Wednesday, November 14, 2012

All in the mind.

Pic unrelated; I just wanted to show off
what an amazing pumpkin carver I am.
One of my grandmother's favorite platitudes when I was a little kid was "it's all in the mind."  Cut yourself? You shouldn't feel bad, because "pain is all in the mind."  Hunger, heat, cold, fear, social rejection, and all kinds of assorted suffering were, to my grandmother, "all in the mind."

I'm sure that processing things that way gave her great strength, and she's lived through a hell of a lot, so I don't begrudge her the fact that that's kind of a jerk thing to say to a crying six-year-old.

But here's how I process things: yeah, technically very true Grandma, suffering is all in the mind.  But the mind is where I live!



So I've been away for a while.  I've been sick.  Sick all in the mind.

Long story short, I've been mildly depressed for a long time, in the last month I had a full-on major depressive episode, I went to a doctor, now I'm on antidepressants and feeling much better.

Long story slightly longer--the horrible Catch-22 of depression is that it makes you hate yourself, but you have to have tremendous faith in yourself to seek treatment for depression.

Because what you have to do, basically, is make a doctor's appointment for "I have sad feelings." And shit, I have enough mental blocks against complaining about anything to the doctor.  I get all "probably it's nothing, why waste money and look like a hypochondriac" when I am actively bleeding.  Making an appointment for my sad widdle feelings, at the same time as the depression was filling my brain with "NOBODY CARES ABOUT YOUR STUPID PROBLEMS"... that was tough.*

Tough, and worth it.  Because the doctor didn't say "you called a doctor for feelings?".  He said "I'm glad you came here.  I know it's difficult."**  He wrote me a prescription for Wellbutrin*** and a referral for therapy.

It's a week later, I haven't even been to my first therapy appointment yet, and oh my God do I feel better.  Chemically better, but still with a lot of recovery to do in the getting-life-and-thinking-unscrambled department.  Which is okay.  It took the chemicals for me to even realize that these were two separate issues.  Damn those are some good chemicals.



The real take-home lesson here, besides "oh my god the Pervocracy is back, I thought Cliff had fallen into the sun or something," is that when you feel bad and you don't know quite why, it's all in your head.

And your head is very real and the most important part of you.  Take care of your head!  A feeling doesn't have to be somehow proven "real" before you're allowed to acknowledge it.  Feelings are real.   (That's not a warmfuzzy affirmation.  That's neurophysiology.)  Finding the causes and solutions for suffering that's "all in your head" is as important--as real a need--as bandaging a wound.



Cosmocking next!  Oh how I have missed the Cosmocking.



*Rowdy helped a lot.  When I needed a push to get help, he was there pushing.  Thanks, Rowdy.  I love you big.  I love you robot servant army.

**I have a pretty good doctor. I realize some are "you're just complaining, it's normal to feel down sometimes" jerks about depression.  If you get one, please remember that the problem is located in the doctor, not in you.  A good doctor might make a different prescription/diagnosis decision than you expected, but if the doctor brushes you off without seriously investigating your symptoms, try and get a second opinion.

***Sex on Wellbutrin?  DAAAMN.  (That's a good daaamn.  Or more specifically, a "oh my god, I think I just tore a hole in the mattress, or possibly in space-time itself" daaamn.)  Hell of a side effect. 

117 comments:

  1. I normally don't comment on your posts, but I read all of them and I've been missing you. Thanks for the update and welcome back! As someone who has to do regular "mind maintenance", I appreciate how difficult it is and I'm glad you're not giving up. :)

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  2. Oh wow! I've missed your posts, and have been hoping you didn't fall into the sun. I'm glad you're back, and that you're getting the help you need. I know it's hard to ask for!!

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  3. I kept looking for you to pop up in my feed reader. I have depression too, and always start to slip towards a major episode around the holidays. It's HARD AS SHIT. GOod on you for getting help. Hang in there.

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  4. Having read this blog for years, I actually was a little worried about you when you hadn't updated lately.

    I'm glad to know that you didn't fall into the sun and that you are out getting help for your depression. It is hard, but you seem to have a good support system. And you have plenty of fans who want the best for you, albeit from afar.

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  5. I don't usually comment but I'm glad you're looking after yourself. You are badass and deserve kindness, both from yourself and others. Props to Rowdy and your doctor for being kind to you when you couldn't.

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  6. I'm glad to read that you're doing better. :)

    Also, the timing of this article couldn't be more on point. At least in relation to my life. And these little pushes, whether through friends or anonymous internet strangers, are always good (even if I'm not quite to the point of scheduling an appointment...one step closer is a good thing). So thank you for that as well.

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    1. I hope you can do it. *hugs* Making that appointment is scary as hell, but so incredibly worth it.

      I actually planned in advance the day I was going to call, then told Rowdy to check in with me on that day and make sure I'd done it. Having accountability to someone else helped.

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    2. I have to do that to make any appointment. Dog needs his shots? Someone help me remember to make the appointment!

      And it's weird, because I need all kinds of prodding to get on the phone and set these things up, but once the appointment is made, I don't even have to really think about keeping it. I just automatically end up remembering and going.

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  7. Thank you for writing about this. A few months ago I started feeling depressed and didn't recognize it immediately for what it was. But, like your other post said, once I snapped out of my malaise and realized that I was actually-for-real depressed it put me in a place where I could get help for myself.

    I'm glad that you're feeling better, because you're awesome and so is your blog. Thanks Cliffy P.

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  8. I'm so glad that you did what you needed to do to thrive. I'll try to remember your words the next time I need to make a decision about self-maintenance. In the meantime, welcome back!

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  9. Glad you're getting better! Also, congratulations on the getting wormholed in bed ^_^.

    I just got diagnosed with ADD today, and I'm going to start medication and therapy soon. I wouldn't have gotten to where I am now without my own pushy partner.

    That is just to say, thanks for writing about your brainshit, Cliff. It helps me feel better about my own future.

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    1. If you're being diagnosed as an adult, you probably already have a few coping mechanisms in place. Unless you turn out to have a Ridiculously Stimulant-Hating Body like mine (I got desensitized to meds obscenely quickly and was constantly pushed from drug to drug), this should help you a LOT.

