Δαφνη Ευτυχια Αρθουρος

First, completely unrelated to anything else in this entry, a bit of randomness: you know that feeling of something soft under your shoe that isn't supposed to be there, at the same time as the sound of a feline squawk or shriek of surprise and/or pain? Man, I hate that moment. (The difference between dark and a sorta-dark: whether the cat gets stepped on or merely chided for taking risks and making me slow down to see where she is.)

I had a rough December. Different parts of the month for different reasons. I hinted, at one point, at a matter with a high melodrama quotient, which I didn't trust myself to write about at length at the time. I owe y'all an explantion and myself a reminder in case I'm ever talked into trying something like this again in the future (or ever forget to take others' brain-chemistry problems seriously). So here goes, the story of that part of the month, told in a far less dramatic fashion than I would've done then. Grab a cup of cocoa and some popcorn, as it'll take a bit of telling to cover properly...

The short version is that there was a very real possibility of my not being around for Christmas, due to exogenous chemical depression. Now when I say "depression", I don't mean "the blues" or "having a rough time coping"; I mean full-blown, bona-fide what-a-pshrink-would-call-depression. I don't even exactly mean the productivity-sucking lassitude and anhedonia that sounds so much less serious than it is unless you've experienced it, and is so hard to realize warrants a diagnosis and a label when you're in the middle of it, as bad as that can be (though that was a part of it). This was "can't trust my own mind" bad. Unsafe-bad.

And the "exogenous" part, refers to the fact that the chemical imbalance didn't start in my brain, it started in a bottle of pills from a pharmacy.

It all started, of course, with the best of intentions: try to treat my fibromyalgia. Kaiser had more or less given up, back when I was insured by them (my every-few-months visits to a rheumatologist were really nothing more than checking in and getting painkiller prescriptions renewed). Then I was uninsured for a long spell, and when I finally started going to a free clinic this past spring, they considered other problems more pressing than the fibromyalgia. Now we're getting to that.

My doctor wanted me to try an antidepressant to see whether it helped with the fibromyalgia. Now on the one hand I did tell her about my previous bad experiences with such drugs and my fears regarding them, but on the other hand her reasoning -- that new families of antidepressants work using a sufficiently different mechanism from the ones I'd tried before that there was a reasonable chance that they would affect me differently -- was an argument that sounded (and even in hindsight still seems) like a reasonable line of thought, enough so to convince me to try the experiment despite my wariness. Though perhaps if I'd remembered more clearly what the effects of the previous drugs had felt like instead of the dispassionate description I used afterwards when explaining my history to doctors, I'd have been even more wary.

In the meantime, occurrences of the word "weepy" in my "track how I'm doing" spreadsheet were becoming more frequent. And then I started having trouble concentrating, difficulty remembering what I was doing for even a few minutes at a time -- worse than any "fibro fog" I remember having experienced before, and it ... well, it felt different than fibro-fog.

Even during the low-pain times, prying myself out from under the bedcovers was getting more and more difficult. I saw that as a very bad sign, but wanted to make sure that I wasn't just using the existence of the drug as a subconcious excuse to be lazy. (I should have taken the fact that I couldn't bring myself to do things that I wanted to do, that might have counted as "goofing off" at other times, as a major clue. But I really wasn't thinking straight at that point. And hadn't yet realized just how disordered my thinking was.)

Then I caught myself thinking, several times, "Yes, I'm hungry, uncomfortably so, but why should I bother to eat when I'll just get hungry again anyhow in a few hours? I'll be hungry then regardless of whether I eat now, so it's really not worth the trouble to eat." I'm sure I could make that a hilarious stand-up comedy line with the right delivery, but it's not a very healthy thought to have seriously when one's stomach is growling. I did eventually realize how wrong that sounded, and started reminding myself of that fact each time the "why bother eating?" thought crossed my mind again, and considered that enough of a Bad Sign to call this a negative reaction to the drug.

The previous paragraph is neither a joke nor an exaggeration, by the way. Yes, I do know how much like part of a stand-up routine it already sounds like. But at the time I caught myself thinking it, it was part of a very real attempt to decide whether to get out of bed and eat something or just bury my head under the pillows and cry until I forgot about my stomach. I'll use it as a joke sooner or later (probably sooner), but it wasn't a joke in mid-December.

I was also noticing more than the usual number of thoughts of hopelessness, helplessness, and despair. Oh, I feel stymied by my circumstances all too often, and often think that I'm never going to be able to make my body work better than it does now or improve my constantly precarious financial situation, and I get to feeling down, even self-pitying sometimes, about all the times I've cancelled plans due to not feeling physically well enough, but this was a very different feeling. A feeling of such oppressive doom that not only was there no point in dreaming, there wasn't even any point in trying to scrape by. I was seriously working from the starting place that, "I'm going to die, no matter what -- everybody does -- so none of it matters". There seemed to be absolutely no difference between "I'll be dead sixty years from now regardless" and bothering to make sure I was still alibe tomorrow.

