Mixed depressions, I got a broken piece, can I return it?
May 8, 2017 7:54 PM Subscribe
Constant mixed agitated depressions with fluctuations in energy, mood over weeks. I'm on medication, see a psychiatrist and yet it doesn't feel right. We've been changing meds because the depressions won't go away. And now I feel like I'm so broken and defective that even the meds that used to work won't work anymore. It sucks. Why isn't there a return policy on the brains?
It sucks. I'm sorry for the whining that's going to ensue. I've had depression for a number of years. Sometimes its better, sometimes not, but it always comes back. Lately, it has been more like mixed agitated depression, some psychotic features where I've sensed dark floating energies above and behind my neck (sounds crazy but well). I have always had periods of time where I'm either super productive for a while, very effective, or shutting down and overwhelmed, anxious, fearful of something bad happening. Those are the only two states of existence lately.
My psychiatrist recently tried Abilify, which I guess helped with the agitation restlessness etc., but I couldn't tolerate it due to side effects. She was insistent on continuing it but I really didn't want it, so she's trying lithium now in addition to my antidepressant. Argh.
Seems like I must be making all the symptoms and thoughts in my mind, but I am not, but it doesn't make sense otherwise what I'm feeling? I wish I could make sense of my thoughts but I'm unable to. I just want to feel better, not have this constant uncertainty about whether my mind is making things up, that its broken.
I seem to be completely capable of rational thought, work (I'm a scientist for what its worth), and continue my everyday research, writing papers, running experiments, but there's a whole another universe unraveling in my head. I'm not able to process all this rationally. Its eating me up that my one brain, is all I've got, and its damaged, its broken, and incapable of healing back to how it was. I've got this illness that I can't seem to get rid of or heal from.
Its a slow death march - if I stay on the medications, the side effects will likely get me, if I go off of medications, the depressions will get me, and even with the medications, its a slow gradual march toward progressively worse misery. I just want an out, but I can't seem to find a way out where I can breathe - I just want to breathe deeply without the guilt or burden or misery. Yes, I've tried a number of things (DBT, CBT, Meditation, this, that etc. but lately nothing seems to be working :-| any thoughts or pointers from those who've been here before?
It sucks. I'm sorry for the whining that's going to ensue. I've had depression for a number of years. Sometimes its better, sometimes not, but it always comes back. Lately, it has been more like mixed agitated depression, some psychotic features where I've sensed dark floating energies above and behind my neck (sounds crazy but well). I have always had periods of time where I'm either super productive for a while, very effective, or shutting down and overwhelmed, anxious, fearful of something bad happening. Those are the only two states of existence lately.
My psychiatrist recently tried Abilify, which I guess helped with the agitation restlessness etc., but I couldn't tolerate it due to side effects. She was insistent on continuing it but I really didn't want it, so she's trying lithium now in addition to my antidepressant. Argh.
Seems like I must be making all the symptoms and thoughts in my mind, but I am not, but it doesn't make sense otherwise what I'm feeling? I wish I could make sense of my thoughts but I'm unable to. I just want to feel better, not have this constant uncertainty about whether my mind is making things up, that its broken.
I seem to be completely capable of rational thought, work (I'm a scientist for what its worth), and continue my everyday research, writing papers, running experiments, but there's a whole another universe unraveling in my head. I'm not able to process all this rationally. Its eating me up that my one brain, is all I've got, and its damaged, its broken, and incapable of healing back to how it was. I've got this illness that I can't seem to get rid of or heal from.
Its a slow death march - if I stay on the medications, the side effects will likely get me, if I go off of medications, the depressions will get me, and even with the medications, its a slow gradual march toward progressively worse misery. I just want an out, but I can't seem to find a way out where I can breathe - I just want to breathe deeply without the guilt or burden or misery. Yes, I've tried a number of things (DBT, CBT, Meditation, this, that etc. but lately nothing seems to be working :-| any thoughts or pointers from those who've been here before?
Lamictal was personally beneficial for me with minimal side effects and it's indicated for bipolar depression, which is the diagnosis I'm guessing your doctor is running with based on the prescription of lithium and abilify. Have you only ever been on SSRI'S before this? Asking because it's important to be aware that they can cause agitation, mood cycling, and mixed episodes in those who have something other than MDD.
posted by wilywabbit at 9:18 PM on May 8, 2017 [2 favorites]
posted by wilywabbit at 9:18 PM on May 8, 2017 [2 favorites]
Build your team or reinforce it. Who do you have working with you on all of this? Is it just you and your psychiatrist right now? You're dealing with something complex and really hard; you deserve and need a group of people to help you.
