How do you keep going?

[Arana]

I've just finished trying my fourth round of antidepressants. I don't know what's worse, bring in them or not being in them.

How do you keep going, day in, day out? How do your partners and children keep going?

I hate feeling suicidal and depressed. I'm so fed up of it. My life isn't that bad, I should be happy. I AM happy, I just can't stop wanting to destroy myself.

Anti-Depressants take up to 3 months to start working properly (& for side effects to wear off).
I tried 2 SSRIs, but it's a SNRI (Venlafaxine M/R 225mg daily) that has worked best for me.

Anti-Depressants (ADs) aren't 'happy pills' - they will never make you happy all the time unlike what the media would have people believe .

ADs do give lift you up from the deep depression & give you the energy to keep going; then you may start to feel positive about life.

Suicide can be a risk when the ADs first start to work - because if you've been too catatonic to even get a glass of water (like i was), felt suicidal but couldn't even get out of bed - well that lift of energy puts you at risk of putting plans into action.
So make sure your family are aware of that - & you must keep the CMHTT Crisis Team / Samaritans etc phone numbers to hand if you do think you want to commit suicide or self-harm - the suicidal feelings WILL pass though & talking to others helps those feelings to go.

One day, you will wake up & life won't seem bleak or pointless. You will look outside, enjoy what you see & be able to live without the constant sadness inside of you.

That's when you know the ADs have kicked in - when you feel normal, not depressed. That's when you will be well enough for therapy.

(PS: NEVER stop taking the ADs (or any other prescribed medicines) without GP / Psychiatrist supervision - if you are asked to stop them; then the dose should be titrated down not suddenly stopped.)

DON'T feel guilty for your depression - it can affect the richest & poorest people anywhere it the world, whatever their circumstances. I wasted effort on guilt & it is pointless - depression can affect ANYONE (just like asthma or flu!).

Some people just won't understand depression or mental illness unless it happens to them - ignore them, don't waste energy bothering to try & make them understand.

Just keep good family & friends close but keep things fairly light - tell them when you feel low but otherwise don't talk to them about the depression - that's what the Crisis Team & Samaritans are for.
The CMHT nurses choose Mental Health as a speciality because they want to help people like us (i keep feeling guilty about 'bothering' them but i remind myself of that). They are far better to talk to than family eg. because they understand & know what to say.

Finally - find things that keep your mind off how you feel - i would say that owning a very demanding grumpy but daft cat saved me: if i didn't feed her then she would make my life hell. (Depression can't bite & scratch - but hungry cats definitely can!!!) :)

Best wishes xx

Forgot to say - regular small meals or snacks are important - lack of food can cause your mood to worsen.
Choose the most healthy & nourishing food that you can get.
I still get short periods of depression, but i do have other MH problems so you may not get that.
I find it hard to bother even making toast - i recommend that you keep food that is easy to get at quickly; eg cereal bars, tins of fish with ring pulls, crackers, microwave rice & beans that take 2 mins, mini Babybels, apples etc - & eat a balanced diet - each meal should have carbs, protein, fruit & / or veg.

OH Arana so so sorry that life is so tough and 4 different ADs have not brought you any relief. Have they all been SSRIs - maybe you could try the old fashioned tryclics - I am on one of those (imipramine) and it suits me but I am still not fully recovered from a severe episode of depression and 3 months on psych ward 2 years ago.

Look I'm sure you will be freaked out at this but I will mention it. When I was in hospital 2 years ago I realised that some patients were having ECT and I was shocked as I thought that had all finished years ago. Apparently it istill widely used for drug resistant depression, and the treatment is now very different from all those awful films with patients convulsing etc. They are given a muscle relaxant and a sedative and they can't remember anything happening. There can be a problem with memory for 48 hours but there is no evidence that there is any problem with memory after this. In fact the psychiatrist said to me that if he ever got depression he wouldn't hesitate to have ECT. as with drug resistant depression it is very successful.

