Red Flags

Over ten years ago, I was diagnosed with Major Depressive Disorder – Recurrent, which means that I’ve had multiple episodes of depression. It’s important for me to learn to recognize the symptoms of an episode quickly, because the faster it’s treated, the sooner it goes into remission.

According to psychiatry.org,

Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.

Depression symptoms can vary from mild to severe and can include:

  • Feeling sad or having a depressed mood
  • Loss of interest or pleasure in activities once enjoyed
  • Changes in appetite — weight loss or gain unrelated to dieting
  • Trouble sleeping or sleeping too much
  • Loss of energy or increased fatigue
  • Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
  • Feeling worthless or guilty
  • Difficulty thinking, concentrating or making decisions
  • Thoughts of death or suicide
  • Symptoms must last at least two weeks for a diagnosis of depression.

Given these symptoms, it’s critical for me to know my red flags – my warning signs – that an episode might be lurking. These are my indicators prior to actual depression symptoms – they tell me it might be coming.

Here are some I’ve noticed.

  • Listening to music loudly –
    • in an effort to drown out my negative or ruminating thoughts.
  • Desire to be alone, or in the dark.
  • Not wanting to go to my regularly scheduled activities – anhedonia.
  • Saying “I’m sorry” a lot.
  • Difficulty concentrating when reading a book or even watching a t.v. show.
  • Wanting to stay in bed, even if I’m not tired.
  • Feelings of self-pity.
  • Crying – maybe. Sometimes I can’t cry, which is also a red flag for me.

When I see several of these characteristics, or if someone close to me notices, it’s time for me to contact my psych doc and let him know that I might be headed into a depressive episode.

[Side note: even though I know these things about myself, I am always surprised. You’d think that after ten years, I wouldn’t be shocked to discover the journey back into depression. I guess it’s a good thing – I don’t ever want to get used to it. I need to accept it, and make every effort to be mentally healthy, but I don’t want to be resigned to a life of depression.]

Over the 10+ years that I’ve battled depression, I’ve gotten better at seeing these things quickly, which means we can modify my treatment and get me the help I need so that the episode doesn’t deepen. Maybe that means adjusting my meds. Maybe it’s increasing my therapy sessions.  Maybe it’s simply monitoring them, being self-aware.

It’s a call to pay attention.

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“Start with where you are.”

A good friend gave me this piece of advice, and I’ve taken it to heart, especially in writing. I find that it keeps me honest, vulnerable, and hopefully relatable.

I remember when she said it. I had just arrived at church, getting ready to facilitate our depression support group. I told her that I had had a few rough days, and thought I might be descending into depression again. I couldn’t figure out how I was supposed to lead this group if I was depressed. She encouraged me to be honest with the group, to just share what I was experiencing. I followed her advice, and felt myself supported and encouraged, even as the “leader” of the group. Expressing my struggle was an example of vulnerability to the group, and they in turn opened up and shared with each other.

When learning about writing, authors are encouraged to write about what they already know. For one thing, it’s easier to write about something I have gone through. Secondly, no one can argue my own experience – it’s mine, and it’s true.

So I use this approach here in my blog. I start with where I am. I try to write about what I’m feeling, or what I’ve felt or experienced in the past. It’s my past – who can argue against what happened or what I felt? Or it’s my current situation. Not anybody else’s. It’s real for me.

My desire with this blog is two-fold. To help Christians who fight depression know they are not alone. While our specific experiences may be different, there’s definitely commonality among fellow sufferers.

My second hope is that I provide understanding to a reader who might not know what depression is, or what it feels like. Maybe that reader has a friend or family member who struggles with depression. Maybe someone in the church wants to reach out to the hurting, but isn’t sure what to say. I hope that what I write will ease that difficulty.

So I write from where I am, or where I’ve been. I hope I offer education, reduce stigma, and open doors for communication and understanding to those who suffer with this disease.

“Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves receive from God.” – 2 Corinthians 1:3-4 (italics mine)

It’s Easy

The thing about depression is – it’s easy.

No, depression itself is not easy – it’s actually a very hard journey. But descending into depression is a cinch. Easy-peasy.

All it takes is several days of feeling alone, using first-person depression language or beating myself up, poor diet and/or sleep, ongoing physical pain. A few negative components, and depression is within reach.

Of course, wellness should be reaching toward the positive, toward mental health, not illness. But sometimes, mental illness feels closer to my grasp.

This should make me fearful, or at least cautious. The problem is, it all feels so familiar. So it’s not scary; it’s almost comforting.

Which makes me scared. And that’s healthy.

I’m realizing that I’m often so close to the edge of the cliff – to the precipice of depression’s chasm.

That means I need to fight really hard for mental health. For mental wellness.

I need to initiate my ladder – the steps my therapist told me to put into place to help me when I find myself in this darker place. Step one – sit with the tears. Well, I don’t have any of those right now. Just a familiar sadness.

