Busy as a Busy Bee: Coping v. Hiding

If I had a penny for every time I've had this conversation, I might be able to penny tile my kitchen floor.

Someone: How've you been?

Me:  Good, y'know, busy.

Someone:  That's good, it keeps your mind off things.

Rationally, I am aware that non-depressed persons probably do use this coping technique.  In fact, I've spoken with a number of people who find it useful to keep themselves busy when upset about something, because it gives them less time to be upset.  That's logical and a seemingly healthy way to handle a problem so long as it doesn't go to the point of complete avoidance.

That said, depression is not a problem, it's a condition.  It doesn't go away because my days are packed with things to do, it just makes those things a billion times harder to get accomplished.

I am a busy person.  I work two, sometimes three, part time jobs.  I'm on the board at my synagogue, I regularly volunteer for a battered women's shelter, I have a standing bridge game, a weekly swing dance, and I work out at least five, usually six days a week.  I also make it a point to write every day that I possibly can, even if only three hundred to five hundred words.

I, for the most part--the part of me that is not terrible at saying no to people--choose to be this way.  I strive to keep myself occupied and feel productive as hard as I possibly can.  That said, no single part of me believes that if I am just busy enough, the blanket of depression will disappear for a few hours, and I will feel better.

Productivity, at least for me, is a learned hiding mechanism.  I figured out very young that the more I do, the more accomplished and useful I am as a person, the less I seem depressed in the eyes of the world.  And with the stigma of depression, as a kid, unable to verbalize why I was allowed to be depressed, to act on feelings that are caused by a chemical imbalance in my brain, that was the safest path.

At this point, it is hard for me to undo a lot of that, even as it's become actively harmful behavior on my part at times.  I am an introvert.  I need more down time and time to myself than the average person probably does.  But I rob myself of that due to the deep-rooted need to appear fine, appear together.

High productivity in depressed persons, although rare, can be a sign of hiding, it can be a sign of frantically trying to keep things together, it can be a sign of habits so ingrained even the depression cannot touch them, or all three.  What it is probably not a sign of is someone trying to run from the depression for periods of time.  Or, if it is, that person is likely doomed to disappointment.

If someone you know is a depressive who keeps busy, the kindest thing is to not assume at his/her/hir reasons for it.  If you're actually concerned, it's something you can discuss with them.  Otherwise, if when asked how they are they say, "busy," a great response is, "Yeah?  How is that for you?" and the intent to actually listen.

Oh G-d: the Intersection of Depression and Religion

Sorry about my absence last week.  This week I am acually posting something I wrote for my synagogue's newsletter.  I intend to discuss why I chose to write this and the aftermath of it in my next post.

Caveat: this post is not meant to imply in any way, shape or form that having a relationship with a higher power is necessary to better the lives of those who are depressed.  There are significant periods of time when I find it much more comforting to believe there's nothing out there, because at least then there's a reason nothing CARES that I feel like this so much of the time.

That said, to the article:

I am mentally ill.  I suffer from severe clinical depression.  Let me be clear about this: this does not mean I am sad.  This means that, when not properly medicated, I spend most if not all of my time thinking how much I would like to kill myself.  This means the desire to be dead is all I feel in those periods of time.  This means that, I can be on medication that works, but isn't quite right, and think the best I am going to feel—ever—is simply not-suicidal.  For most persons who suffer from mental illness, medication is helpful, if not an absolute necessity.  In many cases, it is the latter.

Medication for mental illness has almost as much stigma attached to it as the illnesses themselves.  People who take psychotropic drugs are weak, we "just want to feel good all the time," we "are not strong enough in our connection to G-d."  That last one is something I learned about from a friend.  Evidently, in certain sects of Christianity, taking medications for mental illness is frowned upon because if the ill person "just believed in Christ enough," they would feel the joy they do not feel.

