Published: Fri 13 April 2018
By Ben Hughes
In "lack of mental health" .
Trigger warning: this post can be seen as pretty bleak, talks about depression and suicide, doesn't mention kittens much. It's also stupidly long.Seeing as computers aren't a subject I can write about anymore, I'll write about something near and dear to my heart, the so called black dog of depression. This post will be super personal, almost certainly TMI for many, possibly worrying for some of my friends (I'm not fine, but I'm okay, you know me). I will abuse commas too.
In my teens, as many of us have probably experienced, things weren't perfect. I was, somewhat obviously, bullied in my shitty local school. At least though school was easy, I was good at the maths etc, got through the GCSEs (exams at 16) with almost certainly no revision and coursework that was all made up at the last minute. Except French, I copied the hell out of other people for French. Then once I hit college (in the US, you'd call this high school) , I foolishly took double maths, electronics and computing.. So fun. Electronics was fun enough, computing was easy and ridiculous (visual basic, prolog, 1300 unix accounts from the /etc/passwd file), but maths, I suddenly couldn't do it. Previously maths was just obvious, there was no thinking about it, the answers were just there, now I had to work for them... which I had no fucking clue how to do.
During this time, I was really struggling mentally, teenage + failing at a thing I couldn't do, I went to my local GP because England had the NHS then. I talked to them about maybe if I had what was then called manic depression. The next week or so, I went back and went "nope... I've figured it out... I don't have the manic part". This was when I was first prescribed anti-depressants, the infamous Prozac . Timelines get a bit fuzzy (this was 20+ years ago), but this really didn't do anything for me, so at some point I took two weeks worth at once, then just went to sleep (note: at no time was this a suicide attempt, I was just bored and curious). Upon telling my doctor this, they kinda freaked out. They refused to let me leave the surgery, and then took me to their house, where they called a friend psychiatrist. This is where I started bouncing between psychiatrist... I was then prescribed a high dose of a nasty drug that I had a very bad relationship with by the name of Effexor . Effexor is somewhat famed for its side effects, and what happens when you don't take it. If I missed a day, I would get intense "Brain Shivers" (often said to be like electric shocks in your head, I felt they were like my brain moved at a different speed to my head, and like in Operation, zaps when it hits the side). If I missed two days, I was confined to bed. I eventually got off them in my early 20s, due to them making me feel emotionless and hollow, but that's another story.
My 20s and early 30s were filled with moods all over the place, but nothing so bad as that period. Then, in my mid 30s, I was spending a lot of time feeling down, really down. I eventually got a therapist, thanks to a wonderful friend's recommendation, which I can't overstate how helpful has been. I really didn't want to go back on to medication again, but my prior experiences with it had not been... a delight. I battled this decision for about 6 months, I was real against it, but it was just too much of a struggle. Eventually I visited my local One Medical like the tech privileged SF inhabitant I am, and got prescribed Lexapro (Escitalopram), part of the SSRI family. Sadly I was back.
(A fun science thing I learned, is that the stomach has a lot to do with serotonin, so when you start taking drugs that change your serotonin, your stomach is also hit, hard. I spent about two weeks with some of the worst nausea of my life, and because of the method of action, serotonin being messed up in your stomach, nothing really can be done about it. You just have shitty nausea pretty much all the time for a few weeks.)
But, that didn't help, I bounced between SSRIs, Zoloft (Sertraline), Celexa (Citalopram). One of the possible side effects of SSRIs is anorgasmia (a. told you TMI, b. "persistent inability to achieve orgasm despite responding to sexual stimulation"), which let me tell you, is not a surefire way to help someone be less depressed (you can laugh at this bit, it's okay). To counter that, I was prescribed the "happy, horny, skinny pill" and pretty en vogue right now, of Wellbutrin . Which, I really wish it managed to achieve any of those points, another common SSRI side effect is weight loss, and I've had dysmorphia of one kind or another since my teens.
Wow! Still reading?
