Is there a way out of this?
August 30, 2015 9:33 PM   Subscribe

Dealing with depression, nothing is working, every day is a waste.

This question has been a long time coming and I'm not sure if it'll accomplish anything or even cover everything but I'm running out of ideas. I'm dealing with some mental health issues. I hate who I am and who i've become since this has gotten worse. I moved to a new city a year ago with my boyfriend as he started grad school. I was definitely depressed and socially anxious/avoidant before, but I guess moving hasn't helped and has made me feel worse about what I'm doing (not doing) with my life.

We've been here a year and I'm a wreck. I spent the first 3/4 of the year trying to freelance since I wanted to avoid the pattern I've gotten myself into, of having desk jobs I hate, get burned out on, and leave for yet another same thing. Following a financial crisis where I failed at freelancing and ran out of money, I had to take yet another shitty office job that I hate. I thought this one would be better since it's walking distance to my house and only 30 hours a week, but I still dread work and spend time just counting minutes until each day ends, and I still spend most of the time I have outside of work just dreading having to go back again. I really hate this life.

I have no friends outside of my boyfriend's graduate student groups, who are not really my type. He and I go to a lot of local music shows but I always feel like I'm just piggybacking on his interests. I'm trying to do things like learn guitar but I'm awful at it and not getting any better. my boyfriend's doing so well with his program and hobbies and friends while I have nothing, no goals and no future. I don't want to wake up every day forever to go to my trash job to support my trash life until (if, even) i retire.

When I'm not feeling straight despair, I get really frustrated and angry all the time, to the point where i'll have childlike tantrums where I scream and hit things and pull my hair out. I hate admitting this. but it's what I've put my boyfriend through. he is a saint for staying with me.

I've seen so many goddamn therapists, I was seeing one therapist for the past year, mostly twice a week, I spent so much money and time on this and I haven't even gotten anywhere. She was getting really frustrated with me so I made a new appointment with someone new that does CBT, but I don't really think that seeing yet another therapist will actually help.
I'm seeing a psychiatrist but he's just not finding anything that's working and he's expensive to see too since I have to pay for everything out of pocket (my insurance doesn't have any available). He has me on Latuda now since I've tried all the "normal" antidepressants and they either don't work or the side effects are life-ruining. This current one is in the not working category.

I've been crying all day and I'm really starting to question whether this is all worth it. I'm putting in so much effort at being alive and dragging myself to work every day and I'm just getting nowhere. I don't have the slightest clue how to fix this.Is there a way out of this?
posted by sarahj to Health & Fitness (28 answers total) 15 users marked this as a favorite
I'm sorry you're having a bad run of things, but it's only just that - a bad run; things can change. It's not your fault.

It's very important that you know that your boyfriend doing well in his program does not mean you are doing badly or anything along those lines. They're different things, pay it no mind.

You hate office jobs, that's not likely to change - what do you want to be doing? What can you do to work towards that?

Depression and no money sucks, I know this. Is there anything you like, or gives you more pleasure than another thing? What do you like?
posted by the uncomplicated soups of my childhood at 9:59 PM on August 30, 2015 [1 favorite]

Oh honey. You have reached rock bottom and it's the worst place on earth to be. Have you talked to a doctor about how horrible you feel? I spent about 5 years in the same kind of misery you're experiencing right now and was treated for depression but it turns out the depression was a symptom of a greater problem, not THE only problem. When I talked to a doctor and asked for a blood test, we discovered that not only do I not have a functioning thyroid anymore, but I'm also severely deficient in Vitamin D and a whole host of other nutrients that help stabilize brain chemistry and make us happy, healthy people. It took a week but as soon as my body started working with the thyroid hormone replacement program I was put on, it was like waking up from a permanently bad dream and into the sunlight. I never would have known that every problem I was having was because a crucial part of my body had just stopped working. I thought I was just broken in general (which is different, you know?)

If you'd be open to telling us where you are, I'm sure we can recommend resources that you could try. I'm in SoCal and can point you to some great doctors and another therapist whose approach to depression and illness is much more logical than most therapists (IMO/IME). We've got your back. Let us know what we can do to help you move forward.

PS: Anti-depressants didn't work for me because the depression was a symptom of my hypothyroidism. I wonder if you're having the same issue. That's why a blood test might be the next step to take -- rule out any underlying causes so you can get off the Latuda and whatever else has been prescribed since that seems to be making things work.
posted by Hermione Granger at 10:01 PM on August 30, 2015 [4 favorites]

The old saying "this too shall pass" is the one I always come back to. Anything that can help you remember good times - a piece of jewelry you can carry with you, for example - means something you can touch to help you remember that things change. Your feelings sound perfectly reasonable for contextual feelings, given your feeling so disconnected from things you value.

