standard, legal) drugs, prescribed by a psychiatrist, not a GP. Some people just go to the GP and say "hey, I'm pretty miserable, could you write me a Prozac script?", and some GPs are cool with doing that, and sometimes it works out great. You've got big muscular serious powerful depression, though, so it's psychiatrist time. And then new psychiatrist time, if necessary. Et cetera.

My own refractory clinical depression's far from cured, but it's at least REDUCED now that I'm on a good old-fashioned tricyclic, after shuffling through a succession of "modern" SSRIs that did bugger-all for me. Different brains respond differently to different pills, just as is the case in the recreational-drug world.

Unfortunately, psychology is still pretty much stumbling around in the dark compared with most other branches of medical science; exactly why antidepressants work, when they do, is still largely a mystery. (No, it's not just because they increase serotonin levels, as many people say. We know that's at best a small part of the puzzle, because numerous antidepressants increase serotonin levels right away, but take weeks or months to actually have an effect on mood. I don't think we've even figured out why lithium does what it does.)

This unfortunate state of affairs explains, I think, why it's so easy to find head-doctors who would be run out of town on a rail if they practiced "normal" medicine so incompetently. (I managed to find one who was personally insulted that I didn't believe in god. That single consultation was... unproductive.) But that's fortunately not the norm. I doubt you're going to need to try anything like as many doctors as drugs.

Finding the right medication can, itself, be depressing, or at least irritating. You may get dealt a good hand and nail something much more helpful in the first couple of weeks, or you may, as I did, get a series of medications that make you feel interestingly odd from time to time, but not really any better, before you find something useful.

In some cases, all that turns out to work is withdrawing from society (traditionally by checking yourself into the nut-hatch), so you can sit about somewhere peaceful and simple and wait for the misery to recede, which it may. Or may not. But you're a long way away from that particular dismal prospect; it's probable that you'll get some significant relief, if not a true "cure", from one or another drug or combination of drugs. We do have a bunch of 'em, now.

(And yes, there's ECT too, which in the modern world is indeed not at all the barbaric spectacle it used to be back when it was the last stop before actually chopping off bits of brain. But, again, worrying about that stuff now is like worrying about whether your five-year-old child will one day decide to drive drunk. Drugs 'n' doctors, in the aggregate, are a good bet; it can just take annoyingly long to pay off.)

I also recommend William Styron's slim volume "Darkness Visible". My twisted schadenfreudian mind found Styron's vivid descriptions of ever-more-ghastly personal misery quite cheering in and of themselves. I'm told that normal people like the book because it shows that you're not alone, and there is hope, even if you're as badly off as Styron was. Which you probably aren't, because holy crap did he ever have it bad.

In your particular, magnificently-poorly-supported-by-your-friends-and-family situation, some sort of group therapy would probably be a bloody excellent idea, too. Hit the phone book for crisis helplines (I don't want to say "suicide hotline", but yeah, that's what it may be called); your situation is an entirely appropriate cause for calling a helpline in and of itself, and they'll probably have a list of other resources, which with any luck will lead you to a support group nearby.

In the short term, just talking to professional helpers who actually, you know, try to help, can all by itself improve your condition. That crushing feeling of pointlessness and helplessness that keeps you trapped in the depressional gravity-well will recede considerably when you demonstrate to yourself that help does exist, and you're actively seeking it.
posted by dansdata at 3:52 AM on August 22, 2010

You need to see someone new, immediately. It worries me that the picture you paint is similar to those whose relatives later say, "but we never knew she was so unhappy!" The fact is, you may never get your feelings across to them and that's OK, what's most important is that you get help now. There are 101 antidepressants out there and 101 doctors who will prescribe them. You don't need to stay on them forever if you are able, but it can pull you out of that black dog of dangerous thought.

Also, your husband may have just freaked out because he had no clue you felt that way. Have him read "Darkness Visible" if he is totally unfamiliar with depression.

You're used to shutting up, it's time for you to speak for yourself. Best of luck. Start with a hotline today.
posted by Wuggie Norple at 4:45 AM on August 22, 2010

As you have already read above, you're not really weird or anything; just human. This is not me saying to tough it out. I'm just pointing out that you've got a lot of company.
If the help you're getting isn't working, get different help. I know that's hard to do, especially when things get hopeless. But the fact that you've even asked this question here means that you're taking control of your life, and that's definitely what you should be doing right now.
Be stubborn. Fight for it.
posted by Gilbert at 5:07 AM on August 22, 2010

If you feel this way, how do you keep going? How do you cope? What should I do?

I can really only tell you that I am right there with you. I've been depressed since childhood, and multiple treatments have not helped long-term.

I am not coping very well at present, but I can tell you what has kept me alive thus far: the hope that there is a treatment that will eventually help me substantially. I do believe such treatments exist, and it sounds as though there are treatments (and combinations of treatments) that you haven't tried. I firmly believe that the proper mix of medication and therapy can make all the difference.

First of all, you need to find a psychiatrist (a PSYCHIATRIST), and also a therapist, who take this Seriously. I cannot possibly overstate how important this is. It is a sad reality that, for whatever reason, even trained mental health professionals sometimes refuse to take depression for what it is: a potentially fatal, and in your case, chronic illness. Even in cases where it is not fatal, it can utterly ruin a person's quality of life. The idea that any doctor would accept this is appalling. But it happens.

It is a good sign, to me, that in the past you've found people willing to take this seriously and work intensely with you on treatment. This is what you need, but perhaps for a longer term. There are many different types of therapy, and many different drugs.

Lastly, the way your parents responded to your depression was wrong. Parents make mistakes, some forgivable and some not. Either way, their response was not correct or right. Unfortunately, this is often how people respond to depression. My theory is because depression is fucking terrifying. It seems like an absence of the will to live, which seems like the most fundamental prerequisite to survival. People avoid it, and avoid being around people with it, like the plague, perhaps for fear of somehow catching it.