Why should I bother to look before crossing the street? I'll be just as dead in 2066 whether i die today or next week or next year. Why should I bother worrying about how to pay the most urgent of my bills? I'm going to wind up broke and homeless and dead eventually regardless, so any effort now is just delaying the inevitable -- maybe it'd be less painful to just get it over with instead of dreading it. Why should I bother with this jury-duty paperwork? If they throw me in jail, well it's not like I'm accomplishing anything anyhow so what's the difference? Why should I bother following diet advice? I'm going to die sick and miserable no matter what I do, so why bother trying to keep diabetes from doing that to me a little sooner? It was like time was irrelevant; any bad thing that might happen in the future was guaranteed to happen, and there was no difference between it happening in the future and happening right now. There was no point to anything. Striving for immortality through musical compositions? Nobody will remember me thirty years after I'm gone -- who am I kidding? -- so there's no point. Maybe it would be easier if I just gave up -- stopped being careful about the steep back stair with the funky top step (the bannister's already broken, so we'll just blame that when I land on my head and die). Maybe it would be easier if I just gave up -- stopped paying attention to maintaining a safe following distance on the highway. Maybe it would be easier if I just gave up -- didn't bother to eat, or didn't care whether I ate things that jacked up my bloo sugar too high. Maybe it would be easier if I just gave up ... I was, at some level, aware that these thoughts were a) not usual for me, b) potentially sortakinda dangerous [well, they were more than sortakinda, but as noted above, I was not thinking straight even when it came to analyzing how I was thinking], and c) symptomatic of depression. Problem was ... er, problems were, I had trouble keeping the "oh this is bad and I should do something about this" thought in the foreground long enough to do much more than start and then delete an LJ entry every so often, and even while thinking "this type of thinking isn't 'me' and could be disasterous, there was the corresponding, "so what? I'm doomed anyhow."

And the helplessness went far beyond "the universe is stacked against me and I don't have a long enough lever to tip things my way" -- it was a more profound helplessness than that, hard to describe, a complete powerlessness, an inability to have any effect on myself or my surroundings ... an inability even to make an attempt.

Surprisingly, I did make it out of the house a few times during all that. There were occasional holes in the cloud. I made it to 3LF that week, and I think I mostly managed to hide my problem (though I suppose I should take this opportunity to ask folks who were there whether anything showed). But when I did get to campus and park my car, unfastening my seat belt and getting out of the car -- well, deciding to do so -- was as much of a mental struggle as convincing myself to get dressed and get into the car in the first place. The thought of leaving my momentarily-safe-seeming seat in the car nearly brought me to tears.

Actually, the thought of forcing myself to try to do pretty much anything, when I knew it was all hopless anyhow, made me feel like I was going to cry. Heck, when I got back to Baltimore, the thought of getting out of the car so I could get back to my safe bed seemed like too much, and I seriously considered spending the night sitting in my car in front of my house. I spent a while trying to figure out whether anyone would notice and pester me about it, and whether that was more frightening than opening the car door.

Somehow, even more surprisingly, I made it out to my mother's house in Bowie the next day. Keeping myself distracted helped a little -- driving, trying to act normal for rehearsal, troubleshooting Mom's computer -- but even so, every so often the wall-of-distraction would start to crumble and I'd feel like I was about to lose it. There was a scary bit driving home that night.

I zoomed up I-97 wrapped up in my thoughts and my attempts to monitor my own thoughts while thinking them (in hindsight I'm now realizing how much less attention I paid to my driving that week than I usually do -- it's a good thing I only drove when traffic was very light). 97 drops you onto the Baltimore Beltway about a mile from the exit for 295 north into town. I had the cruise control set at 70 MPH, and I knew that my exit had a 25 MPH posted speed -- it's a somewhat tight, steeply descending curv, and although 25 MPH is a little slow there in dry weather, it's really not a ramp you want to hit going very fast.

It took me the whole mile to decide, arguing with myself, whether it was worth the bother to lift my foot and move it to the brake to disengage the cruise control and slow down for that curve. I might be able to hold the road through that curve at 70 -- I'm pretty good -- but it doesn't matter either way. I'm going to die anyhow, so why does it matter whether I die tonight or next year? And I think these tires have enough grip if I get the angle exactly right ... Yeah, I did think I could get through that curve at 70 MPH in my Accord; I'm not sure which is the more frightening aspect, that I thought I could do it, or that I didn't think it mattered whether I could or not. This was crazy-think. Fortunately, I had some crumb of self-preservation still working, screaming in a tiny corner of my brain for all the other parts to please shut up and touch the brake.