It's probably worth seeing a non-psychiatric doctor and have tests done for anemia, thyroid issues and Vitamin D deficiency. (on preview, what HG said better) All 3 can cause depression that certainly won't get better with SSRIs. After that, the major things that help are exercise and for some, therapy or drugs. If you have any kind of regular exercise regimen that you're neglecting right now, find a way to get back into it, even if you need to ask for help to do so.

You have to get past the acute crisis. Remind yourself that it is an acute crisis, and will get easier with time, and schedule for a few weeks or a month from now a sit down meeting with yourself, where you make a plan for the specific things that are so difficult right now. Career research and examination of your options are good things to do then, and just remind yourself when you start worrying that you're going to have that meeting and figure it out then.
posted by freyley at 10:07 PM on August 30, 2015 [1 favorite]

Give the CBT a shot to help identify self-talk patterns and how you can influence you mindset. Continue to get out of the house and interact with people. I would love for you to find a volunteer opportunity that brings you a sense of purpose and accomplishment in making a kid's life better by reading to him, or some other volunteer work. As you encounter situations or people who are having a rougher time in life than you are right now--make a point of experiencing "gratitude" for the good things you have going for you that others may not be so lucky to have. Keep track of the things you are grateful for and continue to work with a therapist to whom you can relate the different times you have truly felt gratitude since seeing her at the last appt. this approach has lessened my feelings of despair and low self esteem. iANAD, I am just a guy sharing his anecdotal experiences. I wish you the very best. You have a great resource for support and information in askmefi--something other people may not have access to. You are lucky in that respect at least. So, go forth and help someone else while helping yourself in the process. I'm rooting for you!
posted by DB Cooper at 10:47 PM on August 30, 2015

I'm so sorry it's gotten this bad. You are in the real shit right now, the lowest of the low. As someone who has been there, I will say: it can get better. Yes, definitely.

I don't have an answer for you, but I will suggest that you give CBT a go — it's a very different form of therapy than you may be used to. I found that it was the only thing that gave me real, tangible tools for battling my depression. It helped me get back in the driver's seat, so to speak, and made it feel like I had some control over my experience.

It was tough at first. It challenged a lot of pretty fundamental ideas I had and brought into question some core identity pieces (primarily: that my emotional awareness meant that my interpretations of events were correct; that the perception I had about myself was right; that I 'just needed to do all the things to fix myself and I already know what those things are'). It can be kind of a mind-fuck!

You've got a tough road ahead; but it is a road and it does lead somewhere much better than where you are today.

Good luck and ) ) ) ) H U G S ( ( ( (
posted by wemayfreeze at 10:55 PM on August 30, 2015 [2 favorites]

Have you tried CBT before? If not, then as noted it might be worth a shot. It's not going to solve chemical issues, or issues involving medication, but it is a very solution oriented approach to therapy and is the only one that worked for me in the long term.

Agreeing that a full physical work-up is a good idea, if it hasn't already been done. And I assume you already don't use depressants-- alcohol, drugs, cigarettes-- because they all make it worse. Are you sleeping well? Do you do some regular exercise? Running and walking both boost the levels of happy in the bloodstream. They won't fix depression, but exercise can give you back some buffer. Make sure you are taking care of yourself as rigorously as possible right now. Go to sleep early and get a full night sleep. Eat well.

In your situation, I would think the day job would be a blessing in disguise. It gives you structure and gets you out of the house, and those are both things it sounds like you need more of and not less. From what you describe, it's hard to imagine a different career is going to fix the issue, so mostly it seems you need some balance of being not sad before you can figure out what makes you happy.

I'm sure you know this, but happiness is not rooted in career or goals or those kinds of big things, it's about the ability to enjoy the small things in life. The capacity for small pleasure is what gives you the buffer to handle things like day jobs. Fixing where you are in life will not fix your ability to be happy. Does this make sense? Do you any kind of mindfulness work as part of your therapy? I have used mindfulness together with walking as a way to get depression under control and to keep a little margin of calm.

It can get better, and it most likely will. Don't give up.
posted by frumiousb at 11:09 PM on August 30, 2015 [1 favorite]

Sort of related question - but have you had your thyroid tested? What are the numbers? Have you had a full blood panel, including vitamin D, iron and hormones?

Also - are you on hormonal birth control, like the pill? It can really mess with stuff and make it harder to get a leg up on depression.