      One caveat: In my experience, Ritalin/Adderal/Strattera are great for when you need to narrow your focus on one particular thing at a time, but the "mental tunnel vision" that gives you isn't all that good for creative pursuits. It really is more helpful in some situations than others. I never took Concerta, but I took damn near everything else (in quantity: at one point in elementary school, I weighed 50 lb. and was taking 45 mg of Ritalin per DAY before the docs switched me over to Adderall).

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    2. I actually don't have that many coping mechanisms (unless you count going on the internet instead of doing schoolwork as a coping mechanism), because I'm naturally intelligent enough that I rocketed through most of my schooling until junior year of college. I do not have ways to make myself focus or to get myself to do work. That's why I so enthusiastically included "therapy" in that third sentence there.

      Concerta actually is Ritalin as far as I can tell (both are methylphenidate), and HOLY DAMN that's a lot of stimulants. I will probably welcome a little mental tunnel vision, because at this point I would rather my thoughts be very large, shiny stars than stars that I can't fathom into constellations. I'm a teacher and a chemist, so I don't depend on creative pursuits in my daily life.

      Thanks for sharing your experiences, Laura! The more stories I get from people, the better.

      P.S.: I scored really high in inattentiveness measures, but not in hyperactivity/impulsivity. What's your stuff?

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    3. My partner was diagnosed with ADD at age 35 and says the meds have made a huge difference. He is doing better at work and feels more comfortable in social situations because he follows conversations better. Good luck :)

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    4. Aunolin: I was high in both. And...oh dear. Let me guess: intellectually gifted, never had to work for grades in your life, and now suddenly you have to study and don't know what to do? Been there, done that--even though I was medicated from age 5 to age 22!

      Like I said, I took damn near everything. Ritalin and Adderall were basically the same story twice: I got so desensitized to one that I was taking enough meds to choke a horse, then got switched to the other. Dextroamphetamine (which was only on the market for a short time in '93 IIRC) I couldn't keep down at all. And my body got so quickly desensitized to Strattera that after the first month, it did NOTHING. My body hates medication and likes to keep it from working, apparently.

      I quit cold-turkey because when I went off my parents' insurance (pre-Obamacare), the cost of the medication was no longer worth the benefits (especially in places that don't supply the generic). I was lucky enough that I'd managed to cope reasonably well without it by that point, so I just never bothered to get put back on.

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    5. Beth: Thanks! Good to know meds helped your partner.

      Laura: Yeesh, dat hyperactivity-impulsivity :^\. Sorry meds don't work for you, and I'm glad living with ADHD is working out for you. In what manner are you employed?

      And yeah, I've never had to work for grades, but the concern here is more that I won't be licensed as a teacher (my intended career) because I'm terrible at planning and finishing work demands that involve lots of writing, than that I will get low grades. I can't imagine what my life would be like if I actually cared about grades gratia grades, or if I had struggled with the math and non-writing parts of some of the last 17 years.

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    6. I was dagnosed ADHD-inattentive in elementary school, tried Strattera briefly, and when it didn't work I tried to manage on my own until I started college. I'm on Ritalin now, and I really don't get people who say school only got hard in college; lots of tests are so much easier for me than lots of homework, because I can just sit down and do them without worrying about how to start or forgetting where I left the instructions.

      Once I started talking to other ADHD people, I found out a lot of what I thought was just how people work is actually coping mechanisms. For example, a lot of us have great memories and are really good at figuring things out because we're too impatient to write important stuff down or pay attention to instructions. Do you think doing the planning parts with a voice recorder and then writing it down might help you?

      I haven't had problems with Ritalin and creativity. In fact, what happens to me is that I can choose how much energy/focus I devote to something, instead of being stuck between hyperfocus on things I'm interested in and complete boredom with anything I'm not. It makes the "boring" parts of art like lining a sketch or proofreading a story less tedious.

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  10. Today I was training a psychiatric service dog puppy in the mall and ran into an outright asshole who said "But there's nothing wrong with you." Said to a woman who suffers extreme PTSD, General Anxiety Disorder among sundry other issues.

    Not only is it in your head but others can't see it! That doesn't mean it's not there, and that doesn't mean it isn't real and debilitating.

    Also, hooray for working drugs! I'm glad to hear you've found something that is working for you. It can be a real struggle sometimes to find the right drug.

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  11. Realizing that those feelings that were "just in my mind" were real and had huge consequences was the biggest step that I took in order to help treat my OCD, which I didn't even realize I had until then! Therapy is fucking awesome, man. I'm glad that you're feeling better, I've missed your blog tremendously!

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  12. I'm glad you pointed out the fact that being depressed in and of itself makes it harder to seek help. When things are good it's easy to think that if I start feeling bad, I'll just go see the doctor, but it goes downhill fast and there's not a lot of insight going on in the depths of it.

    My experience with Wellbutrin was that it made my chronic migraines much, much worse. But I could see how increased blood flow to the genitals resulting in good times and increased blood flow to the vessels in the brain resulting in bad times could even be the same side effect.

    I'm off meds entirely for the first time in 15 years because I'm pregnant now. My mood has been surprisingly good but I'm concerned what's going to happen after. I'm very committed to breast-feeding, but if I get depressed enough that I can't take care of myself or the baby, I'll have to quit and go back on medication.

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    1. Yep, that catch-22 is very real. My mom had been telling me - and I believed her, I truly did - that I was depressed and needed to see a doctor, and it still took me over a year to do so.

      Having also just gone off meds due to a pregnancy/birth - good luck. I will say that it wasn't as bad as I'd feared - according to my midwife, the hormones associated with pregnancy, birth, and breastfeeding can sometimes override the chemicals that cause depression, so some clinically depressed women actually feel better emotionally after giving birth.

      That said, postpartum depression is no joke. Make sure you have a support structure and that they understand it's ok if you occasionally have to hand the baby off so you can go cry in the corner. It's normal, it's sometimes necessary, and it does not make you a bad mom.

