My Chemical Imbalance

This might seem like a strange post, but I realised this week that I’ve never directly talked about my chronic depression and have only alluded to it. So why post now? Well, my hope is always that someone out there will read this, see themselves in my words and feel better about themselves because they are not alone. If I can help even one person get over the social stigma attached to depression then this post will have been worth it.

So here’s my story:
I was diagnosed with chronic depression 12 years ago (age 20) but most likely have had it my entire life. Even as a child my Mom said I had a lot less energy and was a lot more anxious than all the other kids.

I also prefer to use the term dysthymia rather than depression, mostly because it doesn’t have the same negative connotation as depression. Dysthymia is a form of depression and one doctor did describe my condition that way.

Here is a definition:

Quote:
Dysthymic disorder is a depressive mood disorder characterized by a chronic course and a subtle onset. Many people with dysthymia report that they have been depressed all of their lives and have an outlook coloured by chronic depression.

By definition, dysthymia is a chronic mood disorder, with a duration of at least 2 years in adults and 1 year in adolescents and children. Although dysthymia is often considered less severe than a major depression, the consequences of dysthymia without major depression are grave and include severely impaired functioning and increased morbidity from physical disease.

I describe it this way; depression is often associated with low serotonin levels in the brain. Serotonin is often referred to as our body’s natural mood-altering drug. Serotonin levels also affect many other things such as energy level, concentration, thought process, motivation, etc. So let’s say serotonin levels can be measured on a scale from 1 to 10 with 10 being the highest serotonin ever (like a really, really great day) and 1 being the lowest serotonin level ever. The average person’s daily level might be a 7 or 8 with an occasional 9 for a really great day and maybe a few 10s in your lifetime (like say the birth of a child). On the other hand, a normal person can still have bad days like a 5 or 6 and maybe a 4 when a family member passes away.

Someone with dysthymia naturally has a lower level of serotonin so an average day would be a 5 or 6 good day a 7 or 8 (normal for everyone else) and a bad day a 3 or 4 you can see where a traumatic event could easily put them off the edge which would be called a double-depression. I take anti-depressants to bring me up to normal levels so I still experience the highs and lows, but I get a little higher than I used to and don’t go so low. Explained this way, people can better understand that it is a physical disease.

Double-depression - something you don't want to witness
Sometimes dysthymia can lead to a double-depression which can be quite debilitating… in other words, even getting out of bed is difficult. I’ve had two double-depressive episodes; one when I was first diagnosed and one in 98/99, but am happy to say I haven’t had any since then… well, none that required me to leave my job anyway. I’ve become very aware of my condition and if I feel I am “sliding” I take all the necessary precautions to avoid a major episode like eating healthy, exercise and getting enough rest. I’m pretty proud of the fact that I’ve have maintained an episode free existence since then especially through some pretty stressful times (my brother’s death, the end of a significant relationship, changing careers and moving several times).

How does it affect my life?
Well, for one thing, I get tired easily and when I do I have trouble concentrating and get overwhelmed at minor things. Like right now I’m feeling the stress of school and am always having mini freak-out sessions because my roommates don’t put things back in their place (this would be me getting overwhelmed). Sometimes I just have “bad days” that I can’t explain. I’ll feel down or tired without really any reason. It happens once in a while and usually passes. I also take anti-depressants every day and will likely always take them. I want to point out that I believe I'm one of those "rarer" cases where anti-depressants will likely be needed for the rest of my life. I've been on a variety of anti-depressants for 12 years (starting and stopping repeatedly) and then consistently for 7 years. I think anti-depressants are really important to get you out of the fog so you can concentrate on getting better, but it's not the answer for everyone. I do think doctors tend to over-prescribe without offering additional help that I believe is necessary.