The wrong kind of therapy can definitely make you spin your wheels and not get anywhere. Do you know what style of therapy they were using? The CBT therapist will probably help put a few things in a new light, which might be just the thing to start getting things turned around.

Which anti-depressants have you tried? Have they all been with the same psychiatrist? When you say that your insurance doesn't have any available, do you mean that there are no psychiatrists who will accept your insurance? Or something else? Can a friend or family member help figure out these logistics, or your primary care physician? Having a psychiatrist covered under your insurance is definitely something worth investigating.

Hugs. I've been there.
posted by barnone at 11:11 PM on August 30, 2015

I think the hardest part about moments like these is that you can't expect to change everything at once. While addressing/ruling out underlying medical issues, is there one thing you could focus on changing for the better?

For me, dedicating myself to doing something really basic daily, like getting some exercise or social interaction, or even just eating a healthy breakfast or taking a shower every day, helps me get a small win under my belt and helps me feel capable of taking on the bigger stuff. And that stuff will still take longer, but I personally have more patience for something like learning guitar if I can reflect on other recent life wins when I'm frustrated by my lack of progress. (That last part happens to everybody, by the way.)

Re: the job, it sounds like a big reason you don't like it is that you spend most of the time you have outside of work ruminating about how you don't like it. What if you could leave work at work and actually enjoy that extra few hours you get from not having a long commute to a 40+ hour job?

If that's something you can imagine working towards, identifying the negative self-talk that makes work out to be more than just a less-than-ideal thing you have to do four days a week and diverting it towards appreciating what you have and the next thing you want to accomplish could be an eventual goal. Working with a therapist is great but it's also something where you might be able to make progress on your own until you find one.

We are all pulling for you, best of luck!
posted by substars at 11:14 PM on August 30, 2015 [1 favorite]

To combine with the more general/long-term advice above, a few short-term suggestions based on my experience - maybe one of them will help a little bit.

* "Therapeutic use of sleep deprivation in depression" "Total sleep deprivation (TSD) for one whole night improves depressive symptoms in 40-60% of treatments." This is a weird idea, but read the paper for details. In other words: have you ever tried staying up all night and watching the sunrise with a bit of breakfast? Doing that occasionally, combined with trying to have adequate sleep most of the time, has sometimes brought me a day of lightened mood when other things didn't.

* Do you have a favorite role model who you find interesting and reasonable, such as a character from a book or movie, a historical figure, or a friend or family member? What if you try going to a quiet room, closing your eyes, and imagining having a conversation with that person about how you feel? For me, I have found a surprising amount of comfort at my lowest points by having an imaginary conversation with Spock and listening to his advice. Most people are good at mentally modeling other people - you can use this to your advantage.

* Do you have a favorite song that you can play a little bit louder than usual in your headphones to remind you of yourself, as a source of comfort? Sometimes for me it has been "This Year" by The Mountain Goats - about having a shitty year and getting through it anyway. Sometimes it's been a Kesha party-all-night song. It depends on your style.

I have been to a bunch of disappointing therapists too. I'm trying a new one who does CBT, combined with using this CBT diary app, and I'm hopeful for this. I am hopeful for yours too!
posted by mysh at 11:43 PM on August 30, 2015 [4 favorites]

Yes, please explain to me why all of your bullshit doctors and mental health professionals have not suggested getting tested for thyroid issues, vitamin deficiencies, and/or allergies?

Are you by any chance on hormonal birth control??

Apologies if these options have been examined, but I'm betting most/all have not been suggested and examined.

Stop wasting your time and money, search out more thorough practioners. Start with a thorough blood test and get copies So many doctors rely on the lab to tell them what the results mean, so find someone actually willing to evaluate your results.

Do not discount hormonal birth control, or even something non-obvious like a moldy apartment or work environment.

The answer is probably that simple, but outside the box for professionals only trained to look at one focused area of expertise.

Start googling and asking around. Your boyfriend is in grad school? GREAT! Does his university have a medical program? Because med students and residents love cases like yours.

Keep going. Don't give up!

I don't have much more, but Memail if you want. I may think of other possibilities down the road. Ovarian cysts come to mind as they effect hormone levels, which effect mood. List is long, but not endless. Keep seeking a solution.

And just get out into nature in the meantime!! Lots of studies about how walks, gardening, and outdoor exercise (including looking up at the sky, strangely enough) improve emotional wellbeing.

You keep going. Wellness is just around the corner for you. I guarantee it.

Meditation apps. Download one and use it 2x per day in the meantime. Don't like the first one? Try another! Keep trying those, it will enhance everything else going on.