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    2. Congratulations on your pregnancy, anonymous. Breastfeeding is awesome and I hope it goes well for you. If you haven't found it already, can I recommend Kellymom.com as an evidence-based resource for breastfeeding info and advice. They have a section about breastfeeding while on medication, including antidepressants, that you might find useful. Good luck!

      (Apologies for going off topic somewhat)

      Good to see you back, Cliff.

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    3. I recommend Thomas Hale's Medications and Mother's Milk. Last I heard (caveat: not a medical professional, me) Wellbutrin appears to be safe (unless mother or baby has a seizure disorder) -- relatively low levels appear in the milk.

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    4. Anon: I am a midwife and have an interest in and better than average knowledge of perinatal mood disorders. You do NOT need to stop breastfeeding while on anti depressants. Repeat after me: YOU DO NOT NEED TO STOP BREASTFEEDING WHILE ON ANTI DEPRESSANTS.

      That is all.

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    5. Doesn't it depend on the antidepressant? Some are okay, some aren't, I thought?

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    6. Thanks for all the concern/advice. I realize I didn't clarify that I'm bipolar. While in my past it has been a lot more common for me to be depressed than manic, neither state is safe, especially with a newborn in my care, and mania is a lot more common when on an antidepressant without a mood stabilizer. According to my doctor, there are antidepressants approved for breast feeding mothers, including the one I was on prior to the pregnancy, but less research has been done on mood stabilizers and so far none that have been tested have been deemed safe.

      The situation with the father is tricky. We'll have to take a paternity test when the baby comes because I was raped within a week of the condom breaking with my then-boyfriend. If my ex is the father, we both want him to be involved with the child, but if my rapist is the father, it changes that for us. At any rate, I moved back in with my mother for emotional and financial support. Really it's better for me to be with her after the baby comes anyway since she's known me my whole life and has seen me go through ups and downs and can act as a voice of reason if things are getting bad and I'm feeling like too much of a failure to want to get help.

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  13. I'm glad that you're feeling well enough to blog again! And well in general, not just because of the blog. I feel kind of funny about the "all in your head thing" because it's true but people act like things being in your head makes them invalid. As a sciencey nerd, I'm just like NEWSFLASH guys, EVERYTHING IS IN YOUR HEAD. (insert Dumbledore quote).
    I have been off my meds since February, and I'm starting to regret it, but there's not much I can do now. But just reading about you feeling better makes me feel a little better.

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  14. I worry about the same thing happening to me, going from mild to major depression. I tend to cycle between mild depression and "normal". During the short times I go through the mild depression phase, jack shit gets done. Then when I cycle back to normal, I'm stressed because shit hasn't got done, and the time between depressive cycles becomes shorter. It doesn't help working 12 days out of 2 weeks, and working for 40+ hours, as there is little down time to reorganize my thinking. Damn, I really want some fucking time off work.

    What tends to snap me out of being depressed is having something that HAS to be done. Having family over for T-day? Have to get my ass in gear, to clean and set things up. (SO cooks, which is a good thing, because I despise cooking, especially for large groups of people.) Have to purchase presents for Xmas? Cyber Monday is coming, so better have a list of things that need to be purchased. Bday coming around? Have to organize things so I can take time off, before I start offing annoying coworkers.

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    1. See, the "something HAS to be done" is terrible for Depressed!Cliff, because then I get to thinking "oh God I really have to do this thing and I'm not, this is a bigger failure than usual, I am the biggest failure" and then I've simultaneously screwed up my life and my head even worse than usual. :/

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    2. :( Yeah I get that too. It seems for those of us who have depression, somehing kicks us in the ass, and helps us get out of it. It shouldn't be a problem (but too often it is) that sometimes that help needs to be drugs and/or therapy.

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  15. Yay for Everyone Going to Therapy! I have an appointment this week, just for stress and emotional self-control, but the lovely Captain Awkward drilled the idea that "therapy should not have a stigma, everyone should go at some point in their lives just to talk things over" into my head. I'm so glad she did. And I'm glad that you got out there and did it! Taking care of oneself is good. :)

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  16. I'm glad to hear your brain drugs are working! Also that they don't have the unfortunate side effect that my antidepressants did- Prozac sometimes causes anorgasmia. it once took me two hours to get off and part of my hand was literally numb for three days. ;_;

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  17. Hello! I've been thinking this for a while and this seems like a good place to put it. Don't worry about when you put up posts. A. You have a life outside the internet and we understand that. B. When your posts are rare, I freak out when there's a new one. I savory it, and reread the new post and old posts. It's like pomegranates. They only pop up in the fall, and every fall, I flip and eat them like crazy, so that it's okay that I don't have them for the rest of the year. C. When you post more often, it's only better. It's pomegranates in the Spring.
    I'm glad you're taking care of yourself. I'm sorry your grandmother invalidated you like that.
    We readers are here because we love what you do. We'll be here when you can be here. <3

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  18. ... I think, all possible variations of "glad you're back" are done. Also hooray for chemical treatment of pesky neurological embuggerances. Did the same, got the same result (up to weird libido-related side effects).
    It is the best available thing. Until nano-brain-reconstruction and cyborgification, that is.

    ... yeah, I missed the cosmocking too.

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  19. I'm curious how much you think the wellbutrin alone helped and how much Rowdy pushing you helped? I've tried about every type of anti-depressant and Wellbutrin was the only thing that approached help, but I suspect it's the total lack of emotional support in my life that makes the drug a band-aid over the bullet hole.

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    1. It was about 90% the Wellbutrin. Rowdy is wonderful, but he has limited access to my neurochemistry.

      Which isn't to say it's all neurochemistry. I don't think (in my case at least) it's a band-aid over a bullet hole; I'd rather think of it as a source of energy to address social/cognitive/life issues. It doesn't fix those things on its own, but it does help me be able to work on them.

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    2. For me, one thing I noticed about antidepressants is that even though I was on them, I still felt feelings. If something in my life was legitimately making me sad, or stressed, or worried, or angry, well, I still felt that. But what the drugs did was a) stop my brain from feeling those things when it wasn't warranted, and b) kept those negative feelings from spiraling out of control and making me feel helpless to address the causes.

