There is a holy trinity in mental health care for treating depression and anxiety that us patients rather a hate to be reminded of. (Well, that might just be me.) To maximize the success of your mental health care plan, it needs to have elements of prescription medication management, professional psychotherapy, and physical exercise.
Part 1: Medication: It took me years to have the courage to accept that I needed medication. Once I did, I needed regular check ins between myself, my prescriber, and my therapist. Taking care of this part of the tripod is as much about the consistent check ins regarding what is and isn’t effective as it is about taking the medication correctly
Part 2: Therapy: Therapy has been a part of my life since I was a teen. There are dozens of philosophies and methods. My current therapist has been a part of my care team for a year. She specializes in Dialectical Behavior Therapy (DBT) and insists that we make and work towards goals in therapy instead of simply coming in and ranting about the stresses and tribulations of the previous week. https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy
Part 3: Exercise. Gods, I hate being told that I can’t expect my care plan to be effective if I’m not exercising. That being understood, every doctor and every therapist has made a point of suggesting an exercise plan to coordinate with my medications and talk therapy. I pick up exercise and put it down again over and over, never entirely managing to make it a part of my daily routine. A year ago I managed 5 months of working out 3-5 times a week and ran a 5k Virtual Race. Now, though, I’m struggling to manage 2 weekly workouts. I’m on an upswing, mentally and physically. Maybe this part of my care will stay in balance for longer this time.
We are changing my meds up this week. This is directly because of the issues in my last post and finally managing to tell my doctor about it. My basic antidepressant is staying the same, my supplemental antidepressant is being cut in half for a week and then removed altogether, and to combat the sedative effect of the supplemental antidepressant I have been given a stimulant. I’ve never taken a prescription strength stimulant in the long term, and the dose I’m starting on is moderately high.
Today is Day One of this new medication array, and I expect it to be the day when the stimulant’s impact is most startling. I got up an hour earlier than usual to take advantage of it, and by noon I was dressed (!!!), had putaway three loads of laundry and started a new one, cleaned the bathtubs and toilets, scooped the cat’s litter, watered the garden, worked in my BuJo, and gotten the kids going on schoolwork. It is three times what I have accomplished in an entire day in recent weeks. I know this isn’t likely to be a long term solution, but it feels nice to have access to this energy. I don’t feel high, which I was afraid of. Instead I feel alert and like I have access to the healthy energy levels that have previously been inaccessible.
Once I finish this post, it will be lunch time for the kiddos, then I will work out a plan for dinner and maybe we’ll all walk to the playground. Contrary to the title this post, I can’t actually taste colors. What I can do, today at least, is live up to my own standard regarding what it is reasonable to accomplish in a day. I could cry.
I’m having a rough month. I have no energy, I’m struggling to get out of the house, and even in the house I am hardly moving. Today is the first day in a week when I have been able to write. I don’t expect to get far.
(Note: I really didn’t get far. Those four sentences sat on my computer for a full week without anything else happening.)
The bad days of depression creep up on me. I don’t know how it works for other people. One day I’m muddling along just fine, the next I’m sleeping 15 hours per day and can’t focus on anything for long enough to be productive.
How do I write about the nothingness that is depression without suicidal ideation? It echos. I don’t particularly want to hurt myself. I don’t particularly want anything. I shift from sleep, to staring vacantly, and then back to sleep. My poor kids. Today they are off on a great outing with their daddy while I try to find the will to finish this post and do a little laundry.
The bad days of depression happen in the broadest sunlight, with the windows open and the birds singing. They happen even when I’m taking my meds and exercising daily. The bad days of depression feel like a slow grey suction draining the ability to work effectively; to enjoy the things I usually love; to make use of time that I know is a blessing.
How do I talk about the bad days of depression without sounding like a cliche? This isn’t much of a post. The sun is shining. A bird is singing in the lilac bush. It’s just all exhausting and grey.
We are just back from vacation and things are particularly chaotic. I have an idea that I should have handled our return differently. I should have done more school while we were away. I should be resuming our routine with rigor. I should be cooking more and more often, and sharing it with our friends, who are ill.
I should be better.
I should eat better.
I should workout more.
I should engage with the kids more.
I should clean more
I should be more like other people.
I call this way of thinking “shoulding on myself,” because it creates all of this tension to live up to impossible standards. “Should” implies consequences of not doing it. “Should” implies orders that have come from outside of myself. It is a terrible habit. It breaks up the day into chunks of false urgency and harsh self-judgement.
I’ve missed a week of posting. I got overwhelmed with getting ready for my mother-in-law’s visit, then I fell into the trap of thinking that this hurdle is a complete defeat. I haven’t completely gotten past it yet, and the total lack of people interested in reading here doesn’t help. I may have something to say, and the internet may give me a voice, but that doesn’t make anyone want to hear.