Wanna know a secret?

While I am a BIG proponent of meditation apps with binaural beats (look it up) my fav short meditation is this clip on YouTube.

I promise THAT will put a smile on your face, even temporarily. Enjoy :)))
posted by jbenben at 11:55 PM on August 30, 2015 [6 favorites]

Make some lists. 3-5 per question. Do this for me, okay? But you have to write the answers out. No cheating by answering in your head. No arguing, no discounting possible answers. Just write.

1. People you have a connection with. (Doesn't matter how strong. This can be your boyfriend or a barista you see at the coffee shop.) Write down an interaction you had with this person that gave you a good feeling at the time.

2. Foods you like.

3. TV shows you want to watch, books you want to read, or albums you want to listen to.

4. Stupid things that please you unaccountably. Nothing is too small. (For example, I like puns, Cockney accents, and videos of dogs totally wiping out.)

5. Times you were at work and something good happened. If this is hard to answer, you really need to start bringing donuts to work.

6. Cute animals you have met.

7. Games that you have liked to play.

8. People you love.

9. Times that a friend or family member did something totally ridiculous.

10. The worst jokes you can come up with off the top of your head. NO QUITTING until you have answered the question. Dirty jokes, knock-knock jokes, and "that's what she said" acceptable.

Okay, finished? No? Answer the questions and come back, then.

The stuff you're describing in your AskMe? That's in your brain. You have a great brain, really top-of-the-line, it's obvious to me, but sometimes it lies. The answers to these questions are real. Now talk with someone you love, get some rest, and keep your appointments with your doctor. You'll break out of this ice. I've been there many times before, I've done it, and you can too.
posted by thetortoise at 12:01 AM on August 31, 2015 [15 favorites]

As per mysh's comment just above mine -- sleep apnea or sleep disturbances! Do you or your partner snore??

See. There's another possibility! For real, you need to get tenacious and figure this out. Likely it is a combo of things. Almost assuredly vitamin supplements will help...

Hey! When you try to donate blood, do they tell you no because you are Anemic? Anemia also has a profound effect on mood. Try Iron supplements that are ferrous fumerate. They are better absorbed than all other types of Iron. GNC makes the best one, the Vitamin Shoppe brand of women's ferrous fumerate + b vitamins is kinda crap.

Take a B complex and C vitamin. If nothing else. They can't hurt and will probably help. Also D. And Magnesium.

I could do this all day, so go ahead and get your meds (birth control?) plus a blood test and your diet evaluated, if nothing else.

Seriously. Don't wait. Best to you!
posted by jbenben at 12:04 AM on August 31, 2015

"I'm putting in so much effort at being alive and dragging myself to work every day and I'm just getting nowhere. I don't have the slightest clue how to fix this.Is there a way out of this?"

How much effort are you putting into living?

You have a medical condition that requires medication. Keep working with the doctor to find the perfect drug combination/dosage. You will get there eventually.

In the meantime, do two new things every day. One thing for you that you might enjoy and one thing for someone else. If you were heavy and trying to lose weight, you would have to have to do certain things and you would have days where you didn't do them right. If you were smoking and trying to quit, you would have certain things to do and you would have days where you didn't do them right. Treat your mental illness for what it is, a health issue that you need to address with proper medication and a little discipline. Work towards health and understand that there will be days where you don't do what you are supposed to do but you can try again tomorrow. Eat better, avoid all non-prescribed drugs, and don't drink. Exercise more. Keep trying. It will get better.
posted by myselfasme at 12:11 AM on August 31, 2015

I just slept out on the beach for two nights and watched multiple sunsets and moonrise + sunrises while the moon set.

Yep. Totally awesome and profound. 2.5 days of relentless pounding surf and wind only enhanced the overall catharsis. There was introspection and tears, also profound personal internal change.

Like I said, possibilities are endless. Lots of help is out there. Please please do not give up. There is SO MUCH beyond office life.

Uh.... Since you work an office job and hate it, what about working outdoors? At a state park or farmers market or botanical garden? Plenty of easy entry level gigs available, some with benefits, any would be better than a stuffy soul sucking office job.

Just a few more ideas...
posted by jbenben at 12:14 AM on August 31, 2015

Depression lies to you. It says that things are terrible and will never get better. Hold on to the promise that things will get better.

I'm a special snowflake when it comes to drugs. I've found it helpful psychologically (in terms of holding on to hope) to take a very active role in managing the drugs I take. It's also helped me with the depression: no one knows my body better than I do.