      So if it's a band-aid over a bullethole, it's a *necessary* band-aid - one that can keep you from bleeding out while you work on removing the bullet.

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    3. Years ago, a friend of mine described antidepressants as not getting rid of the feelings that made her want to cry, but making it possible for her to get through her day without needing to cry, so she could function. And as Cliff says, the being able to function helps to make the depression back off a bit, so it becomes a helpful cycle instead of the vicious cycle of depression.

      Here's hoping you get some of that emotional support you need.

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    4. @Mary: At least you felt feelings. My depression tends to be the numb, head-full-of-cotton kind where you'd give anything to feel any emotion, even the less-pleasant ones, and feel like even more of a horrible failure because you can't even feel things, like some sort of robot or sub-human freak.

      It's also why angry metal in the morning helps me. Because then I feel angry, and feeling angry is much better than feeling empty. And then I get angry at all the shit I've left undone, and I'm like "FUCK YOU, I'M'A TAKE CARE OF YOU!" and then Shit Gets Done.

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  20. "That's not a warmfuzzy affirmation. That's neurophysiology!" -- Cliff, this sentence is precisely why I love you. (Also, I'm borrowing this.)

    Go you for seeking help. I know firsthand how hard it is. And thank you for being brave enough to share your experiences here. I hope things continue to improve for you!

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  21. Good luck!


    Yeah, feelings... both for depression type things and for stuff where somebody is claiming that their feelings are important and yours are not and you don't even KNOW...

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  22. Paul Ingraham, a skeptic I follow because he writes well and knowledgeably about chronic pain research, has said (more or less) that chronic pain is often largely "all in your head", but that doesn't mean we have control over it, because your head doesn't really listen to you all that well about these things.

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    1. Chronic pain is 100% in your head. It may be coming from bodily signals, but those signals don't turn into the experience of pain until they get to your head.

      Where precisely the pain originates is important to treatment, but not to determining the reality (or, like, moral culpability) of the pain experience.

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  23. Your pumpkin carving skills are up there! *points up*

    I went through something similar. In my case, the meds helped me yank myself out of my depression cave, but I still had this reluctance with the psychotherapist, like you described. What helped me then was to accept feelings-are-real-neurophysiliogy-you-know and started to work out (cardio, run around, swim, whatever), because this is also one way to up your serotonine levels. Granted, I could never have done that right from the beginning; that's where medication really helped. Also, I am still recovering, so please don't think I am preaching from the high pulpit of hah!-I-did-it! Also, friends and loved ones are great. All the best to you!

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  24. Bupropion does have some serious advantages to regular SSRIs as far as possible side effects. I have it as a complement to my citalopram, to avoid falling asleep everywhere and having no sex drive, and it does help.

    What I found relieving with medication was that if chemistry could make me feel less useless and hopeless, the problem wasn't that I was a bad person, just someone with a physical/chemical disadvantage. It made me feel like less of a whiny failure.

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  25. I was one of those weird people whose depression isn't helped by antidepressant medication.

    Not because seratonin isn't doing Bad Things in my head, but because it made me feel that much more helpless for my emotional state to be at the mercy of a tiny little pill. After all, Daddy fought in Vietnam and saw all kinds of shit there, and he's still normal, right? I should be able to just suck it up and Deal With It, right?

    Yeah, that was horrible for me. I tried to self-medicate with Korn (which really only sounds good when you're depressed) and forced outings in the sun.

    Then I was diagnosed with PMDD and put on the Pill. And wouldn't you know it, my depression turned out to be hormonal. But somehow, I don't get that horrible, impotent feeling this way. Instead, I feel like, "These pills are awesome! They keep my period from being unbearably bad! And as the icing on the cake, my depression doesn't get bad anymore and I don't have to worry about unwanted pregnancy! FUCK YES!!"

    I'm not sure why it's less "dehumanizing" for me to have my depression cured as an unintended side-effect of a medication, than for me to have my depression cured as the main intended effect of a medication. But it's affordable and makes my weird, dysfunctional little brain happy, and that's all I really care about.

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    1. I find it amazing, not necessarily in a good way, how big an effect a tiny little pill can have on us.

      For me, I took hormonal birth control and it made me want to kill myself. The physical effects alone were bad enough, but I also had the feeling that I wasn't in control of my body, that my body was betraying my by doing these awful, miserable things every month.

      And then I stopped taking the pills because of the migraines, snapped out of the depression within two or three days[*], and I'm still dealing with the 'I could have died' feelings.

      [*] I am absolutely not saying that depression is something you can snap out of. I was lucky enough to have a distinct hormonal trigger that was easily removed from my brain chemistry.

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    2. Please don't take this the wrong way, but yay! someone else whose depression is helped/cured by birth control. I've had the side eye and a fair amount of dismissal when I've spoken about this before, as if it wasn't proper depression, which of course hasn't helped my depression any.

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    3. Yeah, I have to be on both anti-depressants for my depression AND the pill for PMDD. Otherwise I will be sad all the time and SUPER SAD AND ALSO ANGRY for two weeks out of the month.

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    4. I got angry on my period. Like, violent urges, pissed at people for saying hello to me angry. (A small part of my mind would be going, "F off is not a rational response to hello" but a much larger part would say "Why is this @#$@$!#^ talking to me?")

      Then I got put on the Pill and like magic I was no longer having to remove myself from all human company once a month. I don't know what it's like to be depressed, but I remember just having this feelings for nogoddamn reason and it was so nice that I could finally make them stop! Hormones are a huge factor in mood.

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    5. Anon 1: The Pill certainly isn't for everybody! Some people have nasty side-effects, no matter what brand of pill they take. Sounds like you're one of them. :( At least you're ok now.

      Also, as a formerly-suicidal type, I get the "Holy balls, I could have offed myself" feeling sometimes. I choose to let it remind me that I didn't realize then that I'd have the wonderful relationships I do now, and that I'm still learning about everything that's out there--good AND bad. :)

      Anon 2: Since chronic depression is nearly always chemical anyway, I think that's a pretty shitty attitude for people to have. Lactose intolerance and allergies are chemical, but nobody acts like they're not a real problem for people just because of that.