My thoughts on anti-depressants:
The thing about anti-depressants is that it does more than make you happy. In fact, I’m not even sure anti-depressants alone can make someone happy. Depression comes with a whole bunch of other symptoms other than the blues: tiredness, lack of motivation, inability to concentrate, you feel as if even the smallest tasks are sometimes impossible, difficulty to think clearly, difficulty sleeping. What I find anti-depressants really help with is to clear away the "fog". It helps me concentrate, think clearly, sleep better so I can work on becoming happier. When I’m in the “fog” it’s like I can’t think clearly. Minor things seem huge and insurmountable.

Taking anti-depressants is very much trial and error. If the first ones don’t work, try another one. I’ve been on anti-depressants for 12 years now. In the first three years I tried several types. Some were for just a few months, some were for a year or two. I eventually found the one that was right for me. I’m on a two anti-depressant combo. One of them I’ve been on for 7 years and the second one was added 4 years a go. Even though it now works for me, I know it might not be the thing that will work for me forever and that’s why I try to be very proactive with my depression.

It’s a disease like any other – why can’t people see it this way?
No one wants to be labeled depressed. But the truth is, it’s a disease, just like diabetes or epilepsy. There is no reason to be embarrassed by it. In fact, dysthemia is very much like diabetes in the sense that it is a chemical imbalance. In Type 2 diabetes the pancreas doesn’t produce enough insulin… with dysthymia, the brain doesn’t produce enough seretonin. See what I’m getting at? Both are chemical imbalances.

I also like to point out that, much like diabetes, dysthymia is a combination of medication and lifestyle changes. Diabetics have to change their eating habits and exercise they also have to take insulin. They could likely "live" without paying attention to their diet and exercise but they are damaging their body and putting themselves at risk. It’s the same with depression. I could just take the meds and not see a therapist to deal with any challenges in my life and stay "alive" but I’m putting myself at risk.

Random thoughts on the disease
I’ve always felt "off" (for lack of a better term). I don’t think I ever really felt "normal". I can’t say the anti-depressants made everything perfect but it help me see things clearer and the diagnosis of dysthymia/depression gave the feeling a name. Knowing what it is and knowing, if I work at it, I can control it, made a huge difference. I had hoped and dreamed of a dramatic change when I went on anti-depressants. I thought my world would be suddenly rosy and perfect. That feeling never happened. There was no grandiose moment of truth... it was kinda slow coming. I think after 6 to 8 weeks I just noticed one day I wasn't crying 4 times a day anymore. I wasn't having anxiety attacks, I was able to go out a bit. I still had work to do, but the anti-depressants made challenges easier to take on.

Other things that help:
Since my brain doesn’t make enough serotonin and/or it doesn’t know how to use it properly, I need to get as much sunlight as possible. Sunlight produces serotonin in the brain. Since I live in freezing, gloomy New Brunswick I need to use a sun lamp daily. It REALLY helps with my energy level!

I am very open about this condition and am not afraid to discuss it with anyone. I like to think I’ve also helped people with depression by talking about my experience with it. However, for the most part, I’ve avoided having this discussion with employers for fear that I would be treated differently. This will make sense to many of my good friends and former co-workers to whom I never discussed this matter. I also never know when it is the right time to discuss this subject with a new guy in my life. The word depression or mental illness still has a major stigma and not everyone understands it. It doesn’t mean I’m crazy or loony, although I often use these terms to make light of the situation. Like I said before, it’s just a chemical imbalance, nothing more.

Dealing with depression/dysthymia on a daily basis
I guess I just deal with it day by day... it's really all I can do. I recognise that I have bad days and good days. When the bad days come, I try not to be too hard on myself and remind myself that it is a disease; I'm not going to be perfect all the time. Exercise and a healthy diet are so important to my mental well-being so I consider this a huge coping mechanism. I also realise that this is the hardest part of my "therapy". Right now I'm not exercising and my diet is all over the map... I can really feel it in my energy level, my concentration and the frequency of my bad days. It's a bit of a vicious circle... you feel down and don't want to exercise... but then you feel down because you haven't exercised! I still haven't figured out how to keep the exercise momentum going.

I know my post is supper long, but I figured I would just put it all in one place! Besides, I really need a reference I can easily copy and paste to email to a prospective boyfriend. :-P