Seeking Remission

My last post was optimistic and full of hope, but to be honest, the last few months haven’t really felt that way. I spent my Christmas holiday mostly in a fog. My mother suggested that maybe the increase in my dose of antidepressants was making me numb, so I agreed to actually seek a psychiatrist’s help.

For someone with a healthy respect for mental illness and the support systems required to treat them, I’ll admit that I don’t really like psychiatrists. I had only ever seen one before I walked in to the counseling center at my undergraduate university—in 2012, when I realized how real my ideations were becoming. The psychiatrist I saw was a family member’s doctor, and I only met with her twice: once, for her to diagnose me with generalized anxiety disorder (GAD), and a second time as a follow up. I then switched my medication to be managed by my neurologist, and he put me on an SNRI to prevent migraines. I’d found the medication to be helpful in managing both my psychological symptoms and my physical ones, and had stayed on it since.

It was with trepidation that I used the walk-in clinic—as many of you know, I sought help from my undergrad’s counseling center but was turned away from individual counseling due to the overlong wait list—instead, I was placed in group therapy, in a group that was mostly men, and all graduate students. I was an 18-year-old freshman girl who was scared of her boyfriend and didn’t feel like eating or being awake: I wasn’t going to talk about that with that group.

Luckily, nine years later, at a different public university, my experience was better. After my intake appointment, I left with a list of therapists to check out and a psychiatric consult the next week.

I estimated that the consult would be familiar territory: explain my symptoms, confirm my anxiety diagnosis was causing my depression, and adjust my dose.

Instead, I found an inquisitive psychiatric nurse practitioner asking me about many different aspects of my life. Are you sleeping? Some, but I have constant nightmares. How is your appetite? Fine, but food doesn’t interest me much—I eat to live. How long have you been on your SNRI? Five years. And on: How are you doing in school? Are you in a relationship? How do you usually feel? How do you feel right now?

I assumed my anxiety was the underlying problem, but she saw in me something else: “I think you have fairly severe major depression.”

Many of my friends are not surprised to learn this, but somehow, I was. I always had thought my depression was a result of my anxiety, not the other way around: for some reason, my self-perception had latched onto the concept of myself as a bundle of nerves rather than a depressive person. Not to say that the two are mutually exclusive, but to me, they seemed distinct.

Next, she told me, “Remember, you aren’t going to feel this way forever. It’s going to get better. We’re going to get you into remission.”

Remission. That was another word I wasn’t used to hearing in the context of my own health: to me, remission is something you want with a life-threatening illness. My illness is an imbalance of chemicals in my brain, or, if you ask many people, the result of laziness. What is remission, for major depressive disorder? Will I be on medication forever? Will I be able to stop one day?

We determined a plan of action: she raised my dose higher than it had ever been, put me on a medication that was intended to stop my nightmares, and told me to look for therapists practiced in cognitive behavioral therapy.

I didn’t realize how hard it would be.

I’ve been relatively lucky: I’ve only tried one medication in my mental health journey that just plain didn’t work. But it appeared my trusty SNRI was starting to fail me. We raised my dose and I suddenly felt more jumpy and irritable. We raised it one more time and I started having uncontrollable tremors in my hands. I started acting stupid: I spilled gasoline all over myself at a gas station. I started the microwave without ever putting food in it. I turned on the stove without lighting it.

We switched to another SNRI.

Anyone who has been on SSRIs or SNRIs can tell you the withdrawal is awful. This certainly was. Even with another SNRI in my system, I spent over two weeks light headed, with tingling running down my limbs. In one moment, I was running when the lightheadedness hit: I got dizzy, and hit the curb at an odd angle, spraining my ankle, pulling a ligament, and fracturing my foot.

I had thought I was irritable before and now it was worse: every single thing that was out of place bothered me. Every single interaction I had with my friends was suspect. I felt like they all hated me and didn’t want to hang out with me.

I’ve leveled out, since then. I went on spring break, and started working on truly relaxing. I can smile and laugh a little more easily. I have more energy—I can get out of bed in the morning, and I don’t want to get back in at lunchtime. I feel excited about the future, about my summer internship, about scheduling trips to see my friends. I’m not moving listlessly though my day: I’m starting to seize it.

Anyway, my point is:

It’s not easy.

Anyone who tells you it’s easy to fix mental illness is selling something. It’s a battle. It’s an every day battle. It requires checking in with yourself regularly. It requires patience. It requires forgiveness. It requires taking time to recognize your own bad habits and wanting to fix them. And it requires help.

I know I’ve had a lot of friends who share the struggle. I appreciate those of you who to reach out to me and offer your stories and your words of encouragement. And I want to remind you, it’s hard for everyone who shares the burden. But you’re worth the work to fix it.