      I think this is just another case of people being confused about the difference between clinical depression and just Feeling Really Sad. Everyone's felt really sad sometimes, but it's a lot easier to recover from "my dog died last month, and I'm grieving" than it is to get over the chemical kind without help.

      Beth and Anon 3: Anger happened, but it was mostly the HOLYSHITFUCKINGDOLPHINS, PAIN!! and the dizziness that I had to deal with. Here's to PMDD symptoms being gone, and good riddance! :D

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  26. I was depressed years ago due to a situation that was entirely outside of my own physiology. It got better immediately once I got out of the situation that was causing my depression, but it still took years before I really felt I'd left it behind, and the scars it left on my psyche are certainly still there. Although I managed to recover without meds or therapy, I now wish I'd had the knowledge, support and opportunity to at least get the therapy.

    I'm glad you're feeling better, Cliff. And thanks for this wonderful post - it often seems to me that a significant portion of the cure for depression is being able to acknowledge that it's a legitimate health problem that often requires outside assistance to overcome.

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  27. Cliff, I'm so glad to hear that you are getting help and starting to feel better! Depression is a terrible disease, and can even be fatal.

    Telling people with depression that it is "all in the mind" and that they should "just snap out of it" is as delusional and anti-scientific as telling someone the same things about cancer or tuberculosis or any other disease.

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  28. Good for you. I live with chronic depression, and going to get treatment was one of the hardest things I've ever done. Even knowing I needed to, I might not have actually gone without the active support of my partner.

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  29. My husband also suffers from major depression, and while it's manageable on meds, it took hitting rock bottom for us to get him to a doctor and get help. As one of my friends said, the problem with depression is that by its very nature it makes you believe there's no point in asking for help because nothing matters and things could never improve. As my other friends say, Depression is a fucking liar. So glad you got help and you got a doctor who doesn't suck.

    We were lucky in that the doctors and therapists we sought out 6 years ago were all great too. Though I will never forget calling the first therapist's office to try and schedule an appointment for him, letting him know it was for major depression and anxiety. "Since your husband is the patient we need to talk to him to make the appointment." "His anxiety is so bad, HE CAN'T TALK TO A STRANGER ON THE PHONE," I told her. (I understand, there are regulations and HIPPA and stuff, but it still makes me look heavenwards and shake my head when I think of that call.)

    Hugs to Rowdy too. It's very hard to watch someone you love suffer like that.

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  30. I'm so glad you got some treatment - I have so been there, with the depression and the minimizing of the depression and the whole thing. I wish you the very very best. I want to echo whoever said that your first (and really only) obligation is to take care of yourself, so please don't feel bad in any way if you write or don't write on a schedule that works for you.

    Also, amazing pumpkin.

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  31. I don't comment often, but I did miss reading your posts. I'm very glad you're feeling better. It's good that you managed to find a nice doctor. So many of them can be real jerks about mental problems. I remember wellbutrin working very well for me when I was depressed. As you said, it makes sex better. Heads up: it also lowered my appetite (which was good for me because I was eating emotionally, but may not be good for you).
    Can't wait for some new cosmocking :)

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  32. HUGS!!! Good for you for getting help and even better for sharing with all of us. I had trouble with depression that started a few years ago. I finally got meds, but at the time I thought it was for the anxiety I was experiencing that had started to become a real problem (I started having panic attacks). It wasn't until things started to get better in my life, and I came off the medication that I realized how depressed I had actually been. I was too stuborn to go to therapy at the time, but wished I had recognized the depression for what it was. I was not fortunate enough to have someone else in my life recognize it either.

    Welcome back! I'm looking forward to reading your next post!

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  33. Good to see that you're back, and that you're getting treated for that. Depression sucks.

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  34. Good for you! Sending happy, healthy vibes your way. :)

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  35. Depression's pretty horrible. I'm glad you've sought out and received effective treatment.

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  36. You are amazing for getting out to get yourself the help that you needed, but you are even more amazing for talking about it so as to show people that depression and mental health issues are things that are important too. They are a part of your body, a part of you being, and a part of your sex/intimate life, and they shouldn't be dismissed.

    So, thank you for being amazing.. and yes, you were missed!

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  37. Always makes me smile to see you pop up in my feedreader, and that only goes double for when it's been awhile. Take whatever breaks you need, we'll all be here when you get back. :)

    Now, on a separate note-- isn't wellbutrin AWESOME? I know a lot of people who HAVENT done well on it, and even for me it hasn't been perfect (at the higher doses, it makes me less depressed but more physically anxious, so I have to take two meds to balance things), but damn it's the best thing I've been on. That whole "may take two weeks to feel better" thing that comes standard with antidepressants is out the window with something that instantly ups your energy levels. It still took time for me to get my brain completely sorted, of course, but when you've been a sad blob of a depressed person, suddenly having ENERGY is amazing. Also, the sex drive. DAMN. :P

    Anyhow, glad to hear from you again. Best of luck with the brain meds and such.

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  38. This post couldn't have been more timely. I've been on a major depressive crash - self harm, suicidal thoughts, the whole deal - and have been extremely hesitant to see a doctor about it because of everything you've outlined above.

    So I guess I should probably get on that.

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    1. Dear Anon,

      Get the number for a psychiatrist tomorrow by 3pm; make the call (like your comment) at 3:36pm? I find having schedules or people to check in with can help.

      I can offer internet fistbumps as a reward, if that'll help?

      Delete
    2. Ditto. I think I'm supposed to check in with my doctor sometime next week? The clinic send me a text the day before my appointments... If I get dead from this, I won't feel like this any more, but I also wouldn't get to hang out with my awesome friends and boyfriends who keep encouraging me (and they wouldn't get to hang out with me, which they assure me that they like doing and that's why they keep doing it, and I'm making effort to Believe Their Words), so I should also put my foot down and refuse to leave the clinic until they've actually changed something about how I'm cared for.

      Maybe a moral support companion would be a good idea? Just to tell me 'no, don't just 'yes dear' your way out of the door before telling the doctor that things are bad?