Sorry if this has upset you but I am only passing on what I heard. A friend of mine was severely depressed for over a year and the meds were't working, but in the end she saw a differet psychiatrist and he added lithium to her AD and she improved within weeks and was fully recovered in a couple of months. She has to have regular blood tests but is just so thankful that she came across this psychiatrist as she was realy struggling.

You say you are happy but I wonder how this can be when you are having suicidal thoughts and wanting to destroy yourself. This is exactly how I feel when the bad days come and as Ralphycat says there are a lot of ups and downs with this horrid illness, and I certainly know this as I can be fine for weeks (even months) and then I wake up and feel totally and utterly crap and won't get up and cry and generally want to get "rid of myself" and also think of just driving into a wall, or even running and running somewhere and curling up a hedge to die - irrational I know but that's the nature of the beast with depression.

Do you know the roots of your depression because if so therapy I'm sure would help - don't know if you have been down this route.

Thanks for the replies. What you said about Ect was really interesting NN. I would consider it like a shot tbh, but I don't know if my psych would.

I've been on citalopram, sertraline and cymbalta for three months each. I tried amitriptyline for a month, and desvenlafaxine for 4 days (2 near suicide attempts, and one case of hospital treatment for self harm and I figured the benefits weren't worth dying for).

When there is little or no stress in my life, it's not so hard. It's the irrationality, the paranoia, the anxiety the wild mood swings that are the problem as soon as there's a small amount of pressure, or unexpected difficulty. This is where the suicidality and self harm comes into it.

The depression is always there, lurking in the background. It's a passive beast, so I rarely consider it a danger in itself unless the other parts of me are stable. But then it slowly weighs me down, saps my energy and motivation, and renders me empty and a nothingness.

On paper, I think I am happy, I'm just really struggling to rationalise it. I live in a wonderful place (lots of sunshine), I have a job that I enjoy and I'm valued by my colleagues, I have a wonderful husband and children that despite their own issues I absolutely love to bits. If it wasn't for them I would have thrown myself off a bridge many months ago. We have enough money that we are comfortable for now and can plan for the future - this is after many years of struggling financially. Life is good. Life is positive, I have hope for the future. Just right now though, it sucks to be me, and I can't put my finger on why.

The fly in the ointment if any, is the relationship between me and my parents, their treatment of me as a child, and their attitude to me now. That's partly why we moved 12,000 miles. It hurts, a lot, and I'm working through it with help, but I do think it's a main source of my anger and self hate.

I'd love to consider ect or something like lithium that might work for my "psycho"ness, but I think my originally very patient psychiatrist is starting to lose interest, I guess because little seems to be actually having an effect (although the diagnosis of adhd and getting treatment for it has meant I've been able to keep my job which is a massive plus for my mental health). I suppose it's got to the point where on paper I really shouldn't be depressed, but I am, and there seems little I can do about it. Again, it probably doesn't help that I can't run/do vigorous exercise due to an ongoing problem with my pelvis/a variety of post pregnancy physical problems (dc2 is nearly 3). I suppose there's always stuff like that getting me down, but I used ti be able to handle it much better.

/shrug

I'll be back Arana - hot having a good day here, but I usually feel better as the day wears on, but sometimes don't lift till 8 or 9. I loathe this damn illness for me and for you and for all other sufferers. People who haven't had it have no idea what a torment this illness is.

Absolutely - I read an article about a horrible event that was blamed on pnd of the mother, and the backlash was phenomenal. Nobody knows what it's like unless you're been there - it's not something you can rationalise.

I'm just going to try and get through another day, another week.

Hi Arana - can you say what your diagnosis is, because it sounds like there are oher issues related to you r MH besides depression, as you mention irritationality,paranoia, wild mood swings, that I don't think are symptoms of depression. I don't like people diagnosing on these threads especially as we don't have any medical qualifications, but I can't help but wonder about your diagnosis and whether this is why ADs are not working.

You are obviously having some sort of therapy or counselling related to your ill treatment as a child, and do you think this is the origin of your MH problems now. Are there any MH problems in your family which you could have inherited.

