I’ve been depressed. You?

vangogh1I’ve been depressed. 

Telling you this will blow my chances of running for president, but what the hell: I have been clinically depressed for the last two years. It’s a form of going crazy. I lost interest in my work, stopped blogging and taking photos. I became a near-hermit. 

dogI want to share my experiences with you so that if the black dog visits you or one of your friends, you’ll recognize it for what it is and take appropriate action. No one deserves to go through life feeling shitty and that’s precisely what depression can do to you. Everything is gloomy. Nothing seems worthwhile. Yet this condition is treatable.

Before going on, let me explain that I am no longer depressed. Hallelujah! I have found my cure and have returned to my normal jovial set-point. Let’s grab a beer sometime.

How do you recognize depression? Lots of us are sad. Pollsters tell us more than half of all workers are disengaged. Many jobs are gone forever; PhDs are pouring the lattes at Starbucks. DoD is in an intractable war with Muslims. The maw between rich and poor widens daily. Technology has accelerated the business cycle into a frenzied pace few can maintain. There’s plenty of sadness to go around.

Depression is more than sadness, however. It doesn’t have a target. It’s irrational and self-destructive. When my last episode came on two years ago, I could sense pulling down the shades on optimism. I was slower, weaker, and lacked energy and the ability to focus. It was physical (the juices in my head) and mental (the belief-set that controls my interpretation of the world).

The acid test: Do you think of taking your life? If you think yes, go to the doctor. Get help. You’re depressed. Or maybe you have a suppressed anxiety disorder (I did.) These two often go hand in hand. Happily, both get better with the same treatment. You’ll recognize you’re getting better when suicide disappears as an option.

My neurologist will tell you that depression is a neurological condition. No amount of trying hard and talk therapy is going to change it, any more than they’ll heal broken bones. Here, take these blue pills and if that doesn’t work, we have some yellow ones. Of course, it makes sense to follow general principles of good health: get enough sleep and exercise.

My cognitive behavioral psychologist tells our therapy group that drugs are largely ineffective. This is psychological condition. Emotions are the products of thinking. Get your thinking straight and your feelings will follow. Let’s look at what’s really going on. Got that? Say it back to me.

Stanford’s David Burns is the author of Feeling Good and cognitive behavioral therapy’s leading advocate. Watch this video not only to understand Burns’ work but to cry your eyes out at the surprise ending.

A few months ago the cloud of doom lifted from my shoulders. I was no longer eternally bummed out. The depression was fading away. 

I dropped out of the therapy group which was beginning to wear on my nerves by this point anyway. Then the psychologist and I agreed I no longer needed his treatment.

My restoration to normalcy is the result of a lot of people, a lot of reading, and a lot of pushing the boulder up the hill. However, I attribute 95% of my change in mood to drugs.

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During an episode similar to this twenty years ago, Prozac did nothing for me but Zoloft restored me for years. Two years ago, I re-tried Zoloft but had grown immune to it.

The doctor and I dropped into a rhythm of taking a few weeks to build up to a proper dose of a drug, try it long enough to know it’s not working, then take a few more weeks to wean and clean out the system for the next round. Again and again and again.

In the last four years, I’ve been prescribed these drugs for depression and/or ADHD.

  • Wellbutrin
  • Straterra
  • Nuvigil
  • Zoloft
  • Effexor
  • Latuda
  • Abilify
  • Ritalin
  • Concerta
  • Dexedrine
  • Adderall
  • Provigil
  • Brintellix
  • Vibryd
  • L-Tyosin
  • Selegiline
  • Sertaline
  • Venlafxine

None of them did anything positive. Zilch! I was running low on hope after years of fruitless drug testing, but I remembered how Zoloft had once turned my life around.

“There’s one more drug to try,” said my neurologist. “It’s rarely used these days but it was actually the first anti-depressant. It can interact with your diet, for instance you can’t eat fermented foods. It’s called Monoamine oxidase inhibitors or MAO-I.