      Delete
    3. This comment has been removed by the author.

      Delete
    4. Original anon here, I appreciate the comments. I had classes today so I didn't make any appointments or anything, but I think I will probably make an appointment with my family doctor for a referral. Otherwise I have no idea how to go about this, besides calling this one local mental health resource number and I just hate phones so much so that is probably not going to happen.

      I don't usually have a problem talking once I'm /in/ therapy, it's just the getting there - and getting someone who isn't a total asshat - that's the difficult part.

      I'm on an upswing right now so that should make seeking help a little easier (as long as I do it fast enough that I don't convince myself the problems are all gone forever this time)

      Delete
  39. As a corollary: if taking pills makes you feel better, it is still actually you actually feeling actually better. Saying Wellbutrin etc. doesn't count because it's chemicals overlooks that it's all chemicals.

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    1. And the other thing I wanted to say, perhaps tangentially relevant but if I don't I'm going to fucking forget it again: I've started -- even in the blog I get paid for -- to say "flare" rather than "episode" for mental illness, to emphasize that they are illnesses. If my Crohn's can flare, so can my almost-certainly-anxiety.

      Delete
  40. I went on Wellbutrin for anxiety. Didn't help a whole lot, but no way am I going off it. Sex drive! Orgasms! I'm staying on it til my husband is too old to give a fuck. It's even better at a higher dose, but that gives me a raging case of ADHD.

    I'm also getting therapy. Therapy with good therapist is awesome. I recommend using some of that energy to seek one out, because they're hard to find.

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  41. So glad you're feeling better and are back to posting! So not glad that your brain has been giving you troubles :-(

    I hope that you continue to feel better -- I have missed you.

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  42. I'm very glad you haven't fallen into the sun and that you're doing better. I guess having actual medical training helps ignore stupid shit people say about mental illness, at least you know they're talking out of their asses. Anyway, best of luck with everything and have some e-heart-shaped-chocolate-cookies and hugs if you like!
    A.

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  43. Great to see you back. I'd love to give you hugs, y'know, if that's OK and everything.



    You found some good-side-effecty chemicals? Wow! Keep enjoying them then!

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  44. I wasn't so lucky with that for a side effect when I tried Wellbutrin. It just made me edgy and insomniac'ed. I'm now on Prozac finally for my depression and, while it's made my already weak libido nearly non-existent, it's a price I'm glad to pay. I'm not the same woman I was last year thanks to it.

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  45. That is a pretty badass pumpkin. Wish it was still around. Transient pumpkins.

    *high five* on getting yourself on the road to recovery.

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  46. I'm so glad you're back and feeling better. Thanks for this post; it really hit close to home. I've been trying to find the right medicine combination for over a year now and I just got on Wellbutrin! We'll see if it works. At least my sex drive is starting to come back after SSRIs killed it.

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  47. I'm really glad that you're feeling better! Getting on the road to recovery is really tough. Keep it up, you can do it! Because random anonymous words of encouragement mean so much, I'm sure. lol. I'm really, really happy that you've posted this, I was worried about you because you didn't post for a while.

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  48. This is so stupid, but as a fan of your blog: I'm so glad you and Rowdy didn't break up. I know you don't need to be with someone to be happy and that all relationships end sooner or later, but I like you guys together and I was worried the absence/depression came from you guys breaking up.
    In the words of Tumblr: I ship you two so hard.

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    1. Why do so many people say all relationships end? Forgive me, but aside from death, many relationships are lifelong. Its a choice, commitment, chemistry, whatever. That other viewpoint to me is so....depressing.

      Delete
    2. This^ is a different anonymous, from Detroit. Cliff....t hank you for your wellbutrin experience, had no idea a med existed that did not kill libido. I'm trying to get thru mine rite now with no meds. Had an experience in the past with severe anemia brought on by heavy periods for about 6 -8 yrs also.It caused severe depression.

      Delete
  49. "the horrible Catch-22 of depression is that it makes you hate yourself, but you have to have tremendous faith in yourself to seek treatment for depression."
    Oh man I hear you. I do not think I would have even considered seeing a doctor if my mom had not insisted on it. Pretty stupid in retrospect, since I was not sleeping or eating at the time :\ I mean, obvs something was wrong, why was I being so dense about it?

    Anyway, good luck to you.

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    1. Other people can definitely be better at noticing problems than you are yourself. I've been getting migraines at a slowly-increasing rate for the past 4-5 months, and if my boyfriend hadn't said something about how unusually-often they were happening, I wouldn't have noticed how bad it was. (Taking an Excedrin a day because you flare up at least that often =/= normal. I hadn't even noticed I was doing this until he said something.)

      I've found a neurologist who's covered by my insurance, and I made the appt for the soonest time I could. It'll still be a couple of weeks before the consultation, but at least I've gotten the ball rolling, and that in and of itself feels good.

      Delete
  50. Glad to have you back : ) Happier still that you're feeling better. My Mom calls it, "better living through chemistry," and it's something I wish people were less angsty about embracing.

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  51. Wonderful news, welcome back! Great post too.

    My personal favorite is when people say that psych drugs are "just a crutch." I had a broken ankle once, and boy howdy were crutches the best things ever. It simply would not have healed otherwise, nor would I have been able to function in the world. Somehow people are OK with that when your body needs an ACTUAL crutch...

    flightless

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    Replies
    1. It's even sadder because a literal crutch is something you need to use for a while, then stop using once you recover.

      You don't just suddenly not-have depression when you take your meds. If you stop, it comes back. So recovery isn't permanent.

      It's more like insulin injections for a diabetic, really. Sure they're annoying and expensive, but if you stop taking them...bad things happen.

      Delete
    2. Yeah, I kind of view antidepressants as something to help you function -while you get help for your depression-, much as pain meds can be there to help you function while you heal from surgery. They aren't the cure, they're something to keep you going until you're cured. Or at least mostly so. It's not a perfect similie :P

      Delete
    3. Some people do use crutches long-term.

      I think a crutch is also a good metaphor because the crutch alone won't make you walk. You still have to put in plenty of effort; but the crutch is the outside assistance that makes it possible to make that effort.