Now the fun stuff. Depression manifests itself in a lot of different ways, for me at least of the past number of years, there's been a constantly feeling of hopelessness and futility. Now some of this stems from my very nihilistic view of life, the universe and everything, and how the heat death of the universe is the single saddest concept ever thought. Due to my devout Richard Dawkins hating atheism, after you die, there's nothing, it's just that simple. Thinking anything else is folly, no really, a fairy tale. From here, naturally, the idea that everything in life is therefore meaningless, because it is (or rather, any meaning anything has is utterly ephemeral, just as a really insightful conversation between two dinosaurs is now today). This path leads to the feeling of "so what's the point", which boils down to there not being a point to life and when down, feeling that why carry on living when all it brings is this painful hollow void, occasionally punctuated with other feelings, but always ending up back there. My life became this battle against the voice in my head (not /that/ kind of voice, it's the internal monologue voice, I'm not that crazy) which answered pretty much any question, especially any on self reflection or with a negative angle, with the suggestion of killing myself.
scene fades.
On average days, thoughts of suicide dance in to my mind every few hours or so. On worse days, it's a few times an hour, often as an "answer" for whatever I was thinking about. How I haven't been successful in X, or will never do Y, to that part of my brain, killing myself is the answer, and here's a very vivid mental image of how that could go. I, clearly, don't act on this, but boy is it exhausting. For example, I often have this frankly horrifying image of just ripping through my arm with a Stanley knife (US: box cutter/utility knife), which I am not a fan of! The point is, I don't want these thoughts, it's exhausting and draining to have your brain present suicide as the only option to 90% of problems, until I manually step in and work through it. That's during the points where I'm coping, which isn't all of the time, there's times where I'm not, where I just stare in to the middle distance and fantasise about ending it all (friend note: I'm still okay, this is just how my brain works).
I can still laugh, and joke, and mostly function. Seem cheery on the outside, function as a human, ish. Food has flavour, I appreciate sunshine, but music if listenable to at all, will just be on loop, conversation will be over as quickly as humanly possible, and any social interaction will be cancelled, avoided or annulled.
So on top of Celexa and Wellbutrin, I now have lithium to add to the mix. Part of me, the grunge kiddy, was psyched... the tiny part of my brain that worries about me, was all "Lithium!?! that's normally for bipolar disorder". Which is true, but not at the kind of dosage I'm on is for mood control and quelling suicidal thoughts. It does okay. I was on 300mg, then went to 600mg.... then I lost coordination and became clumsy and mentally clouded, and then ran back down to 300mg... I was doing great, but in the last few months I'm up to 450mg.
(fun facts about lithium, medical science does not know how it works... genuinely. They just have seen it work, and continue to work really well, but without a clue as to how...)
Speaking of changing doses, any change on the dosage, up or down, has ramifications. These can range from rapid mood swings, disproportionate reactions to emotional things, randomly crying for actually no reason. Stupidly, again and again, I forget that the reasons I may be feeling this, may be due to changes in medication, as I lay on the couch sobbing (like a year ago, all good). Even going from 10mg Celexa to 7.5mg, gave me weeks of fragility...
Where am I going with this? no idea, but I've wanted to write this for a long long time, and now seems a good time for me. I have a therapist I love, a psyche who's wonderful, a collection of drugs that means the FDA is investigating me for me a hostile takeover bid of Walgreens. I wanted to share my view of depression so hopefully other people can see that others have similar, I've personally found hearing of others suffering through this to at least make me feel slightly less alone. I certainly don't feel fixed, nowhere near, maybe never will. I have opinions about both Big Pharma and Big Farmer, but they help and they don't help. I feel a better human than I was whenever in the past. It doesn't stop me hating and everything about me, but we get by.
We get by.
I'm a mess, but everyone is a mess. I read a review of the brilliant show Fleabag that called the lead character "a broken person", which disappointed me, as we are all broken people, and that's okay, even better than okay. The few people who aren't broken are the freaks and the liars.
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