I’m coming to terms with just how bad of a depression I’ve been in for  – (I’m trying to pinpoint when it started getting so bad and I can’t remember a time in the last few years when I wasn’t super depressed) – let’s just say for a long time.  I’m on medication and I ought to increase my dose but I’m terrified of messing with my meds and gaining more weight.  I have been lying to myself.  Sometimes self pep talks work at pulling you through the rough spots but sometimes you tell yourself things aren’t as bad as they feel and your mind agrees intellectually but emotionally you just keep sinking deeper.  Naturally I rarely tell the truth to other people about how I’m “really” doing.  It’s a self defense mechanism that runs so deep in my psyche that even when I want to tell the truth I can’t because I know I’ll want to hurt myself if I do.  I don’t feel that way when I write it down or even when I write it down publicly.  You can say what you like and if I want to I can delete your comments or take my post back into obscurity.  I’ve talked about this before so anyone who’s been reading this blog for a long time already knows about my face to face lying.  There are very few people (but there are a few) to whom I always tell the truth in person.  One of them is Philip.

But of course I can only tell him a truth I recognize myself.

There are so many symptoms of depression and most of them can be caused by other problems.  What is most telling is when they are all happening around the same time.  I would say that only a professional is qualified to diagnose serious depression but people who are self aware usually know their depression has ceased to be a response to normal outside stimuli and has become a recurring problem that interferes with normal functioning.  So first you have to be brutally honest with yourself (it doesn’t matter if you’re honest with any of your friends and family until you’re ready to and feel safe) and then you MUST be honest with a professional if you are seeking help and you actually want them to help you.

Most common signs and symptoms of depression in my own words:

• Desire to sleep all the time.

• Actually sleeping all the time.

• Not able to get out of bed and/or doing any of the following in bed all day: crying, sleeping, hiding, ignoring phone calls, not changing your pyjamas, not brushing your teeth, drinking 100 proof vodka*.

• Crying all the time without any particular acute reason.  Or crying all the time for all kinds of reasons when you didn’t used to cry very often.

• Hurting yourself.  There is a broad spectrum of ways people can be hurting themselves, I’m talking about physically here.  Cutting yourself, purposely endangering yourself, pulling out your hair (also can be an indication of OCD), biting yourself, picking at yourself (this can also be an indication of OCD), punching yourself, or burning yourself.

• Feelings of being overwhelmed with pretty much everything.  Everyone feels overwhelmed with life sometimes but if you have to think about and psyche yourself up to take out the trash, this is not normal.  If calling a friend you miss seems like too much trouble and makes you feel tired?  Big clue.

• Feelings of sadness that don’t go away for long periods of time even when you’re doing activities you usually enjoy.  People can feel sadness for all kinds of reasons but when you’re sad all the time for no particular reason, this is a red flag.

• Suicidal thoughts.  This seems obvious but it isn’t always.  Sometimes people say stuff like “If it weren’t for ______  I wouldn’t have anything to live for.” That’s a pretty telling statement.  I heard someone say that once and suggested she get help but she exclaimed that she didn’t say she WANTED to die.  But what she was saying was that she doesn’t have much to live for.  That’s not a healthy way to feel.

• A constant or frequent physical feeling of inertia.  This can be debilitating or gentle but if it’s all the time it’s unpleasant and it’s easy to dismiss when it’s not so dire you can’t get out of bed.  I dismissed this for months and months several years ago before I went to get diagnosed.

• Your head is full of self loathing thoughts either all the time or enough of the time to really interfere with your self esteem.  This will often get worse as you go untreated because the self loathing increases as you feel guilty that you can’t pull yourself out of your bad space like everyone says you should be able to.  Believing that your depression is a sign of your weakness can easily become a vicious cycle in which these thoughts and beliefs increase your depression and increased depression convinces you of your “obvious” failure as a person.  People out in the world who don’t understand depression will constantly inadvertently make you feel worse and deepen the cycle.

• Overeating or appetite loss.  I didn’t used to overeat when depressed but that’s because I could smoke cigarettes.  It was definitely an effective way to keep myself from overeating but the tradeoff of being at a way higher risk of cancer eventually didn’t seem worth it.  Now I seem to be more classic in the overeating department.  I wish I was the opposite but I only say that because I loathe my body – in reality a loss of appetite is not any healthier than overeating.

• A whole slew of physical aches and pains that do not go away when treated.  Depression is quite hard on the body and depressed people have a tendency to get sick more often and to be in pain a lot more.  It isn’t fake pain, by the way, it’s just that the cause is invisible to the naked eye.  A good diet and exercise will NOT make these physical manifestations of depression disappear until the depression itself is treated.

It is my goal in discussing the subject of depression to be sure you have access to the best information I can share with you.  My list above is based on personal experience and research about my own mental illness.  I want you to do some of your own research too.  The two best sources of information on this subject (aside from talking personally with a psychologist who is skilled at mental health diagnostics) are these:

National Institute of Mental Health on signs and symptoms of Depression

National Alliance on Mental Illness on signs and symptoms of Depression

My own current signs and symptoms include:

• I have a near constant desire to crawl into bed and if I can’t actually sleep I just want to lay there.  In fact, I’ve been managing to stay in bed until 11am or 12pm nearly every day.  This is unprecedented for me.

