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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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

Feeling Good

A couple of years ago, I told my therapist, Ted, “It feels good to feel good.”

I met with my psych doc today, and told him that I think the new meds are working. Even after the wonderful Christmas break with the kids, and my concerns about sorting out the effect of the new meds vs. my family fun, I can say that the new cocktail is effective. Yay!

It’s sunny today, and I noticed! I feel lighter, more quick to smile. I actually asked after my doc, instead of making the appointment all about me. I’m signed up for a book club at the library. I’m looking forward to my week. I’m ready to try a new knitting project. I’ve inquired about a volunteer opportunity – I just need to pick up the application.

I really like my new therapist, Pam, at Valley Hope Counseling Center. At last week’s appointment, she challenged me to look at these different experiences, and try one. I came home and investigated all of them! Knitting groups, book clubs, volunteering at an adult care center. She pointed out that I’ve been talking about volunteering at the hospital for a year, but I haven’t done anything about it…why not? Good question, and I think it’s because I know it won’t result in on-going relationships, which is what I long for. But a couple of weeks ago, as I turned into the parking lot at the grocery store, I saw the Adult Care Center, and my curiosity was immediately piqued. Volunteering there – talking to guests, playing games, building relationships, maybe making a difference in someone’s life. Now that’s appealing.

The point here is that I have energy again. I have enthusiasm. I want to do stuff. Anhedonia is gone.

God is good. He is patient with me as I struggle in and out of depression. He is waiting for me to come to Him so that He can pour His love into me. He puts people and medications in my life to heal me (at least for now). And I’ll take it!

10 Days and counting…and gratitude

So it’s been 10 days since the doctor’s appointment and I don’t feel any better. The depression is not lighter.

I realize that 7-10 Days is kind of arbitrary. Feeling the effects of a change in meds can take longer. But I had really hoped…

I wasn’t planning to go to my small group today – was going to text the leader and say I wasn’t coming. But then one of my daily devotionals talked about fellowship. And since I had just asked God to make it clear if it was okay that I skip, I felt like He answered me directly – “Go!” So I went.

And I was blessed for going. We spent time in worship – just listening to praise songs and entering prayer and the Presence of the Lord. I always have my journal, and I wrote down some of the words to the worship songs, as well as praise to some names of God. Redeemer. King of kings. Lord. Holy God. Father. Creator. God of All. Protector. Provider.

I’m glad I went. I realized – again – that I’m not the only one struggling with loneliness. And Jesus knows my feelings, and I can feel Him draw near to me to comfort me.

He knows I’m not better after 10 days of the increased meds. But He loves me in the middle of my mess. He is acquainted with sorrow. He’s not surprised by my sadness. He sits with me in my isolation. He tells me that He is with me – I am not alone.

And as my therapist reminded me the other day, I am more than my depression symptoms. I may not feel like it, but I am greater than my depression.

I am working on thanksgiving. Having a grateful heart. It seems to me that gratitude will build contentment, which will fight bitterness. I want a thankful heart. One of gratitude for my daily blessings, large and small. I’m writing them down, to make them concrete. I desire to fight depression with gratitude. Oh Lord God, help me to make it so!

🎶 Give thanks, with a grateful heart.

Give thanks, to the Holy One.

Give thanks, because He’s given Jesus Christ, His Son.

And now, let the weak say “I am strong.”

Let the poor say “I am rich,

because of what the Lord has done, for us.” 🎶

So it’s been 10 days. And it may be 10 more. Or longer. Until the depression lifts. But in the meantime, I will continue to praise and thank God for His blessings. Friends who know me and love me anyway. A husband who supports me always. My kids. My work. My home. Medications. Moments of sunshine. New friends who want to get to know me better. My Lord and Savior, Jesus Christ, the Lover of My Soul, the Giver of Grace. May He receive all the glory. Amen.

Getting better 

I’ve been on my increased dosage of new meds for one week, but I think I’m seeing a difference. I think they’re working! I went from tears to apathy to caring a little bit. I’d say that’s improvement.

The doctors will say that a person won’t see any progress with meds for 4-6 weeks, but I know I often respond more quickly. I think I’ve seen improvement in just 7 days. My husband thinks so too.

I’ve had a busy week with work and the start of Bible study, and I managed it all well. I “put myself out there” at Bible study, initiating some conversations and welcoming others. I went to a friend’s Open House. I had another friend over for breakfast and socializing. I struck up a conversation with a stranger. I’m reaching out, and that’s a definite improvement over the isolation that depression brings.

I don’t see my new therapist for another week and a half, but I scheduled a distance-therapy session with my old therapist for Monday. I’m really looking forward to that. And there’s another improvement – looking forward to something.

When I’m in the midst of depression, it feels like it “will always be this way.” And that’s a very familiar feeling, like a comfortable sweater which I can wrap around me and cozy into. There’s no real desire to get better, because the illness feels familiar, and it’s easy. Getting better requires an effort. And effort takes energy, which I don’t have when I’m depressed. It takes energy to get out of bed, to shower, to care about the day. It takes lots of energy to engage in conversation, to be interested in what another person is sharing. It’s easier to isolate, to stay home in silence. To listen to sad music or nothing at all. To sleep and hide away from the day and its demands. To refuse invitations, to be alone. Those are all features of depression in my life.

But it’s worth the effort. It’s good to reach out, toward wellness. I’m a more complete person when I’m mentally healthy. I’m more interesting, and certainly more interested in others. I care about them, which is my real nature. Depression steals the real me away, and makes it seem like it’s ok. But it’s better to be the real me, to be invested in others, to pray for them and care about them and want to be with them.

I’m thanking God for these small improvements, knowing they will lead to bigger ones. Thanking God for medications. For my psych doctor who cares and keeps track of me. For friends who reach out to me even when I’m less than myself. For my husband who stands with me through mental illness and health. To Jesus, for understanding and loving me anyway.