Judaism, to its credit, does not approach treatment for mental illnesses in precisely this way.  The torah has examples of depression in figures like Saul.  Saul has periods of extreme dejection, jealousy-fueled rage at David, and otherwise irrational melancholy.  The torah tells us that David playing the harp for him helped somewhat with these emotional periods.  In the torah, David's music is the "therapy" Saul needs.  Obviously, in biblical times, the type of drugs we have today weren't even a thought.  There might have been homeopathic remedies for cuts and burns, bruises and infections, and alcohol or the like for self-medication, which is a far different thing than being properly medicated and seen to by a physician. Saul, though, didn't have the option of taking Prozac or Celexa and remembering that, oh, yeah, he was king, and things were pretty good.

From the outside looking in, it's hard not to see Saul's depression, his illness, as the reason David takes the throne instead of Jonathan.  Jonathan essentially comes from tainted blood.  Saul cannot trust in G-d enough, cannot connect to the divine enough, and therefore, David, who can, succeeds to the throne, and leads our nation, becoming a legend.  Saul's legacy is far less brilliant.  Although he is a byword for wisdom, his time as monarch is deeply overshadowed by David.  It is really no wonder persons who suffer from mental illness feel turned away by Judeo-Christian religious communities.

To make more comprehensive what I am trying to get across, telling a person who is depressed to trust in G-d, or be grateful for what G-d has given him or her, is much like telling a deaf person to just listen harder.  Helping a person who has depression (or is manic, or having a panic attack, or in crisis in any other way) to get help, however, is a way to bring him or her back to a place where s/he has the basic ability to trust in G-d, to appreciate what G-d has given to him or her, to do things with what s/he has been given in life.

I am not saying medication is right for everyone.  I am saying that a general reliance on religion has healed absolutely nobody I know who struggles with mental illness, and in many cases has made the illness worse.  I am saying that therapy of some type, or a mix of therapies, be it animal, music, art, physical, talk, medicine, or otherwise, is absolutely necessary for alleviating the worst of the symptoms of mental illness. 

We as Jews pride ourselves on taking care of our own, on tikkun olam, on our compassion.  Let us be leaders in showing compassion to those with mental illness, in helping them to get what they need, instead of judging them for their inability to be who we expect or want them to be.  Let us be leaders in caring enough to help people like me reach a place where a positive relationship with the divine is a possibility, rather than an ever out-of reach desire, another failure on our part, one more reason to leave the community.   

It's Not a Happy Pill, It's an Anti-Depressant

In 2007, I went on anti-depressants.  This is notable, because I was diagnosed as needing to be on medication in 1999.

Why the eight-year hesitation?  A few things:

1.  Anti-depressants have a HUGE stigma to them.  The term "happy pills" in an of itself is an issue, it suggests that people who need--not want, NEED--to be on these kinds of medications are in fact just looking for an easy out.  It's as if we're somehow just going to our doctor instead of down the street to score some illegal substance that makes us feel better for a few hours.

To illustrate, here is a comment once directed at me by a family member.  A family member, who, by the way, is nominally in the health industry:  "Yeah, anti-depressants are great in the wake of, say, a tragedy.  I took some [when my father died] and they helped me to get through it.  But you can't live your life on a pill just to make everything easier."

In other words: stop being weak.  The rest of us are just fine without pills to help us get through the day.

2.  Anti-depressants come with side-effects.  One of the most common is significant weight gain, which isn't fun for anyone, but for a woman--and, in my case, a woman who already has societally-induced body dysmorphia--that can be devastating.

On one of them, I stopped sleeping.  On another, I was so nauseated that even basic toast wanted to come back up.

Additionally, they can have counter-indications.  I was on Prozac long enough that it started CAUSING suicidal ideation, rather than alleviating it.  They also cause long-term liver damage, which means they essentially shorten the lifespan of almost anyone on them.

To sum up: they are not fun and are terrible on your body.

3.  For me, I was terrified.  What if I went on them and they didn't work, and this was what life was like for the rest of it, a very possible seventy or more years?  More importantly, what if I went on them and they didn't work because there was nothing wrong with me other than being lazy and pessimistic and a bad person?