I know it's really hard. I'm sorry. Hang in there!
posted by persona au gratin at 2:26 AM on August 31, 2015 [2 favorites]

I was in a horrible place roughly a year ago. Reading the comments here, it was super easy to slip back into that brain place and negativity habit - for every decent suggestion someone has given, my brain can instantly come up with a really compelling reason why it couldn't possibly work for me. Lists of stuff I like? A cruel joke - I didn't like anything any more, plus being reminded of the fact that I couldn't feel pleasure set me off into a despair spiral.

One year on and I'm something resembling a functioning human (some bits are still missing, but this is the most whole the entire deal has been in a long time). Here are some of the things that happened:

I thought therapy was pointless, but I stuck with it and it actually helped. This turned out in part to be because I was deflecting every time we got close to some of the deep painful stuff, and my therapist called me out on it, and by the time we'd got to this point I was doing a bit better mood-wise and I was able to consciously try to stop deflecting and actually go a bit deeper than I was comfortable with. This changed my mental model of my therapist from "bullshit lady who makes me talk about my awful feelings" to "genuinely useful thinking partner". I could not have accelerated this process. The thing that made it work was going every week and giving it time.

I spent a lot of time ruminating on my own inner state, and would fixate on things which I was convinced would un-break me if only I could manage them. "I only feel like this because I [don't have any hobbies and can't enjoy myself any more]. If I could find [projects to work on/games I could stand/books I could actually read/crafts that didn't make me want to die], I'd probably feel better, but I can't because [anxiety/I would fail at them/I'm too stupid to read these days]". Or, "I wouldn't be depressed if I had [life goals/a plan], but I can't make meaningful progress in this area because [there's nothing I want/life goals are fatuous/I'm too depressed to come up with anything that isn't horrible]." I put huge amounts of stress and effort into trying to solve (read: ruminating endlessly and anxiously about) these problems, convinced that they were the key to me not being depressed any more. I had another episode earlier this year, and the exact same thing happened, and when I began to come out of both of them the stress around not having a plan/activities/whatever eased massively...because it had been the depression causing the anxiety, not the depression being caused by whatever I thought I was lacking. My lesson for next time, I assuming I can perceive reason, is to try to stress a lot less about this stuff, and recognise it as a symptom and not as the One True Cure if Only I Could Find It.

A bunch of super stressful stuff happened in my life. My dad was really sick for about a month, and then he died. Leaving my sister and I to look after his difficult, terminally-ill mother, who had no other relatives, who then also died and made us executors of her estate. I also changed jobs within my company, had minor surgery and a couple of hypomanic episodes mixed in among the depression. Basically, the last year has been a shitshow. But having external stressors meant I spent less time thinking about myself and how terrible my own situation was (I mean, don't get me wrong, I still did plenty of that) and worrying about other stuff. Do you have the ability to be a little bit more engaged at work? Enough so it pushes the balance towards "I am worrying about stuff that might happen at work" rather than "I am worrying about how much I hate work"? It's okay if that's not possible, but recovering from this shit is all about time, and having something else to focus on while the other stuff resolves itself can be useful and distracting. You'll still feel bad, just less bad about yourself some of the time, and more bad about other things. Handy.

I advocated for better medical care. This shit is hard. In my case, that was a bipolar evaluation - I've been through a string of GPs in the last few years due to being a student and then moving around some, and no one had really twigged that depression nearly every year for considerable periods of time + occasional self-reported elevated mood + elevated mood in response to the latest in a long line of SSRIs could add up to bipolar. I took a graph of my moods since 2001 (it was spiky) to a new GP, and only then did she hit the eval button. I also stopped taking Zoloft, which was fucking with me to an immense degree. Saw a new psychiatrist, bipolar diagnosis, tried lamotrigine but I got a rash, switched to lithium and it's...fine. Stabilising to some extent. I've still had some mood episodes while on it, but it's generally a force for evening-out.

So, my conclusion here is that the process of becoming less depressed is mostly about time and distraction, plus trying to get better care if that's an option. I also did some of the stuff that falls into the category of "things people who aren't depressed right now tell me might make me feel better" (going outside, low-level exercising, journalling, meditation), and I can't tell if they made a difference in the long term, hence not recommending them outright. They might have helped in the long run, but some of them made me feel crappier in the moment. You have my permission to channel whatever level of emotional energy you have into getting through the day (and, ideally, seeking better medical care if you can - I bet that feels impossible too, but it doesn't have to be), and not into aspirational feeling-better activities if you can't handle them.

