Wednesday, September 26, 2012

The real quandary for the depressed: you often are too depressed to take action

Marjorie Morrison is the author of the recently published "The Inside Battle: Our Military Mental Health Crisis" (Military Psychology Press, $8.99 ebook). Yesterday, she wrote a great column for the Huffington Post. Here are some excerpts:
From 2005 to 2010, service members took their own lives at a rate of about one every 36 hours. There are currently more deaths in the military by suicide then killed in combat. Suicides in the US Army increased 80% in 2004 to 2008. 
This is the excerpt that rang true for me:
A service member who seeks help has significant barriers to overcome. Almost all of us can look back at a time when we felt depressed. Typically, it isn't until after you get through it that you realize how distressed you were. It's difficult enough to ask for help, but considerably harder when one feels hopeless.
This is the problem, isn't it? People who suffer from clinical depression often cannot reach out of that big black hole to get help. In other words, we are too depressed to know we are depressed and too depressed to get the help we need. It often takes someone close to us to urge us on. Unfortunately, we may be too depressed to act. We may pretend that we know better. We may pretend that we are fine.

I am not a veteran. I do come from a long line of veterans who suffered from depression and PTSD. I know what depression feels like. I know how hard it is to reach out to get help.

I was first diagnosed with depression in 1990, when I was 40. I have been on and off antidepressants ever since. More than one psychiatrist has told me this: "Stay on antidepressants. You have clinical depression."

Did I listen? Of course not.

Here is the danger. Antidepressants may seek to work effectively over time. If we are seeing clinicians on a regular basis, they may discover this and switch our meds. If we are not seeing clinicians on a regular basis, who's to know? We may just decide to quit taking Prozac or Zoloft or Mertazapine or Effexor or Wellbutrin or any of the other drugs that help to ward off the hopgoblins.

Big mistake.    

We should pause here to entertain objections from those who think that antidepressants are the work of the devil, or a means to mind control. Any Scientologists in the room? I can see why objections may arise. Many of those who commit suicide are taking antidepressants. It's easy to assume that antidepressants lead to suicide.

When I was embarking on my latest antidepressant regimen, I came across an article about a young Iraq veteran who had committed suicide. Tip for the depressed: never read about suicide when in the throes of depression. The photo in the story showed the vet's bedroom. Near his bed were myriad bottles of pills. One read "Mirtazapine." Thing is, I'd been taking the very same drug at the very same dosage for two weeks. Nothing was happening. I was feeling a bit desperate. Was I ready to kill myself? No. But I was depressed as hell. It would be months and months before that med and several others finally combined to give me some relief.

Now that I am no longer depressed, I realize how depressed I really was. And I am amazed that I am front of you right now, that I am typing on this keyboard and entering fairly sensible words on the screen. Amazed.

I was lucky. I had an understanding wife. I had understanding colleagues at work. I have friends. I have health insurance. I am en ex-jock who knew that exercise can be a way to the other side. I am a writer who believes in journaling. I have an extra dose of Irish cussedness in me -- it keeps me going when things look blackest. I have some wisdom endowed by six decades on the planet. I know how to pray.

What if I was 21, just back from a terrible war? Would I know what to do? I've never had to face that. But thousands of others have to face that every day.

Be kind. That's what combat veteran and ex-POW Kurt Vonnegut used to say. Be kind. He knew that little acts of kindness can go a long way. If nothing else, that's something we can all give to one another.

Be kind.

And take your freakin' meds, ya dimwit!

That's me talking to myself. When I'm feeling right. When I'm not, well, I say nothing.

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