Vignette: I think I am getting a baseline…

You know the saying about how when a noise suddenly stops is the first time you can perceive how loud it was?

That.

I have been now on a combination of fluoxetin and voxra/wellbutrin for about 2 months. And I realize thinking back on the recent weeks that I have been feeling… normal. Or at least what I imagine normal might be like.

Gone is the constant work trying to figure out whether there were any subtexts I should have picked up on.
Gone is the constant worry someone, somewhere might not like me and what I do as much as I hope they do.
Gone is the constant conviction that nobody, nowhere, actually likes me particularly much.

I feel now that what I observe is far more in harmony with how I represent it internally. People's emotional states match up better with what I think that they are.

Facebook argument

Today I had a perfectly friendly argument on facebook.   I posted something, a couple of friends disagreed, I argued, that's about it.   I found it engaging, it was perfectly good humoured, nobody was rude or offensive to me.   But in the end I found it a bit depressing.

My facebook usage used to be have a lot of  posts with complaints about things, most often things that annoyed me in the news.   A few months ago I made a conscious effort to be a bit more positive, not bothering to post the negative things and being more likely to post more positive ones.   I don't honestly know if it has helped me, except it's nice sometimes to spread good news when I would not previously have bothered.

This is nothing to this story.  Nobody was mean to me and I hope I wasn't mean to them.   But I found it a bit depressing.

Link: The Elephant in the Room: The Stigma Around Mental Health

The Elephant in the Room: The Stigma Around Mental Health is an excellent article by a young student at Huffington Post Students UK.  

This post happens to be by a relative of a friend of mine, but that's just how it came to my attention on facebook.  It focusses on the difficulties of being diagnosed with depression as a young person, both medical and family.  

One of the points she picks up on is the problems caused by the multiple meanings of the word depressed, which I've also blogged about.  At least on this blog, I try to use a word like "dispiriting" instead of "depressing" if I mean the non-medical type of depressing: e.g. "Getting a paper rejected is dispiriting."

In site news, there's not been a lot of posts recently. I can't speak for Mikael but for me that's generally a good sign. I haven't been feeling depressed but also have had a cough which has slowed me down.  The good side of the cough is that I have had a lot of seriously serious naps.  Yesterday my naps were an hour, 20 minutes, and two hours.  Lovely.

It's Ok Not To Be Ok

The ever wonderful Keelium pointed out this post by Miri on facebook, saying 

"Seriously good shit. Read immediately. As someone who has spent the same decade (14 to 24 for me though) learning from depression, I'm with Miri 100%."

Miri talks about making life decisions - including not doing a PhD - based in part on how it will affect her depression.  She makes the excellent point that if somebody has bad knees, nobody criticises them for not running a marathon.  The same should apply if your mental health precludes certain areas of activity.

image credit: Miri

Vignette: Just what I needed

Of course. This is exactly what I needed today. An anxiety attack out of the blue to really drive home the message that just because I get (quite a lot of) good days from my new meds doesn't mean everything is already solved.

I have a lot of deadlines right now. Two job applications, one 400k€ grant application and one major conference paper deadline with a submission video I'll be rendering and editing myself.

All in the span of about 8-10 days.

So I feel a large pressure to focus. To actually get all these things done. Which in turn means I react without much grace to being forced to focus. Today I got about 30 minutes worth of work done. All day. Last day to prep before I get access to the video editing suites tomorrow.

And the pressure to focus means I paralyze. Freeze up. Don't get anything done anymore.
And the paralysis means I start fretting and eventually freaking out about my productivity in the face of these external pressures.

I was doing remarkably well before. Today I'm not even able to cook dinner, and the thought of having to be involved in cooking and cleaning up after had me panicking.

21 Tips to Keep Your Shit Together When You’re Depressed

http://www.diycouturier.com/post/47249603128/21-tips-to-keep-your-shit-together-when-youre

A fashion blogger writes about depression and about perky suggestions to “Just Feel Better” with 21 concrete tips for people struggling with depression, many of which resonate with me.

Moving post on "Moving On" by Keelium

A very moving post yesterday Moving On by Keelium.

Some warning though: it could upset you.

It talks about many sides of depression in academia from a grad student's point of view.  How being ill makes it difficult to perform in a overworking culture, how this can lead to the termination of studies, this in turn of course causing health problems, and then all this can be brought back to you much later out of the blue.

Effects and side-effects — an update

After about 2 months on Fluoxetin, we adjusted my medication.
Since mid-March, I have been taking Fluoxetin and Voxra (Wellbutrin) together.

I am now getting to the point where observations can be written down; where I have more than a few days worth of a sample.

First off, the really good: my mood is much more normal now. On Fluoxetin alone, I turned flat; I kept being sad for much of the time, but the crashes went away. I just was bored, dull, apathetic instead of having daily anxiety attacks. Improvement, sure, but not up at good just yet.

With the combination, my dull flatness has gone away. I have my ups and downs — I had a fullblown classic breakdown a few days ago, but it's once in 2 weeks, not several times a week. And I'm happy and energetic far more often than earlier in the past year.

So as for the primary effects, the combination seems pretty much spot on. Sure, it would be nice to get more stable than this, but it is already an incredible improvement on Before.

Now for the side-effects. I have gotten rid of some, retained some, and gained a couple of new ones.
My grinding and chattering teeth are remaining. Last night, it was apparently bad enough it helped keep Susanne awake at night.
I am far more sensitive to alcohol than I was before. On the other hand, I have always tried to pay attention to my body signals when it comes to alcohol consumption, so this doesn't really worry me.
I wake up several times each night. This is new.
I am tired. A lot. I grow almost uncontrollably tired around 9pm; we used to have a family diurnal rhythm with bedtime at midnight. Now, I go to bed between 10pm and 11pm instead. This, too, is new.