      Delete
  52. Jibblies, I think my sex drive is pretty normal on Wellbutrin. Assuming it's not "more libido" then I'm a bit jealous. But normal is fine compared to the SSRI I was on first -- no libido, and no ability to orgasm.

    Glad you're all medicated up and starting to feel better.

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  53. (Long-time lurker, first-time commenter!)

    I can very much associate with the part about depression making it harder to seek help for depression.

    When I'm depressed, my phone phobia (which is bad enough as it is) only further decreases, and the general coherence of my speech becomes much worse. (Curiously, I can still communicate quite coherently in writing, because my brain's weird like that.) And not only that, but I become more self-conscious about these communication issues.

    Naturally, the only way to contact mental health providers-- even crisis lines!-- is by phone. *facepalm*

    Thankfully I've had friends available via instant message during my worst moments. Because honestly, if they hadn't been there? I'm not sure what I would have done.

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    1. I completely relate to this - and have a resource that might be helpful to you or others should they ever find themselves in crisis.

      imalive.org - a chat based crisis line.

      Delete
  54. Seeing a lot of female perspective here wondering if other males on anti-depressants can weigh in. My husband's don't affect his desire/drive to have sex but can make it VERY difficult for him to actually reach orgasm. A male friend of ours confirmed he has the same side effects.

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    1. I'm a guy on anti-depressants; as far as I can tell, they haven't made much change in my libido at all.

      Then again, I'm trans, so *shrug*

      --Rogan

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  55. I'd just like to say, hooray, you're back! We missed you! Internet hugs :D

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  56. Hey, good to hear you're okay, I was starting to wonder.

    And yeah, I hear you. I've been going through some rough times myself. (Though it's exacerbated by a knee injury forbidding me much mobility, roommate issues which I have trouble avoiding because of lack of mobility, and the holidays.)

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  57. I've never commented on your blog before, although I became a regular reader at the summer of this year. I have spent an embarrassing number of hours plowing through the archives and I was always glad to see a new post.

    I am so sorry to hear that you have been going through this. Depression is so debilitating and it's even worse when you're trying to hide it--something just seems off, even when you're laughing and putting on a brave face. It helps to get help and surround yourself with compassionate people.

    Your blog actually has helped to get me out of my own depressive spells. They can be cyclical, but your blog helped keep that in check. Your compassion, intelligence, unbelievable humor and beautiful insight helped me more than I can explain in words.

    Thank you, and I hope you get better soon.

    -Ro

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  58. It's good to hear from you again, Cliff. I'm so happy to hear that you're taking care of yourself and starting to feel better again. Depression is a bitch.

    I have a related problem of being shy of seeing a doctor for things. I have chronic fatigue and am just starting to own up that something must be properly wrong with me (after a year of friends telling me it wasn't right that I had to leave parties at 9 or earlier to get to bed). Going to a doctor just to complain that I'm TIIIRED seemed kinda trivial. Having friends in your corner really helps, so I'm glad to hear you have people on Team You helping out.

    The pumpkin is awesome, and I look forward to the next Cosmocking! Your posts brighten my day.

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  59. I'm so glad you're feeling better. :) This happened to me very recently, I'm 3 weeks into medication and I think it's starting to work. For the first week I felt much worse, which can happen sometimes apparently, so I'm glad yours didn't have that effect.

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  60. Good to hear you're feeling better.

    And that is a fucking awesome pumpkin. *jealous of your skills*

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  61. Well timed. Gonna call the doc now.

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  62. As others said: we missed you! so glad you're back! (my boyfriend and I have been checking on your website at irregular intervals to see if you were back :) )

    *Excellent* post, well written as always, and I'm VERY glad you have good support from Rowdy and you got yourself to a good doctor. Oh, the side-effects of the Wellbutrin sound pretty awesome too :)


    and I missed Cosmocking too.

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  63. Congratulations on making it over that wall. No, that's not sarcasm. It really is something to celebrate when you can push past your fear and sadness and feelings of low worth to reach out to a system that you worry might belittle you further. I've met and worked with people that truely believed that chemical imballances were a matter of positive or negative thinking. Somewhere along the line they decided that the only thing that happens in a person's brain are thoughts. Somehow, it ceases to be an actual physical working part of their body and they can will it better and therefore it is the person's own bad attitude or weakness that caused the problem in the first place. That is like saying that heart attacks are caused by not loving enough or that diabetes is made up by people that are scared of sugar.

    So happy that you are feeling better. You help a lot of people but I hope that you take the time to take care of yourself first.

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  64. Thank you so much. I moved country a few months ago, and have been struggling since, leading to a major depressive episode last week where I couldn't leave my bedroom, wasn't eating, the works. I really needed to hear that someone else got through this, and how they took the first steps.

    Just, really, thank you.

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  65. Great to see you back, Cliff. And it pisses me off how people often look down on depression as no real illness, or think people should just pull themselves up by the bootstraps rather than taking meds for it. I have a psychotic disorder (I have no specific diagnosis but have had sort of mixed symptoms, a bit of positive schizophrenia symptoms and a bit of manic ones, so I guess it would be "schizo-affective" if the doctors ever feel the need to label me). I've had it since I was ten, but have eventually learnt to manage... Anyway, THIS people see as a REAL problem. Lots of people still have the stupid idea that psychofarmaka is just putting band-aids on bullet holes and you should sort it all out through therapy and then you're gonna be normal again, but at least people realise it's a real problem. The thing is, I've been depressed three times in my life, and according to my experience, that's WORSE than having positive schizophrenia symptoms. When I've had paranoid experiences, for instance, at least I was DOING stuff and taking action to protect myself. Depression is just like... there's nothing. No hope. No point in doing anything at all. And that's worse.
    So glad you're getting help.

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  66. I'm so glad you're taking care of yourself! (and back! I missed this blog a lot but obviously that's secondary to you not feeling terrible.)

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  67. Sex on Wellbutrin? DAAAMN. (That's a good daaamn. Or more specifically, a "oh my god, I think I just tore a hole in the mattress, or possibly in space-time itself" daaamn.) Hell of a side effect.