As far as ECT is concerned - you could ask your psychiatrist and whether there are any drugs (other thanADs) that could help you. I do feel for you as I know how awful it is to have MH problems because so few people understand it.

Very true that in RL people don't understand unless they've been there - same with a lot of problems i guess.
I've returned to work (PT for now) & hardly anyone knows about my problems except the managers.

I have Epilepsy - btw DON'T try Epilim Chrono if it's offered as a mood stabiliser - ok, i took the top dose for Epilepsy but the side effects were horrendous & i've been left with memory loss & osteopaenia after 15 yrs of taking it - despite changing to newer meds recently.
The Venlafaxine works for my depression (now diagnosed as chronic major depressive disorder) - but has a side effect of lowering my seizure threshold so i still get absences, myoclonus & deja vu seizure - luckily i'm aware of the triggers & try to avoid them.
My main problem is Borderline (aka Emotionally Unstable) Personality Disorder. I'm on the waiting list for DBT & see an NHS Psychiatrist 8 weekly, & a Cons Psychologist 4 weekly. The Psychiatrist acknowledges the problems (extreme mood swings, temporary psychosis, irrationality, paranoia & self-harm are the worst things) but doesn't want to add any more meds as they won't go with the new AEDs & the Venlafaxine - unless my mental health really deteriorates.

If you are getting mood swings then i totally sympathise - they are a PITA & can be quite anti-social too.
I've learnt to avoid other people (& knives eek!) when i get angry or agitated & go out in the garden to destroy the weeds & cut hedges... really feels good to attack things that actually need it (ahem)! Also brushing the cat is satisfying as she's a Persian & i have to work hard every day at brushing or she gets ill with furballs. & playing with her is good too - usually end up laughing so much i feel better :)
The depressive moods are bad - because it doesn't take much to feel suicidal. The main triggers are: being alone, being bored, thinking people don't like me if they criticize me (yes, they actually do like me).. also a bad shift at work, getting hungry & too tired. I even get depressed about having BPD & Epilepsy.

BPD is exhausting because when i'm with friends, family & colleagues i find it hard to stop constantly analyse their every word or facial expression - in case they don't like me any more or are against me.
I know the real reason for my fear is that i'm scared of ending up lonely - daft because i make friends easily.
People would be shocked if they knew how i feel. It's not all the time - the paranoia & over-analysing everything is worst when i get anxious or get PMT.
But difficult to live with.
The therapy i've had helps but my memory loss means that i often forget to use the strategies i've learnt.

So i do get quite miserable (not for more than a few hours at a time though - thanks to the Venlafaxine) & i try to keep fighting the depressive moods - it's hard to bother to fight it but i don't want to end up dead because of stupid mood swings.

Arana - these are my tips for when you feel depressed:

Eat something - even a glass of milk & a cracker can help.
Get outside, away from your own company & any potential self-harm implements!
Going for a walk then sitting in a cafe with a nice cuppa & a fashion magazine is good.
Phone a friend; you don't need to say you feel depressed if you don't want to - just chatting can help.
Log onto Mumsnet! - AIBU & Chat can be very funny!
Read a book - if you can't concentrate then look at one with nice photos eg an wildlife book; if you can then the Shopaholic books are good. Also i had a laugh reading the children's books when looking for a gift recently - some are actually quite funny :)
Pamper yourself - shave your legs & apply body lotion, paint your nails - simple but nice to feel more attractive.
Sleep - set the alarm for 1 hour, then just rest.. any longer & you will upset your sleep pattern though.

AVOID ALCOHOL - it's a depressant, & can stop ADs working - i find that even a small glass of wine or a single shot is bad for me; so i had to stop drinking totally. (Sob.. i miss my mojitos..) If i can stop drinking then anyone can!

AVOID lots of caffeine - i find caffeine in tea is ok, but have to avoid cola & stick to decaf coffee - or i get quite agitated.

Take care xx

PS sorry for essay but i've been feeling quite crappy with things since Friday & typing it all out in a logical way helps me see things a bit clearer.