But you're in it. You need, and deserve, to partner up with professionals who have the fortitude to stand by your side and advocate for your life while you're in it.
posted by Ouisch at 5:11 AM on August 22, 2010 [1 favorite]

This hurts to read even though I feel pretty similar to a lot of things you mentioned. Please dismiss all your current doctors and start over. If you had a broken arm and the doctor kept telling you that you were fine and to get over it, you wouldn't continue to see him. Mental illness is all too real, but it is shocking to me how many people still seem to think it's something made up. There are better drugs and there is better therapy. Please seek it out. Life doesn't have to be this hard.
posted by CwgrlUp at 7:34 AM on August 22, 2010

You should not feel ashamed of your sadness. And you probably don't want to hear this, but if your husband isn't able to sit and listen sympathetically when things get really bad, offer a hug or something, without freaking out, then he is not being a very good partner to you. There's a huge difference between the 24/7 drama queen and someone who is truly suffering and needs a shoulder to lean on when things are at their worst.

Get a new doctor. Try some new meds. And definitely pick up a copy of Feeling Good and try the CBT. CBT-type stuff is great for the day-to-day coping and the feelings of guilt that surround having depression in the first place (I get from the start of your question you go through the cycle of "I'm sad and a terrible person --> So many other people have it worse than me, I should be happy --> I'm such a terrible person for not being happy! etc"). CBT isn't about "thinking away your feelings," it's about recognizing when you've entered into a negative-thought loop and breaking out of it.

It may also help to think of the depression as a disease of the mind. The same way cancer destroys the body, the job of depression is to destroy the mind. It's not you. Remember, the feelings are something it wants you to feel, and only by saying "This is not me, this is the disease, and I can reject this" can you start moving towards feeling better.

(The last thing doesn't always work when things are really bad, but it's good for the sort-of-down times)
posted by schroedinger at 9:00 AM on August 22, 2010

I can't recommend CBT for you initially. CBT requires determination and self-reinforcement, and forgive my saying that it's too much to ask for based on your description. I went through CBT unmedicated and found, often enough, I just didn't fundamentally believe in what I was expected to do when depression/panic feelings came up.
Eventually I found a good psychiatrist, eventually settled to a good medication regime, and I've been OK through all kind of difficulties that would have shot me down like Duck Hunt.

If your GP is a primary care approver and you can't see a psychiatrist without a referral and be insured, dump this fool and find another one pronto. Your sickness is causing these ideations and they will only get worse with continued exposure to this execrable ass-cake.

Find a psychiatrist who specializes in adult depression. You need an expert who understands the horrific landscape you're walking in, can capably prescribe and will openly discuss the process of tuning medication until you stabilize, and will treat your illness by believing you, understanding what you're experiencing, thinking and feeling, in effect walking with you through to recovery. And you'll need to have your husband in at some point so he really understands what is happening to you and can properly support you.

You are not alone. I'm on memail if that's of any help.
posted by nj_subgenius at 10:07 AM on August 22, 2010

PS - to the latter part of your question, I find that (for me) regular exercise - and I mean an hour plus in the gym, serious cardio + resistance training - helps, particularly when I'm feeling sad or troubled. It's a good maintenance regime, not a primary therapy. I practiced TM and am not one of the people who believe in it. If I had to recommend any physical activity that might be really good as you get that proper doctor, I'd recommend Sivananda or Kundalini yoga. Yah, right, you might say, but the satisfaction of getting a maneuver you thought ridiculously impossible is really something. Sivananda goes a bit heavy on the holistics and hindu thing, but I just let that go in the left ear and out the right. Oddly, learning to breathe was my biggest discovery there.
posted by nj_subgenius at 10:30 AM on August 22, 2010

I was shocked. I consider my self a loser. I am full of self loathing, but put on a good show. I am like a dark pit of despair, with a fun sparkly party-girl covering.

I haven't read the other comments yet, but I wanted to pop in and say that this is exactly my situation too. Hardly anyone believes I'm depressed (well, unless I show up to them crying) because I have this massive reputation of being energetic, vibrant, cheery. Your conference example happened to me 2 years ago and happens fairly often.

So here's a hug. I'm not sure what the answers are either. It can be tiring to feel like people expect you to be this happy go lucky fairy child when all you want to do is die or disappear. Like you feel that you're not depressed enough because you manage to hide your angst and put on some glamour and no one needs to know.

so much love for you.
posted by divabat at 9:13 PM on August 23, 2010

Well it has been a while since I have felt absolute crushing despair like this but you don't really forget the feelings.

I had a similar experience in therapy as you did where I was basically told that I was imagining things so I may as well get used to being "unhappy". That was my last therapy session. So I can understand a bit of what you have been through. Being told you are so "stupid" you don't know what you are feeling makes you die a little inside.

What has worked for me is recognizing early enough when I am starting one of my downward spirals and doing something to stop me from going so far down I don't have the energy to get out of bed. What works varies - forcing myself to go out with friends, work on a project or play games online but the bottom line is to sink as little as possible into the pit of despair so when you eventually come out the other side you have more energy to deal with life and all of the little triggers that are there to send you back down on the ride to the bottom. After a while you get to the point where you at least have a more even state of mind and a bit more energy to work at getting back to normal.

I really hope that something here helps get you back on your feet and helps you to start to deal with all of this crap. I wouldn't wish this on anyone. Sorry this post isn't particularly coherent but it is hard enough to write in the first place without going back over for editing. If talking it out helps you send me a memail. I would be happy to chat.
posted by troll on a pony at 5:50 PM on August 24, 2010

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