Wikipedia reports:

Because of potentially lethal dietary and drug interactions, monoamine oxidase inhibitors have historically been reserved as a last line of treatment, used only when other classes of antidepressant drugs (for example selective serotonin reuptake inhibitors and tricyclic antidepressants) have failed.[2] New research into MAOIs indicates that much of the concern over their dangerous dietary side effects stems from misconceptions and misinformation, and that despite proven effectiveness of this class of drugs, it is underutilized and misunderstood in the medical profession.[3] New research also questions the validity of the perceived severity of dietary reactions, which has historically been based on outdated research.[4]

The reason most of the restrictions on diet are bunk is that MAOIs can now be delivered with a patch, thus bypassing the liver. The current regulations were set for pills, not patches.

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Every evening I peel off the old patch, leaving a red mark behind for a day or two. I apply a new one to the other arm. Every morning I awake with a smile. This stuff works for me.

PatientsLikeMe has reports from people who have used these various drugs. What works wonders for one person sends the next screaming to the toilet.

My message for depression sufferers is to keep trying. The latest research recommends trying both drug and CBT treatment as well as community activity. See what works for you.

We who have wrestled the black dog seriously are sort of a secret society. Lots of people I’ve talked to begin with, “Yeah, when I was going through that….” All are open to helping one another. There’s camaraderie among people who have been there. Ask for advice. You’ll be surprised at how commonplace this is.

12 thoughts on “I’ve been depressed. You?”

  1. Me too. In 2011, I told Don Taylor I was planning to go home. He thought I meant SA. I meant ‘to the earth they shall return’.

    This went on so long I’m not even trying to get most of it back. I’ve made peace with this more introverted, less ambitious version of me. Life is quieter and I am gentler on myself.

  2. Thank you, Jay. I also suffered what became career-threatening and relationship-threatening depression and anxiety until I finally got diagnosed. I had to accept that this diagnosis was about a chemical imbalance and not a personal failing. An initial prescription for Cymbalta helped at first but as time wore on I started feeling “flat” and I went from controlled moods to largely ambivalent. After switching to Cipralex I’m feeling a little livelier and less “flat”. I’m experiencing more moods than before but the cycles seem to be shorter.

    It takes courage to share what you experienced. You have been missed and I hope this post means you will be a more regular presence for us in L&D.

  3. Jay, I’ve known you for years and it’s hard to believe you’ve had to suffer from depression, but experience has taught me that it’s not always evident in public settings. I know the black dog from both sides of the equation. You’re very brave and I applaud you. Anytime you want to talk, let me know.

  4. Thanks for sharing this with so many. I’m with you on the ride, brother. Finally found a great psychologist, nearly 10 years ago. She cut through my bullshit, helped me with talk and then tried a variety of drugs. Lexapro is on my diet every single day. About once a year, I think I’m “cured” and taper off. The wolves return in a few weeks. And yes, thoughts of ending your life are a very key sign that you need to run for help.

  5. Thanks, friends. It’s uplifting to hear from so many people who have traveled the same nasty little path. 🙂

  6. Thank you so much for sharing this! It’s so nice to know we are not alone…wearing the mask in public, but cuddling the black dog behind the scenes. It is a terrible thing. We’ve always read such terrible things about MAOI, seeing them on so many labels of possible interactions, how fascinating to know this is working for you. May have to try this as well, as my list rivals yours and nothing has worked. Being flat is terrible and often they have made the blues worse. Congratulations! Here’s to many more positive days to come… 🙂

  7. Hi Jay. Thanks for be authentic and sharing. I think most of us have gone through bouts of depression. I feel like it’s part of the human condition. It takes courage to talk about. We are all so “busy” trying to be professional that we forgot that we are all human. This was a great reminder.

  8. Jay, I was touched by your honesty and disclosure. As a therapist who has transitioned into training and development, I am all too familiar with the struggles that people have with depression and anxiety. I am so glad to hear that you have found something that works for you! Keep pushing forward!

  9. The awful reactions to MAOI were to the original oral version. The patch doesn’t have the same baggage.

  10. It must be a sign that you are feeling so much better if you can make this post, which is great. It’s wonderful that you are willing to share this. It will be a great help to so many people. Keep well. Jenny

  11. Jenny, I’m on top of the world. Thank heavens for friends and modern pharmacology.

    I get a boost from helping others. It’s a total win-win.

    jay

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