Happy to talk on memail if that would be useful.
posted by terretu at 2:51 AM on August 31, 2015 [7 favorites]

This is pretty much how I felt before I got diagnosed with thyroid issues -- angry all the time for no reason, stressed, tired, overwhelmed, sleeping badly, hair falling out. In my case it was hyper, not hypo, but both sides are bad. Hyperthyroidism is really common in women in their 20s and 30s.

Seriously, go see a GP now and get tested for that (and all the other things suggested above). Tell them about any medical symptoms you have as well (weight gain, weight loss, difficulty swallowing, tremor, anything even if it seems unrelated).
posted by pie ninja at 5:14 AM on August 31, 2015

A few issues for me to comment on here: If your thyroid numbers are low, but acceptable, many doctors will look solely at the 'acceptable' part and ignore everything else, including a textbook list of every single symptom. I strongly suspect the 'book' on thyroid will be re-written soon. (well, in like the next 20 years, anyway...) but if your thyroid might be an issue, you will likely have to self advocate like crazy. Finding a doctor recommended by a thyroid community seems to be the fastest way to get an acceptable doctor, knowledgeable about what seems to be a genuine issue/gap in the 'general med school doctor knowledge'

Get everything tested! A family member had terrible B12 and B14 (I think) and shots of those largely cleared up some issues.

Depression lies. Depression tells you EVERYTHING IS RUINED FOREVER! And since it sounds like your own voice, coming from your own head... we tend to believe it. But the pit of depression is NOT bottomless, and you CAN escape it. Taking tiny steps seems like you make no progress, but you really do. As pointless and hopeless any steps seem, you are in fact making progress. And you keep climbing, and climbing, and one day, after ignoring the depression lies, you look around and see that you aren't at the bottom of the pit, that there is light, and fresher air, and maybe, just maybe, something really good ahead.

I think you are doing better than you suspect, even as hard as it is :)
posted by Jacen at 7:25 AM on August 31, 2015 [2 favorites]

freyley: "It's probably worth seeing a non-psychiatric doctor and have tests done for anemia, thyroid issues and Vitamin D deficiency."

I had no particularly outstandingly low values in my blood tests (I'm mildly anemic and mildly low on vitamin D), but I started taking a daily multivitamin and it was like NIGHT AND DAY. My mood, my sleep, my energy all improved within a week. Still taking antidepressants, but now they're helping at least.

Intellicare is a suite of apps that helps with depression and mood disorders. I've found them middling-useful ... not magic, but helpful in getting me off the couch and feeling a bit better. They help me get some forward momentum going.
posted by Eyebrows McGee at 7:26 AM on August 31, 2015

I would encourage you to check out free therapy online (here's one option). I don't have a ton of experience with it but it was helpful to just vent to a person. I found myself wanting to vent to people in my life and that made me feel badly so being able to vent to someone else was nice, plus a different perspective is useful.

One of the big things I've done over the last few years is work to identify my feelings and why they are what they are. It's hard with certain feelings, especially frustration, but being able to name the feeling and the reason for it helps me create some distance from the feeling. It's easier for me to talk myself down when I can say to myself, hey, it's not okay to be mean to your husband because you're grouchy that a guy on the bus was rude. Then I can say, "sorry husband, a guy on the bus was rude, I need some space for a few so I can chill out."

Similarly, I frequently tell myself when facing difficult feelings that they're just feelings and feelings change. Depression makes me catastrophize ("a guy was rude on the bus, everyone is going to be mean forever!!") so taking a step back and saying, this bad feeling is temporary makes it more tolerable. It makes me feel less like a helpless passenger on the hell ride my brain is taking me on.

Part of your question that stood out to me was "every day is a waste." I get that but that's the depression talking. When I'm in a really bad place, I try to tell myself that living another day is a win because that means depression didn't win.

I think part of the reason that you spend a lot of time dreading work is because you don't have a lot to look forward to outside of work. Can you try to meet people who share your interests on Meetup? What are you interested in? What if you made a list of eight things that you've always wanted to learn more about and dedicate a week to learning about each thing? If you get to the end of the week and think, I'm no longer interested in that thing, then you're done but if you want to keep pursuing it, go ahead.

I know it's hard. I really do. But the fact that you asked this question means that you're not ready to give up and you're not hopeless. You know how they say that when you lose something, it's always the last place where you look? The solution to your particular problems is hiding in the last place where you'll look. So keep looking!
posted by kat518 at 9:31 AM on August 31, 2015 [1 favorite]

Strongly nthing "get everything checked." Women, in particular, get handed antidepressants and told "you're depressed!" in response to very real physical problems, because women are crazy amirite?! Misogyny in medicine is a thing. So insist on getting absolutely everything physical checked - thyroid, iron levels, complete blood count, even test for autoimmune illnesses (common in women) if you think you have one.

