Moving Beyond Blue
Therese Borchard at Beliefnet’s Beyond Blue interviewed me in October 2007. She asked many insightful questions including, “how do you think you know when or if you can go off your meds?” and “What did you do when you relapsed?”
I had no idea that my answers were interpreted as controversial based on the comments that flooded the interview!
For the most part, people understood (correctly) that my answer to the first question had to do with my early perception of what I was going through, when I knew just enough to admit that I had a condition that required medical intervention, and when I was still naive to know that depression can return like a vengeance, as I had personally experienced when my depression relapsed in 2001. Did I genuinely believe I could “fix myself” with one year of vigilant medication therapy and psychotherapy back in 1998? Yes, that was my naive personal belief at the time, based on my rudimentary understanding of my own depression, mixed in with a lot of denial that I would be managing the risks for this condition on a life-long basis. Am I saying that this is what people should aim for? NO!
There were some who interpreted my personal experiences and choices with medication as “anti-medication” and therefore expressed concern that I was advocating against medication. This was, of course, neither my intention nor my personal practice or belief. It would be strange for me to be antagonistic in biochemical intervention when I had earned a doctorate in biochemistry and specifically trained in looking at the biochemical basis of living systems. Those who are regular visitors to this website will find that I talk about medications and medication therapy as often as I talk about other complementary therapies (for example: exercise). I have a lot of respect for drugs because I have worked with many of them both in research and in clinical trials during the course of my health care career. I’ve always emphasized (here and on my other sites) that drugs are powerful agents with risks and benefits, and should always be administered judiciously, based on a partnership between doctors and patients.
During my relapse, I immediately went for both routes - the chemical route (antidepressants) and the psychotherapy route - as I had done when I was first seeking help for depression. Unfortunately for me, I tried 3 or 4 antidepressants and the side effects were intolerable. I remember taking two antidepressants made by a drug company that I used to work for; one made me extremely drowsy, the other made me so dizzy and nauseous that I was unable to stand up and walk a straight line.
I was forced to resort to psychotherapy as my main line of treatment, and just to be on the safe side, actually enlisted both a psychologist and a psychiatrist for double dose of psychotherapy weekly. The psychiatrist and I tried to find a drug that would work, but after almost 3 months, ultimately decided that given the suboptimal dose of a SSRI that I could tolerate, I wasn’t getting the therapeutic effects anyway, and we would stop trying to find the med that would work given that I was doing well on psychotherapy. If I wasn’t improving on psychotherapy alone, would I continue trying different medication therapies? You bet. My goal was to get better.
My approach to health - including mental health - is quite simple: I have personal responsibility for my own wellness.
This means I am accountable as a partner with my doctor(s) for my health, and given that I know I have risk factors (depression is one), I have a responsibility to monitor my own mental health so that I can recognize early warning signs before something more serious emerges.
This means I need to educate others around me, especially people close to me, so that they can help me detect abnormalities if I miss the signals.
My goal is to be well and stay well. When warranted, I make sure that the treatment decisions I make with my doctor is based on sound scientific evidence, and I make sure that I do my part in whatever non-medical (i.e. lifestyle) changes I need to make to get better.
Emotional Invalidation, Brands or Generics, Worrying, and More
Barbara’s article on emotional invalidation has a lot of details to help you recognize emotional invalidation and the many forms it comes in. What I’d like to see is a follow-up article addressing ways to respond within yourself and to the other person when you know you are facing emotional invalidation.
GrrlScientist was recent sent an article on Creating a Mouse Model of Bipolar Disorder to study the manic phase of bipolar disorder. GrrlScientist gave a good background of the biology of bipolar disorder and potential research directions in this area. What’s important to note is that the mouse system did not cycle between mania and depression the way humans do. This underscores the limitations of studying an illness that is often a manifestation of a complex, whole system by 1) picking apart its individual components and 2) using a different system, albeit a whole animal system. One of the limitations of modern medicine has been our fixation on “targeting” specifics, which makes sense on one level, but also means we may often miss unforeseen long term side effects. Read more
I’m Here to Remind You that You Are Not Your Illness
Medically speaking, I’m “in remission” from clinical depression. When I get the blues now, the blue mood does not expand and darken into the sinister depression that left me functionally crippled (albeit still highly functioning) for many years. For a while, I struggled with keeping up this website. I used to see this website as a constant reminder of the pain I experienced from depression and emotional abuse. Who would want a constant reminder of these? Moreover, I wondered if keeping this website would be akin to “holding onto my past” instead of “letting go of my past so I can get on with my life.”
I have gone through relationship “crises” with this website, and it’s sort of like parent-child relationship, although I can’t be sure whether I was the parent or the child. At times I hold it in gratitude, for this held a record of the shadows in which I lived for a long time, and a record of my emergence from those shadows. At times I rebelled against it, for I did not like the reminder of the shadows when life seems to be going so well and when I was supposed to be “out there setting big hairy audacious goals for myself.” Read more