    So, uh, yeah.

    Speaking as a long time past Wellbutrin user, I'd like to say "enjoy it while it lasts" (And all humans are different. A lot of us have much the same wiring, or medicine wouldn't work at all, but sometimes people are very different.) but if it doesn't last, realise that that is the drug and depression, too.

    And don't go get even more depressed because you're not interested in sex all of a sudden and "you're being a bad partner, and you're just a failure, and you should just give up". Just, go talk to the doc, and get different drugs. (No one actually said any of that to me, but if you've been depressed, you know that insidious little voice inside your head. I went a good 6 months without getting an erection once, and it was more like a year and a half in which I had about a 2% baseline interest in sex at all. And then new drugs and voila.)

    Just, like, been there, done that, on that particular drug, just advising you of the shape of that minefield as much as I've mapped it out myself. Glad to hear you're feeling better.

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    1. I've seen a lot of conflicting reports on Wellbutrin and sex. Some people says it kills their sex drive, some say it raises it, some say it does one and then the other, or does one but then levels out. So I'm guessing it's really individual.

      But I will keep in mind to consider "maybe the drug is doing funny things to me" rather than "maybe I'm just terrible at sex" if I do start experiencing problems.

      Delete
    2. Also duly noted (although I'm hoping for short-term therapy anyway). I also occasionally find it strange how much Cliff's life parallels mine.

      Delete
  68. Yay! I missed your writing.

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  69. That’s amazing. I am seriously impressed and happy for you. I imagine that had to have been so rewarding for you after the long wait.

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  70. Hey, I just wanted to say thank you for this post, because it finally kicked my ass into contacting a therapist. (Who has, zomg, a web site with a form you can fill out to make an appointment! As though she realizes that getting help can be HARD AS A CONSTIPATED SHIT and wanted to make it as painless as possible!) I've been depressed on and off for years and years, but after a terrible experience in my late teens with a college shrink I decided toughing it out was way better than "Did you exercise this past week like I told you to? You... didn't do anything but drag yourself out of bed and make it to class? I can't help you if you won't help yourself!" Obviously those are not the only two options, but the badbrain, it is strong, and the inertia is even stronger.

    It's really amazing the absolute horseshit your mind will come up with to talk you out of getting help. I've heard it compared to a garbage truck dumping smelly refuse on your mental lawn all day. "Oh, come on, that veil of emotional numbness between you and the rest of the world doesn't hurt or anything. What's a therapist going to do, talk you out of being a lazy worthless shit? And the years of eggshell-walking emotional-blackmail empathy vampirism while trying to support a friend with major depression, that was in like 2010, you should be over that by now, and besides she was the one with real problems, yours are piddling and exaggerated by comparison and you should've been a better friend to her. And don't try to bring up the hookup that turned awful and nonconsensual earlier this year, you were so proud of being able to laugh and defiantly raise your middle finger and say "I'm okay, really" right after it happened, what would that version of you say if she could see you were still hung up on it? Oh, poor widdle thing, you don't have anyone to talk to about this, maybe that's your own damn fault for always crawling back into your Depression Turtle shell instead of maintaining friendships like a functional adult."

    Horse. Shit. Somebody please pass me the remote, I'd like to tune in to a different channel.

    (Also thank you for mentioning Wellbutrin, because I had no idea it worked the way it did and I just realized one of my giant barriers to seeking treatment was terror of turning into an SSRI zombie. I have tiredness/detachment/numbness/inattention problems as is--they're among the primary symptoms of my depression! Making them worse in exchange for shutting up the badbrain is not a price I'm willing to pay.)

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  71. My thoughts are saying "its just in your head" is like saying "the bridge is on fire but the rest of the ship is ok so it's not a problem!"

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  72. The Kittehs' Unpaid HelpNovember 26, 2012 at 2:54 AM

    Oh, the brush-off medicos. I had such a bad episode on the weekend - anxiety, stress, total tension, vomiting, you name it - that I was scared enough to call the ambulance (and 000 thought it serious enough to send one out). And what did Mr Ambulance Man say when he arrived? Literally that it's all in my head and if I was stressed at home I should GO TO A MOTEL. Thank goodness I got through to a registered nurse on call after that, someone who listened and said to get to a doctor within 24 hours.

    I've never posted here before but after reading so much of your comments on Man Boobz, I really should read the blog more often. I'm sorry you're ill and glad you're getting help.

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  73. Hey Cliff... thanks for your writing. I finally went in today to get Welbutrin scip. Feeling hopeful for the first time in... months? My doc was really sweet about it and not at all judgy. We'll see how it goes...

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  74. I am so glad to see an open, helpful conversation on mental health somewhere other than a mental health forum only. (A mental health forum saved my life a few times though, not bashing them, it's just refreshing to encounter so much supportiveness in the wider internetzy world...)

    I'm glad your wellbutrin is helping. I never tried that medication, i was prozac's poster child on and off from about '91 to '99. I suffered since early childhood from Borderline Personality and Bipolar conditions. I was suicidal all through my teens and early 20s and even put myself in a coma one time. The prozac and weekly psychotherapy helped, but years later i was still experiencing constant emotional pain and self harming. I have a wonderful marriage and a cushy gig as a stay at home mom and artist, but no health insurance. Plus,, i felt like i'd already tried everything ordinary psychiatry offered that i wanted to try, with still these intensely painful conditions just devil dogging me 24/7.

    The thing that helped is called Somatic Experiencing (SE) Treatment. I noticed that everyone is (rightly) blaming neurophysiology for the woes of depression, and this treatment protocol addresses that at its source and with body work instead of drugs. After about 9 months of monthly to biweekly visits, my emotional reactivity dropped and my nervous system was reset. Everyone who knows me agrees that going to SE was the major turning point in my transformation into well-being.

    Everyone ought to "In an Unspoken Voice" by the founder of SE, Dr. Peter Levine. Wow, the richness and depth of evolutionary neurobiology coupled wwith anthropology! To me, this book and the protocol it describes is truly "being the change that we want to see in the world".

    Thanks for your blog and thanks for keeping yourself well! The world needs you.

    Love,
    Cat

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