A therapist or counselor who you can talk to more often than you do your psychiatrist could really help, especially with tracking patterns, habits, and progress on things that you (totally understandably) have trouble seeing in yourself. Depending on their style they can also help you wrangle and communicate with the rest of your team.
A small group of friends who know about a lot of what you're dealing with and can provide accommodations and distractions as needed are invaluable. I have this mostly online, but that doesn't lessen their impact. Have you dropped a lot of your social stuff because of your depression? Spend some of your energy on reconnecting with trusted people, ask them to help you push yourself to do things that bring you pleasure, rather than just work stuff. Of course depression does that shitty thing where things we used to love feel empty now, but if you can remember things that made you happy in the past you can try revisiting them, just to help reform good habits of self care. Start small, just check in with one person, but one person can be invaluable.
Assuming you have a GP, set up an office visit to talk about your lifestyle and other health stuff as it pertains to the meds you're on. Be sure your psychiatrist and GP have the same information on you, and a way to communicate with each other. Mental health is physical health, you know? Our brains are organs but also depression can cause physical changes that change the depression in turn, like vitamin deficiencies, blood pressure problems, insomnia, the list goes on. Having a doctor who communicates with the people helping with your mental state is invaluable.
A community group you can become a part of will help bring you outside of yourself and give you lots of small things to feel good about when you remember them. If you're religious, you have a lot of easy options to try. But there are so many things that don't involve religion that can give the same benefits, like any local neighborhood group, art or culture clubs, animal shelters, library volunteers, intramural sports teams, knitting circles, large board game or larping groups, environmental cleanup teams. Really anything where you can show up, contribute with your presence, and generally exist among other people without spilling your inner life onto them. This can help so much! Grounding you, giving you things to schedule that aren't work, and pulling you back into the world.
I totally understand how this feels hopeless and grim, but remember, a huge part of that is the depression lying to you. That's how it often works and it's awful but treatable. You need other people who understand what you're working against to tell you the truth and give you perspective. And you need to take steps to join the world and be among lots of different people so you can find hope and goals along the way. Things to fight *for* instead of *against*. You deserve them!
posted by Mizu at 9:52 PM on May 8, 2017 [6 favorites]
A therapist or counselor who you can talk to more often than you do your psychiatrist could really help, especially with tracking patterns, habits, and progress on things that you (totally understandably) have trouble seeing in yourself. Depending on their style they can also help you wrangle and communicate with the rest of your team.
A small group of friends who know about a lot of what you're dealing with and can provide accommodations and distractions as needed are invaluable. I have this mostly online, but that doesn't lessen their impact. Have you dropped a lot of your social stuff because of your depression? Spend some of your energy on reconnecting with trusted people, ask them to help you push yourself to do things that bring you pleasure, rather than just work stuff. Of course depression does that shitty thing where things we used to love feel empty now, but if you can remember things that made you happy in the past you can try revisiting them, just to help reform good habits of self care. Start small, just check in with one person, but one person can be invaluable.
Assuming you have a GP, set up an office visit to talk about your lifestyle and other health stuff as it pertains to the meds you're on. Be sure your psychiatrist and GP have the same information on you, and a way to communicate with each other. Mental health is physical health, you know? Our brains are organs but also depression can cause physical changes that change the depression in turn, like vitamin deficiencies, blood pressure problems, insomnia, the list goes on. Having a doctor who communicates with the people helping with your mental state is invaluable.
A community group you can become a part of will help bring you outside of yourself and give you lots of small things to feel good about when you remember them. If you're religious, you have a lot of easy options to try. But there are so many things that don't involve religion that can give the same benefits, like any local neighborhood group, art or culture clubs, animal shelters, library volunteers, intramural sports teams, knitting circles, large board game or larping groups, environmental cleanup teams. Really anything where you can show up, contribute with your presence, and generally exist among other people without spilling your inner life onto them. This can help so much! Grounding you, giving you things to schedule that aren't work, and pulling you back into the world.
I totally understand how this feels hopeless and grim, but remember, a huge part of that is the depression lying to you. That's how it often works and it's awful but treatable. You need other people who understand what you're working against to tell you the truth and give you perspective. And you need to take steps to join the world and be among lots of different people so you can find hope and goals along the way. Things to fight *for* instead of *against*. You deserve them!
posted by Mizu at 9:52 PM on May 8, 2017 [6 favorites]
There's no need to feel bad about sharing your troubles, or to feel like you're whining! Ask is here so that we can share our problems with others.