You mentioned sleep problems in your past questions - have those been looked at? When I got a CPAP for my apnea, it was like a whole new world opened up. Like that scene in The Wizard of Oz where it goes from black and white to color, seriously! I was not depressed, just severely sleep-deprived. You may not have apnea but you may have something else that is interfering with a restful night's sleep, so get a sleep test.

For depression meds, have you tried Wellbutrin? People who don't respond well to SSRI's often respond to Wellbutrin, it doesn't cause weight gain, and it can help with energy and fatigue issues.

It can be hard to advocate for oneself at the doctor's, I know. I find it helps to carry a notebook or tablet, and have questions and concerns written down in advance, so I don't forget anything. It also helps to use clear, specific language, such as "I can sleep for 10 hours and still feel tired," "I'm finding it very difficult to hold down a job because of X, Y, and Z," etc. rather than vague subjective issues such as "I'm tired all the time, I hate my job," etc. Good luck! I hope you can get things sorted out soon.
posted by Rosie M. Banks at 10:05 AM on August 31, 2015 [1 favorite]

Thank you so much for your kind words, everyone.

In the past I've tried everything I can come up with health-wise... My last psychiatrist had me on Liothyronine (among other stuff) a couple years ago and there wasn't a noticeable difference. I took a sleep test a couple years ago and was on stimulants for a long time, now my insurance doesn't cover them. I had blood tests done back when I was seeing a ton of doctors (~1.5-2 years ago) but nothing came of it. I just got a second Mirena put in but I've been feeling like this since before I had the first one. This shit is just in my family.

I'm hesitant to look for doctors because my insurance is pretty bad and I've noticed there isn't much available where I am (St. Louis) at least in terms of psychiatry that has openings available. I've just been paying out of pocket for psychiatry and therapy. Luckily my new CBT guy will accept my insurance but I've read some of Feeling Good and I can't get through it, I just don't think that's going to be a thing that helps me.

This sounds dumb but I just really really don't want to write or draw or anything. That's what my problem is, I just can't look at or deal with anything I'm doing. I don't know how to describe it.
posted by sarahj at 10:38 AM on August 31, 2015

forgot to add. I've been trying to work out but it just feels pointless since i don't even want to be existing at all. but i'm trying to keep up with doing stuff even though it's not helping. i don't drink much but my therapist thought an occasional drink would help me socially. my psychiatrist just gave me a prescription for ativan to take when i get frustrated and stressed out and tantrum-y but it just turns it into endless crying.
posted by sarahj at 10:49 AM on August 31, 2015

Man, I'm sorry to hear you're feeling like this. Are you an animal person? If you are, I'd really suggest looking up volunteer opportunities at animal shelters. (Actually, you said you're in St. Louis, so here you go). There's something about being around those little buds that can really help with depression (scientifically and anecdotally confirmed). Their unadulterated joy and appreciation for small things (running around, sniffin' butts) and the fact that they have no clue about the bullshit we have to deal with is incredibly reassuring. It seems like you've found some other activities pointless, but this one definitely isn't. They love and want kind human contact, and spending any time with them at all is no waste in their mind. Doing this might also help you develop a social network outside of your boyfriend's friends.

I'd also like to add that pointlessness is A-OK. A lot of things we do in life are totally pointless but there's nothing wrong with that. We fill our days with pointless things and have glimmers of meaning every once in a while. Some months, those glimmers are rarer than others, sometimes they come in retrospect, but they're there amidst all the noise. So don't worry about activities being pointless, that's totally okay if they are. I really hope that things get better for you - keep us updated on the regs with how you're doing.
posted by thebots at 12:03 PM on August 31, 2015

FWIW "Feeling Good" left me cold. Having someone work through that same basic stuff with me in person and with a sympathetic ear to my specific situation was a very different experience.
posted by wemayfreeze at 12:52 PM on August 31, 2015 [1 favorite]

When I was very unhappy for a very long time, long ago, I began therapy to fix me. I had wonderful CBT with an exceptional psychologist for 18 months, and was no better, albeit feeling heard, affirmed and directed. I finally suggested that since I was following all suggestions and getting nowhere, I be treated for depression. My psychologist sent me to a colleague, a psychopharmacologist, who started me on two very specific-to-my-situation psych meds, and six weeks later, all I'd been learning in CBT started working for me...because I wasn't blocked, anymore, from growing from what I was learning by BEING DEPRESSED!