Thanks for all you wrote Latara, I always find it interesting to hear about other peoples' experiences and techniques for dealing with the shit.

I definitely have depression and ADD. Whether there's anything else I don't know. I can go from normal to psycho in seconds almost (although with a fairly obvious trigger), but can also go for months being very stable. I certainly tick most of the boxes for bpd when I'm in psycho mode, but when I'm not, it rolls right over me and I don't even notice stuff that at other times would make me feel suicidal.

At the moment I'm having a break from the ADs, so just mainly on the ritalin, which does help. I have minimal side effects (please, could I not just have reduced appetite for a bit??) and really notice a difference on days when I don't take it.

I haven't self harmed for nearly two weeks. The last time I scraped my knuckles on a concrete wall for about 15 metres while I walked along, and now I have hideous scabs that look like I stubbed cigarettes out on each on my knuckles. Usually my self harm is hidden, so it's been a bit unusual to have people ask what I did to my hand. When I say I scraped it against a wall, most people assume it was an accident, but a couple of people have twigged.

I'm currently using smoking as a coping strategy. I really dislike smoking, but it seems to provide a good alternative outlet to self harm. I only have one or two a day, at times/occasions when I'd go and cut myself. It's usually enough "time out" that the moment has passed, and bad enough for me that I get that "fuck you world" feeling when I do it.

So there's me at the moment. Feeling pretty stable, if a bit empty, but that's normal for me. Making it through another week.

I've also downloaded a free ebook that I've just started called Getting Unstuck: Unraveling the knot of depression, attention and trauma. The target "patient" describes me to an absolute T, so I'm hoping there might be some good strategies in there. Print price is £20 do it might be worth a free download before the price rises, even if you end up binning it later. I'm only on page 17 so apologies if it's a pile of crap!

Nooo don't smoke - especially if you dislike it. Because when you get better you might find you can't give up - even a couple of fags a day increases your risk of lung disease, cancers, heart disease, stroke, circulatory disease etc etc you know what i mean.

Plus it gives you wrinkles. And smells.
Throw the cigarettes in the toilet noooowwww.

OK I HATE admitting THIS: My icky habit is picking at my scalp when i'm anxious / bored / angry. I hate the results (had to have lots of antibiotics for infection, it hurts a lot - but only afterwards; & is bad for hair growth). I am trying SO hard to stop - so can you try to stop smoking please; make a cup of tea to help you relax instead

I guess it says something for my life when doing something I dislike intensely is something I choose to do in order to "get better".

I need a firework up my arse.

On a side note, I've been prescribed tramadol for the pain in my pelvis, and having read up about it, apparently it has some antidepressant qualities and can help with restless legs which is something else that irritates me intensely.

Hi Arana. Don't give up on the AD's. I tried prozac, citalopram, seroxat and venlafaxine to no avail (depression, eating disorder/self harm) saw various psychiatrists (all infuriating). A GP I'd never met came to see me after I'd stormed out of a psych assessment, and said by the way I was sitting I was on the wrong type of meds. Put me on lofepramine- a 'modern' tricyclic and from then on everything started to improve (though ups and downs like anyone...) Soon after I stopped harming myself, don't have eating probs now either. But you need other help in conjunction with the meds- I hope you are getting it.

Tips for coping- if I feel like harming I get into bed and pull the covers over my head til it passes (not always possible)
-put happy music on

• go on t'internet
• break some crockery/other stuff if desperate (I go through a lot of crockery......dh sees this as unreasonable behaviour but I say it is better than breaking me) Not one for when kiddie winks are around as it'll freak them out. You get all the shock/guilt thing of harming due to mess/lack of mugs, but no physical scars (rules- focus on clearing up mess before anyone finds out then you tick the dirty secret mental box too)
• postpone it- I can't harm myself til I've done x,y,z or until 9 o clock/tomorrow or whatever. Usually urge has passed by then- but as you're promised yourself you can do it the feeling is less desperate for some reason.

Apologies if this is no help at all

Take care x