I wish I could say that finding the right depression medication wasn't a series of shots in the dark, but I can't. And even if you find the right ones, bodies are subject to change and they may not stay the right medications for ever. And even if you find the perfect practitioners, you may outgrow each other or be separated by changing insurance policies.
Just know that while you're out there fighting the good fight and finding the things that work for you, you have friends here at MetaFilter who have gone through similar experiences and are rooting for you.
posted by The Underpants Monster at 11:43 PM on May 8, 2017 [2 favorites]
I wish I could say that finding the right depression medication wasn't a series of shots in the dark, but I can't. And even if you find the right ones, bodies are subject to change and they may not stay the right medications for ever. And even if you find the perfect practitioners, you may outgrow each other or be separated by changing insurance policies.
Just know that while you're out there fighting the good fight and finding the things that work for you, you have friends here at MetaFilter who have gone through similar experiences and are rooting for you.
posted by The Underpants Monster at 11:43 PM on May 8, 2017 [2 favorites]
1. Try to tone down the judgments.
2. Self-soothe.
I hear you on the uncertainty of whether your mind is making things up. I am absolutely certain that my mind makes things up, I know how to deal with it, and STILL it is very annoying. I have accepted that this is how it is, to some extent; I had better get used to these weird thoughts and learn how to live with them.
Right now you are feeling terrible about your mental state and the fact that your brain is "broken." So, you may not be able to do anything about the broken brain, but you CAN do something about your reaction to it. It sounds like your reaction to this is judging it, and perhaps making up stories about what this will mean for your future. Maybe one little judgment (brain is broken, I will NEVER be good enough) was just enough to pry open the floodgates and now you're in a Doom Spiral. It's not BAD to judge yourself, it is very natural to do so, but it is not a good way to make yourself feel better. And it is just adding totally unnecessary suffering.
So. You are in the midst of this worst-case scenario Doom Spiral thinking, so what you need to do is very patiently, nurture yourself, as you would a crying child. (would you yell at a crying child that they are broken and will never be the same? No you wouldn't!) Just Netflix, eat chocolate, pet your cat, take naps, take a bath, or whatever it takes to sooth your nerves. I promise you will be much more up to facing these issues when you are feeling more emotionally stable.
posted by shalom at 11:51 PM on May 8, 2017 [4 favorites]
2. Self-soothe.
I hear you on the uncertainty of whether your mind is making things up. I am absolutely certain that my mind makes things up, I know how to deal with it, and STILL it is very annoying. I have accepted that this is how it is, to some extent; I had better get used to these weird thoughts and learn how to live with them.
Right now you are feeling terrible about your mental state and the fact that your brain is "broken." So, you may not be able to do anything about the broken brain, but you CAN do something about your reaction to it. It sounds like your reaction to this is judging it, and perhaps making up stories about what this will mean for your future. Maybe one little judgment (brain is broken, I will NEVER be good enough) was just enough to pry open the floodgates and now you're in a Doom Spiral. It's not BAD to judge yourself, it is very natural to do so, but it is not a good way to make yourself feel better. And it is just adding totally unnecessary suffering.
So. You are in the midst of this worst-case scenario Doom Spiral thinking, so what you need to do is very patiently, nurture yourself, as you would a crying child. (would you yell at a crying child that they are broken and will never be the same? No you wouldn't!) Just Netflix, eat chocolate, pet your cat, take naps, take a bath, or whatever it takes to sooth your nerves. I promise you will be much more up to facing these issues when you are feeling more emotionally stable.
posted by shalom at 11:51 PM on May 8, 2017 [4 favorites]
Your worries remind me a lot of my own and my intrusive ocd. Right down to feeling constantly broken. Before my OCD diagnosis, CBT made it worse as I became obsessed with the idea that if I thought the right things I'd be able to behave properly, feel properly and fix myself. I read a ton about treating pure ocd and dealing with intrusive thoughts and my thoughts upset me less than they used to. You may not have OCD like me, but if you're dealing with comorbid issues, they can be hard to untangle.
I switched to Latuda after the side effects of Abilify became too much to deal with. I don't have manic episodes and I also switch from productive to anxious, overwhelmed and depressed. It's so important to have a psychiatrist I trust to listen to me and make informed choices. If you don't trust your psychiatrist, get a second opinion.
But yes, it sucks. It's not fair, but is any chronic illness fair? I'm working on accepting my own broken self and muddling along the best I can. So what if I'm broken? Even broken people have value and deserve love. And remembering that, personally, helps me a lot more than the positive messages I've been told.