Over the years I've had to start new psych medications when careless/ignorant docs or insurance companies changed my meds or wouldn't cover the brand, and a generic didn't work, or what I was on just gradually ceased working. Meanwhile, I also became hyperthyroid, then later hypothyroid, finally got regulated, and years into treatment, had to fight for a thyroid dose level that my dr. was sure was way too high and I was sure was too low because I felt like I did when I was hypothyroid...I was right.

My last deep depressive episode I ended up with a neurologist/psychiatrist who kept impeccable records of everything he changed about my treatment, as well as doing repetitive mood/behavioral testing each time I visited to see if I objectively (not subjectively) was doing any better with any single change he had made. He started out adding calcium...sounded nuts to me, being off all anti-depressants and deeply depressed. The next visit my testing showed my mood was elevated by 50%, just with the calcium. Then he started me on a low-level anti-dep and gradually raised the dose, until my tests showed I was in a good place. He was thorough, regularly testing my thyroid and various other labs as well as taking a very detailed personal as well as familial medical and psych history.
I say all this to say that-1)likely the best treatment provider you'll ever have is still in your future 2)that no one ever can or will advocate for you better than you, no one can know you like you, and no one will/can ever throw themselves into finding a solution better than you. 4) that detail -oriented arrogant know-it-all overly trained docs who are total nerds, who live, eat and breathe their specialties and are determined to solve the problem you bring to them, are the ones you are looking for.
posted by mumstheword at 8:17 PM on August 31, 2015 [1 favorite]

Do you know if the blood tests you did a while ago covered all the things people have mentioned? Sometimes just one standard thyroid test gets ordered, and it doesn't necessarily tell the whole story (to put it mildly); vit D might not get looked at at all. It is really worth doing again, if you can. Maybe some of the shit you think comes from your family has an alternative explanation.

Agree with you, and everyone else - it is so hard to stand up for yourself against medical indifference or incompetence, or just to find the energy to deal with delays and roadblocks in a wonky system. It's hard enough to do that when the main problem isn't a thing that primarily involves demoralization.

Do you have anyone willing to talk to you after an unhelpful appointment, help you think through next steps and your overall healthcare strategy, and encourage you to stay on track with it? I'll tell you now that I'm not sure I'd have had the juice for a(nother) round of knocking on doors if it weren't for having a couple of good people in my corner. Is your boyfriend up for offering that kind of support? (If you don't know - have you asked him to?) Or do you have a friend who you think would be there for you, if you reached out?

If you're on your own that way, definitely look for online support, to start with.

Jacen's idea is great - following that, here's a list of docs (some endocrinologists, some general practitioners) in your area (first Google result, am sure there are others).

(Sleep deprivation can improve mood temporarily, and I've also experienced the kind of mild euphoria mysh talked about, but I think it might not be the best approach if you do have long-standing sleep issues [it can aggravate circadian rhythm disorders, if that applies].)
posted by cotton dress sock at 10:01 PM on August 31, 2015

Have you read the webcomic or book called Hyperbole and a Half? Her depictions of depression were so comforting to me. Just seeing some of my own thought processes externalized made me realize that I was in the thick of things.

Ask your boyfriend to sit on the couch with you, not facing you. Or sit on the back porch, facing out to the night. Or go for a nice drive together. Tell him that you're at a breaking point and need specific help to get a plan of action.
- tell him that you want to make a doctor's appointment but need help figuring the steps
- make a list with him of all the things you want to tell your doctor. Specifically ask for your TSH (thyroid stimulating hormone, which comes from your pituitary gland), T4 (one of the thyroid hormones itself), Vitamin D, Iron, full CBC blood panel, and anything else that you think might be helpful.
- have him help you call the doctor. Maybe he calls for you, or just sits there while you do it. Say you're not feeling like yourself and it's a very urgent situation. Hopefully they will help fit you in.
- Make a list of all the medications you've tried. Or call your previous doctor and have them send over the files. You can skip this if you don't feel like it but it will save time and energy.
- I think you should print out and bring in this thread. You can black-out certain parts if you don't want them reading. But they need to see how you're feeling.
- Start there, and come and report back here.

Let me just say that I felt exactly the same, and now I don't. It was a trial to get here, but I look back at that time as "in the dark tunnel" and I only knew how awful it was until I wasn't there anymore.

Please come back in a week or two and let us know how things are going.
posted by barnone at 11:11 PM on August 31, 2015 [4 favorites]

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