Step two – Tell my husband and best friend. My husband will be home shortly, after having been out-of-town for a few days – I hate to admit that this probably contributed to my current emotions. I’m okay with him being gone until about day five – then it gets hard for me. So that piece will improve soon!

Ok, time to be really honest here. Let’s back up a few minutes. Drinking wine does not help depression. I suspect that if I hadn’t had a couple of glasses of wine – which is a depressant! – I wouldn’t be feeling so negative right now.

I’ll write more about my ladder of self-care another time. The steps really don’t matter for this particular post. What matters is to illustrate that depression can be only a few choices away.

So I need to make wise choices. Initiate my ladder of self-care. Get good sleep. Eat a healthy snack, healthy meals. (Too bad I had to throw away that salad mix due to the recall – that was my healthy meal!) Get regular exercise. Be careful with alcohol.

Ultimately, I must remind myself of God’s truth about me, because that’s what really matters. He loves me no matter what. I am a new creation, because of Jesus’ grace. Depression is not who I am; I am a precious daughter of the king of the universe, the king of all creation.

Reminding myself of these truths are keys to fighting the familiarity of depression. Keys to fighting the lies of the enemy. Keys to my mental health.

I am not my depression

This is the subtitle to my blog.

It’s also a concept I’m grappling with right now.

Years ago, toward the beginning of my therapy, when I was healing from the blackest, deepest place of my depression, my therapist taught me to consider depression as separate from me, like it is its own entity. Like something else in the room.

Not “my depression.” Not “I’m depressed.”

Instead, more like “me struggling with depression.” “I’m battling depression.”

This seems like just semantics, but words are very powerful – especially the words I use with myself and to myself.

The first set of phrases makes me the owner of the depression, or certainly the victim of it. The second group places depression apart from me, not on nor within me. I’m not a victim – I’m a warrior.

The second set of phrases is more empowering. Stronger. More hopeful.

I’ve noticed that in the past several weeks, I’ve gone back to referring to depression in the first person – those first phrases. And I’m not sure why.

It could be a subconscious reaction to the biographies I’ve read recently – folks who wrote about their personal battles with “the black dog” of depression. Some people call those biographies written by “depressives.” That wording is really self-defeating!

It could be the ongoing (4 weeks and counting) of back and leg pain that is plaguing me. The diagnosis is lumbar stenosis – a narrowing of the openings where the nerves of the spinal column come through the spine itself, causing pressure on those nerves and then the nerves responding with inflammation. So far, neither stretching nor ibuprofen nor massage nor chiropractic are helping. (Next steps: yoga and stronger meds.)

It could be because I’ve been thinking about my journey through depression a lot lately: in writing, in therapy, in my Fresh Hope workbook. It’s been on my mind.

Whatever the cause, today is the first day I really caught myself speaking of depression in first person – “my depression.” I need to change that. I need to change the words, change my thinking, put distance between me and the illness.

“…but let God transform you into a new person by changing the way you think…” Romans 12:2b, NLT

Depression is… and is not…

 

Depression Is:

  • Real – it has been scientifically and medically proven to exist – it even shows up on brain scans; it’s not just “all in your head.”
  • An illness – but it is invisible to onlookers.
  • The result of a fallen sinful world – this was not part of God’s original perfect design for humankind.
  • Exhausting – some days, it can take all of my energy just to get out of bed.
  • Endless – it feels hopeless, like it will never end.
  • Different from sadness – it’s deeper, darker, heavier, more debilitating.
  • Isolating – I want to be alone in my despair; it’s too hard to pretend to be okay around others.
  • Common – 1 in 3 people will experience at least one episode of depression in their lifetime.

Depression Is Not:

  • My fault – I didn’t do this to myself, and there is no one to blame.
  • A sin – it is not disobedience to God, nor is it punishment from Him.
  • Easy to overcome – healing can be a multi-faceted process, and sometimes a long one.
  • Simple – it’s complicated by circumstances, genetics, brain chemistry, and more.
  • Discriminatory — it can affect anyone, regardless of age, income, gender, or race.
  • The same for everyone – that’s part of what makes it so complicated to treat; though there are common symptoms, everyone responds differently to the disease and it’s “cure.”
  • A choice – anymore than I could choose to have diabetes or cancer.
  • A sign of weakness – in fact, the strongest folks may be those with depression who keep waking up each day.

Depression is a complicated illness, a mess of the wrong amounts or kinds of brain chemicals. It’s not something I can just “get over.” In fact, the longer I wait to get help, the longer my recovery will be.

If you or someone you know suffers from depression, don’t be afraid to seek help. Tell  your doctor or medical professional. Or call the National Suicide Prevention Lifeline at
1-800-273-8255 (1-800-273-talk).