Coming Down From the Depression Mountain

Well, not entirely and it’s a rather premature title, but I took that step down from the depression mountain (which is counterintuitively, a way of taking a step up? Go with me on this metaphor, folks), and I’m proud of myself. In one way or another, I’ve dragged my feet on doing this for five years. Five years of thinking I could talk myself off the mountain. Five years of gaslighting myself that it’s not as bad as I think it is. Five years of thinking, why try to fix it, I’m doomed anyway. But I did it. I took that step today. And part of taking that step is that I want to keep being as transparent and open about what taking that step looks like. If it helps anyone else to talk about it, to encourage them to also take that step down the mountain, then I will. And selfishly, as with any writing I do, it’s always catharsis for me to talk through it as well.

To be back up, as part of my kidney donation process, I needed to establish a regular physician (which is a good thing to do regardless), so that the kidney team can “pass me off” to the physician, as it were. Now that I have one kidney, I obviously need to regularly keep in check with my blood pressure, kidney function, and the rest of it. That was the first reason for going, but the second reason was to talk about my depression and anxiety with the doctor. Even as I was sitting there in the doctor’s office in my Toy Story shirt (oh yeah), I still wasn’t sure if I was going to do it or not. But then my physician’s assistant asked if there was anything else that brought me in today, and I awkwardly said, depression and anxiety, and she brought the typical forms in that you would expect: rank from 1 to 3 if you have experienced X, Y and Z in the past two weeks sort of thing. For the first time in my life, I filled out those forms honestly without artificially holding back and lying about how I actually feel.

Then the doctor came in, and of course, after some small talk (and turns out, he grew up in my newspaper coverage area and actually recognized my newspaper by name, so small world), he asked about the depression/anxiety and my answers. More or less, re-asking what I already answered on the forms. That was even more difficult. When I am pushing against talking about something, I tend to stutter and mumble and get flustered, so I had to push through all of that. Part of that is figuring out where to start with it. And obviously, a huge part is abject fear. Once I verbalize it, the gaslighting internally in my head begins. “You’re full of crap; you don’t actually feel this way, why are you saying that?” Aren’t you over-reacting? Is it this bad?” If you haven’t experienced this sort of thing, my mind constantly gaslights in that way because as hard as it is to admit verbally to a health professional, it’s even more difficult to admit to myself. Heck, even in my rough draft, I replaced all the first-person throughout this with second-person, as if subconsciously distancing myself from my own experience. Dang, brain!

The weirdest thing occurred after talking through it with the physician, though. That is to say, nothing happened. That is, alarms didn’t go off and men in white coats didn’t haul me away. I didn’t get thrown into a padded room. That sounds silly, but honestly, a large part of what scared me about ever being honest or verbalizing the depression and anxiety in my head was that cliché scenario. That it would set off a chain of events where I end up in a psych ward and poked and prodded sort of thing. It’s completely irrational, but hey. The second half of that fear is that people would look at me weird, like I have a steel rod sticking through my head. Once I verbalize such a thing. Once they realize I’m taking medication. That I will be a walking billboard for being broken, damaged, a misfit. It’s all silly stigma, but it’s stigma for a reason. In fact, one of my biggest gaslighting efforts was to think I was smart enough and cognizant enough to navigate such silly stigma, and nope, I’m as susceptible to it as anyone else.

So, what did happen was that my physician asked me if I wanted to take medication, and again, awkwardly, I said, yes. A family relative went through this same experience, of going to the physician, explaining how they were depressed and anxious, and receiving prescribed medication. I didn’t believe it could be that easy. Alarm bells and drowning in red flags, and such. But it really was that “easy.” But not? It’s never easy to verbalize this stuff, but it was easy in how receptive, for lack of a better word, the physician was. I’m grateful to him for that. He put me at ease, inasmuch as one can.

I don’t know if it would be proper to say I was diagnosed? Because the physician isn’t a mental health specialist? But he did write “dysthymia” on my after-visit write-up and obviously, I was prescribed medicine, in this case, an antidepressant that treats major depression and generalized anxiety disorder called escitalopram. I’m glad I only have to type it and not pronounce it. Dysthymia is the term for “persistent depressive disorder.” The idea behind the drug, as I understand it from Googling, is that it’s part of a class of drugs called selective serotonin reuptake inhibitors, which affects chemicals in the brain that may be “unbalanced” in people with depression and/or anxiety.

In other words, for the layman (which is myself, but this is how I understand it), antidepressant drugs are not drugs that are taking you to a higher level, as it were. The point is more so to help make you “balanced” again. The doctor advised that it will take a few weeks to do its job in that way, which makes sense to sort of circulate into your body, and that it could cause some drowsiness, so I should take it in the morning. My next appointment is in a month to see how things are going.

One thing I obviously checked was whether taking these drugs would interfere with having one kidney and my blood pressure. Since the liver deals with that, I’m good. But also, something I didn’t think to ask, but am curious about now, I wonder why escitalopram? I know people who take others, like sertraline (brand name Zoloft), which is a SSRI as well, but what’s the difference between those two, if any, and why is one subscribed to someone and another to a different person? There’s also bupropion (brand name Wellbutrin), which isn’t a SSRI; instead, it’s a norepinephrine-dopamine reuptake inhibitor. I don’t want to stumble around in the dark trying to understand the difference between SSRIs and NDRIs, so I won’t.

Incidentally, all this science mumbo jumbo is hurting my brain. I need to do more research when I get a chance, but I’m glad to even be at the level of doing the research, and I really just wanted to share my experience today more than anything.

It was scary how scary it was and has always been, and also scary simple to say, “Hey, I need help,” and to hear back, “Oh, okay.”

What has been your experience with these medications, if so? Any recommendations and words of advice?