Take care of yourself and practice self care. I'm another person rooting for you.
posted by SometimesChartreuse at 3:38 AM on May 9, 2017 [3 favorites]
I switched to Latuda after the side effects of Abilify became too much to deal with. I don't have manic episodes and I also switch from productive to anxious, overwhelmed and depressed. It's so important to have a psychiatrist I trust to listen to me and make informed choices. If you don't trust your psychiatrist, get a second opinion.
But yes, it sucks. It's not fair, but is any chronic illness fair? I'm working on accepting my own broken self and muddling along the best I can. So what if I'm broken? Even broken people have value and deserve love. And remembering that, personally, helps me a lot more than the positive messages I've been told.
Take care of yourself and practice self care. I'm another person rooting for you.
posted by SometimesChartreuse at 3:38 AM on May 9, 2017 [3 favorites]
Stop saying this: "its a slow gradual march toward progressively worse misery."
It's not true. It's more of an aimless stroll through a varied landscape of misery, joy, fear, love, blah blah blah, all of them. Handle it like a girl scout: be prepared. Whatever you run up on, learn the knots and the woodcraft that will help you progress and survive in that landscape.
I've known people for whom lithium worked well, who could be productive on it, made beautiful, beautiful things, were simply lovely, my favorite person. (Okay, it was one dude. Boy did I love that guy, though. He played piano beautifully and was the life of parties. Weathered hideous woe, still kept plugging on. When he was just in a gray coat all the time, in one cold, gray room in Brooklyn, he'd still let you in and you could sit in the cold and look at all the books around and he'd lie in bed and talk to you and eventually if he could you'd go somewhere for a bagel and if he couldn't, you were still happy to have come. He will always be my inspiration for depressionsurvival, no matter what befalls him, for the beauty with which he dealt with it for the years I knew him.)
I know someone else who was never medicated. His depression... just lifted after he hit late middle age. It either drifted away entirely or lessened so much that it didn't impede him anymore. Which is remarkable because he was beset by it for years and it wrecked relationship after relationship and ruined his worklife for a couple decades. Looking back over his life, he didn't do so poorly. He floundered for a long time but then ended up in a perfect-fit job and had in the aggregate a productive worklife and many friends. He was a teacher and a good one, nearly universally beloved by his students. He didn't do so badly, taken all together.
You're not headed someplace. None of us is. You're wandering and running up on things. The things will not all be bad.
posted by Don Pepino at 9:42 AM on May 9, 2017 [2 favorites]
It's not true. It's more of an aimless stroll through a varied landscape of misery, joy, fear, love, blah blah blah, all of them. Handle it like a girl scout: be prepared. Whatever you run up on, learn the knots and the woodcraft that will help you progress and survive in that landscape.
I've known people for whom lithium worked well, who could be productive on it, made beautiful, beautiful things, were simply lovely, my favorite person. (Okay, it was one dude. Boy did I love that guy, though. He played piano beautifully and was the life of parties. Weathered hideous woe, still kept plugging on. When he was just in a gray coat all the time, in one cold, gray room in Brooklyn, he'd still let you in and you could sit in the cold and look at all the books around and he'd lie in bed and talk to you and eventually if he could you'd go somewhere for a bagel and if he couldn't, you were still happy to have come. He will always be my inspiration for depressionsurvival, no matter what befalls him, for the beauty with which he dealt with it for the years I knew him.)
I know someone else who was never medicated. His depression... just lifted after he hit late middle age. It either drifted away entirely or lessened so much that it didn't impede him anymore. Which is remarkable because he was beset by it for years and it wrecked relationship after relationship and ruined his worklife for a couple decades. Looking back over his life, he didn't do so poorly. He floundered for a long time but then ended up in a perfect-fit job and had in the aggregate a productive worklife and many friends. He was a teacher and a good one, nearly universally beloved by his students. He didn't do so badly, taken all together.
You're not headed someplace. None of us is. You're wandering and running up on things. The things will not all be bad.
posted by Don Pepino at 9:42 AM on May 9, 2017 [2 favorites]
This thread is closed to new comments.
You've tried CBT, but it didn't work? that might be a factor of your therapist more than the modality.
My suggestion would be to find a therapist (CBT) that works closely with a psychiatrist who may be able to better manage the meds, the combination of therapy and meds will lead you out of this.
This is NOT a hopeless situation, deep breaths, you'll get through this.
posted by HuronBob at 8:08 PM on May 8, 2017 [1 favorite]