It was like I heard that voice was there but couldn't make out what it was saying because I was busy trying to figure out exactly how to steer through, until the very last second, when I thought, "What am I doing?" and brought the car down to a just-barely-manageable speed for that ramp. I don't remember much of the rest of that drive, but apparently I did make it home.

(Note that I do like to drive fast -- I've been meaning to write an entry about that, including how it usually feels easier to handle my car at 75 than at 65 -- but I usually give a damn about Not Dying while I drive, and have a much more realistic idea of my limits and the car's limits.)

That was when I decided that the antidepressant experiment wasn't working out, and finally noticed that it could actually get me killed. Thinking about all the different ways I could die by not caring enough to watch out hadn't really registered, nor had all the thoughts about why I "should" just give up and die, but "I very nearly did something incredibly stupid and probably extremely painful in the car last night" did sink in, if not anywhere near as clearly as my describing it now, in my right mind, makes it sound. And that's when I started thinking I might not have a Christmas, that there was a good chance I'd be locked up, dead, or hiding in my bed unable to drag myself to the car and to the family gathering. (I really don't know which of those was most likely at that point, and at the time I was in full doom-and-gloom angsty-teenager mode (which, as I noted last month, I'm a bit old to carry off) so they all seemed equally likely then.) But it still took another day to drag myself into motion again to try to do anything about it.

So that's my really fucked-up December and why I almost didn't get to Christmas. The story of that Friday, symptoms I didn't get around to describing in this entrey, and my not-at-all-excellent adventure finding out whether it was safe to simply stop the antidepressant cold, is worth a post of its own; partly for length, and partly because as painful and frustrating as it was, it has more elements I can make entertaining in the telling than this part of the story did, so it'll have a somewhat different tone than this entry. I'm not sure whether I'll get that that today or not, so the key information for anyone who didn't read my journal on Christmas is: I was doing a whole hell of a lot better by Christmas morning. The fibromyalgia messed up my plans for the day a little, but I did get to celebrate with family, my mood was good, and I was sane again. *whew*

Further experiments with whatever new classes of antidepressants they invent in the next ten years are right out. I've risked my brain (and the rest of me) more than enough for that particular line of investigation.

And a probably important note about depression ... Several people who read my journal suffer from, or have suffered from, depression. They know about this stuff; I don't know whether they're feeling very sympathetic because they understand what I've tried to describe, or a little annoyed because I've made a big deal over something that, however bad, was very brief -- but this note is for the rest of y'all: What I've described here, which I could have made more detailed and stronger if I didn't think the toned-down version sounded a little too dramatic as it is (toning it down any farther would have made it awfully inaccurate, sorry), illustrates some pretty severe symptoms (and so will the next chapter) ... but I was suffering like this for a little over a week (less than a week for the worst of it) and the "cure" for me was simple and quick (stop taking the offending drug). But for most people who suffer depression, we're talking about years, not a mere week. And not only is the solution not always as simple as taking (or in my case not-taking) a pill -- sometimes it is and sometimes it ain't -- just figuring out that there's anything to be done at all in the first place is a lot harder than it sounds. Remember that I went into this experiment already armed with a fair bit of knowledge about depression, prior experience with it (including some not caused by drugs quite a ways back, which I may or may not write about someday), and an awareness that I should be watching out for danger signs, and I still came close to becoming a highway statistic or doing myself various sorts of damage in other ways, I still had trouble deciding when it was 'real' and when it was 'bad enough to need to do something about', and trouble bringing myself to act even once I'd sorted out what I needed to do. Everything I was feeling told me that there was nothing at all that I could do despite my intellectual knowledge to the contrary.

So if you ever find yorself tempted to dismiss depression as "just feeling sad", something to be gotten over by just being a little tougher or doing things that would cheer up a not-depressed, merely sad person -- or if you find yourself wondering why a depressed friend or loved one doesn't "just go get help" -- please remember that it doesn't look anywhere near that ckear, that simple, or that easy from the inside, and it's a hell of a lot more destructive than just feeling sad.

Finally, I've not identified the drug here because my story is about my brain's atypical reaction to an entire category of drugs, not the specific dangers of one particular drug. I'll identify it in a comment if anyone's really curious, but I didn't think that information really needed to be in the main body of the entry.

And now it's time to shower, grab breakfast, and go tell this story to my doctor. Given that my sleep cycle is scrozzled and I've got this appointment this morning, the odds of my making it to 3LF rehearsal tonight are less than 50%, but I will try.