In the end, though, I had to try.  Because, honestly, things couldn't get worse, and the hope, however small, that they might get better was impossible to turn away from.  My medication history has been full of ups and downs.  It took several tries to find the right medication the first time, but I will never, not if I live to one million and three, forget the feeling I had when the right one--Lexapro, at that time--kicked in.

It wasn't sudden, it was slow, but there was one day when I got home from work and the gym, and wanted to do something that wasn't sleep.  I had the feeling tomorrow might be a pretty good day.  I felt like ticking a few things off my to-do list.  And I thought, "Huh, look at that.  There's a person in there."

And then I cried.  Because for the first time since I could remember, I could feel something that wasn't soul-numbing hopelessness.  Even if it was sadness that I'd waited so long to go on the meds, it was real, an emotion, not just a blanket of brain chemical malfunction.  And, as it turned out, when on meds that work, I'm actually pretty chill about a lot of things, even things that objectively suck.

Now, let me be clear: when I am on anti-depressants that work, not everything is easy.  Life is still life.  It is still stressful, and I still have to accept that I am not going to get a lot of things I want or wish for.  People can still be hurtful, and loss still occurs.

The difference is, my brain's default reaction to all of this is not, "What's the point?  Why should I bother with this anymore?" or, at the worst, "Everything and everyone would be so much better off if I just sat down with a bottle of pills and disappeared."

That's not a happy pill.  I've never taken any hardcore street drugs, but from what I have been told by people who have, it's a COMPLETELY different sensation.  What's more, it's ephemeral.  You come down from it.

Anti-depressants don't cause happiness.  They cause the brain to work the way it's supposed to.

Here's the truth: being on anti-depressants is a pain in the ass.  Forget all the stuff I mentioned above, okay?  Your body gets used to them.  And you slip back into depression.  And sometimes the best they can manage is to keep you from living in a haze of suicidal ideation.  Sometimes it takes years to find the right combo, because just having that much help makes it feel like they're working.  And, to some extent they are.

I have changed meds seven times since 2007.  Every time is a gamble.  And for years at a time, I have been willing to accept, "not actively suicidal" as "meds are working."

I'm lucky right now.  I'm on the one-two-three punch of Welbutrin, Lexapro, and Abilify and it WORKS.  It works in the way where, when I have free time, I actually want to read or write or watch some television, instead of sleep.  It works where I can do things like plan ahead: go to the grocery store with an actual list, and come home and make meals for the week.  It sounds simple.  It's not.  It's the difference between a life that is just made up of days of forcing myself out of bed and to do every little thing that has to be done until I can get back in bed, and days where my life is actually happening, and I'm an active participant in it.  And because they actually work, instead of just providing base-stabilization, it's the first time since 2011, which was the last time I was on a combo that fully worked, that I can remember who I'm like as a person underneath the depression.

Right now, my insurance is refusing to support the Abilify, which means I'm going to have to appeal and try and figure out another way if they still refuse, since it is $830/month, which is, you know, outside my ability to afford.  I'm still underemployed, and still have been for over two years.  My rabbit has an ear infection that will not go away, and my dog vomited directly where I sleep on my bed while I was dancing Friday night.  And you know what?  It's all okay.  I'll find a way to afford the drug, because I need it, and I have always figured out ways before.  My rabbit is almost nine years old and this is her first ear infection, which is a near miracle.  The puking forced me to clean my mattress, which really needed it.  And I'm in the process of interviewing for a job I might get.  If I don't, well, back to the drawing board.

I cannot emphasize enough: these drugs aren't happy pills.  They do not blind me to the things that I'd rather NOT happen in my life.  They don't give me moments of ecstasy.  They allow me to COPE and to live my life without the constant specter of suicide.

If you or someone you know is avoiding medication because of stigma or fear, I cannot stress enough that neither of those are good enough reasons to continue being miserable.  Please, please try, or get them to try, talking to a prescribing doctor.  Maybe meds aren't for you.  But maybe they are.  And maybe underneath how terrible everything is, there's a person, screaming that zie just needs a little help, just a shove in the right direction.  Get yourself, or try to help the person you love get that shove.