• I don’t want to see people.  I have very few people to see in the town where I live anyway.  But even so I am aware of feeling like staying away from places where I might know people and have to make small talk.

• Constant inertia.  Part of why I want to stay in bed all day.  I just feel tired all the time.  Physically, mentally, and emotionally.

• Everything is overwhelming me.  Things that are overwhelming me: health insurance paperwork for Max’s health insurance, cooking, taking the trash out, doing yardwork, cleaning, running errands, trying to find clothes that Max will wear, putting food away in the fridge, laundry, my 6 animals, my garage, the rotting pumpkin in my garage, writing books, looking for an agent, aspirations, junk mail, projects, figuring out what to make for dinner, tying my shoes.

• Self loathing.  Constantly compounded by the things I do to self sooth which keep me fat and as long as I stay this size I feel a tremendous amount of self loathing plus I don’t feel physically good but inertia is very hard to fight.  Self loathing is also compounded by the dermatillomania which makes me feel disgusting and it still makes me want to hurt myself to write that down publicly but I refuse to keep that in the dark.  The more depressed and anxious I am the worse the dermatillomania becomes.  I will not discuss this with anyone in person.

• Constant feelings of sadness/emptiness/hopelessness/depression.  Okay, “constant” is a relative term here.  There is a cycle within the cycle and I have good days and bad but my “good” is not a high bar of goodness.  Let’s just say that my good is still bad but better than the worst and therefore notably “good”.

• Really bad sleep cycles in which there’s a lot less sleep and a lot more mental cycling.**

There are a few more but I think that’s enough to give you the idea.  I have not been willing to admit how bad it’s become because there are so many external factors out of my control right now that are exacerbating my depression and anxiety.  They are external factors that I don’t see a solution for yet.  Admitting to myself first and now out loud that I’m in a deep depression that’s been going on for years and simply getting worse is the first step to improving things.  As I said, there are many things pressing in on me that I don’t have control of and I can’t afford to get professional help which is what I really need.  We just can’t do it right now.  That’s what I would have done six years ago but our insurance back then didn’t cover mental health and then we had to get rid of it.  My son’s therapy took precedence over my own needs.  So here we are.

What I’m doing or plan to do to help alleviate the depression:

• I reached out to a close friend this week who lives very far away and was lucky that she was there when I needed her.  This is a person I never lie to and she buoyed me up.  Having people to lean on and talk to who you trust is so important – I don’t have a lot of people I can lean on or that I’m willing to lean on when I’m this bad, but I’m glad I did this time.  We ended up in a discussion about “Lincoln” style beards and our feelings of animosity towards them which got me laughing really hard which was a great wee dose of medicine.

• I am working hard to break my inertia enough to get more exercise in.  I took a two mile walk yesterday and last week I got out twice and the week before something like three times.  It’s hard.  Inertia is a whip wielding bitch.  I am going to take a shower when I’m done with this post and go on another one.  (I take the dog so it has the extra benefit of serving her needs too).

• Big effort to stop eating when I’m not hungry.  To eat smaller amounts more often and not late at night.  I am using my trip to Blogher Food 2012 to motivate me.  In conjunction with this I’m making a fresh push to drink less alcohol.  I don’t want to be sober  but I don’t want to be an alcoholic either.

• I am trying to take care of smaller things around the house to ease the feeling of being overwhelmed by it.  It’s a small step but it’s hard so I’m doing what I can.

• Self pep talks without hiding the truth.  I need to write daily in my private journal to address the things I’m experiencing and encourage myself in the best way possible to never give up on myself.  This is a personalized form of Cognitive Behavioral Therapy and kept me alive as a teen.  Literally.  The psychologist that diagnosed me years ago taught me CBT and he said that considering some of the things I’d gone through in the past I was in remarkably good shape and said that my obsessive writing of pep talks to myself (daily) were very similar to CBT practices in which you identify what aspects of your emotions are coming from factors you can control and which aren’t and you learn to do what you can with what you can control and let go of what you can’t.  Real CBT has a lot more to it.  But this works.  I’m out of the habit and I suppose part of that is because I started writing a blog six years ago and that’s when I stopped writing my daily personal journal.

It’s an ongoing journey.  Because there is no “cure” for major depressive disorder, only treatments to manage it, it’s something I will always be working on.  If you’re on this journey too I encourage you to not give up on yourself either.  We’re not alone and we must always remember that with the weight of this disorder come gifts.

*I don’t sit around drinking 100 proof vodka in bed all day, in case you were worried.  I’m just pointing out that if one was doing such a thing it would be a red flag that they are in crisis.

**This is also exacerbated by my high levels of anxiety.  Both can produce insomnia.  I suppose since I suffer from both disorders it might explain why I have had insomnia for most of my life.