Staring at my own brain

I hope you don't mind if I tell you I had a bout of depression a few weeks ago.

It came on very suddenly, over the period of an hour - though the days before I recall some unusual anxiety and a sense of hopelessness. "It" lasted about 36 hours, and then I woke up feeling pretty much normal - though a bit emotionally tender.

While it was happening, as you might expect of me, I took notes. I watched as quite normal thoughts would drift into negative and hopeless conclusions. I found certain benign things (notably: yellow cars) intolerable. Normal interactions with my husband and kids took this plodding and excruciating patience. The only time I left the house was almost comically unsuccessful. I was easily hurt. I could think of only one thing at a time. Just sitting there was work. My brain was very slow, and I cried a LOT.

I knew, even as I was "in" it, what it was. I had a depression as a teen, and though this felt entirely different, the symptoms were obvious.

I knew, at the time, what to do: I told my family, I went to bed, I turned off the computer, I put aside all responsibilities as if it was a stomach bug and not this bizarre brain problem. My family treated it much like a flu: brought me tea and sat close and listened and took care of me. My best friend took my crying calls which turned into laughing about crying calls. No one was condescending or tried to jolly me out of it. No one got angry at me. They were wonderful.

I did not email or blog. The phone kept ringing because my friends thought I'd broken both hands and been kidnapped.

I knew that if it continued that I would go to the doctor and call a therapist - I had a plan.

36 hours and only a taste of living in that brain state indefinitely. Even with full knowledge that what I was experiencing was a brain phenomenon, and all the resources at my disposal, how long until that state became me, and I burned out resource after resource there to help me?

I'm feeling quite well now (though slightly superstitious that talking about it might shake it awake again). I am mindful of the luxury of a more fluid and peaceful brain. I am calling on all the tools I know to keep my mental health strong and flexible - and adding some new ones.

And I remain fascinated, on a detached and intellectual level, at the behavior of my own brain.

Comments

  1. sorry that your brain has been sick. I'm glad that this brush with this horrible illness has been short, and that you have returned to health ready to analyse what went on, learn, and promote knowledge.

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  2. It's interesting how well you were cared for. I'm glad you are feeling better. I've had bouts of "depression" and they run the other way when I'm down, which in turn makes me feel worse. Next time I'm heading to your house!
    Seriously, I find omega 3 oil a powerful medicine though a B complex will also do the job. I can feel myself coming back to my real self, confident and secure within a few hours. I also write, pen and paper, as it helps me clear my head. I've never wanted to take a prescription for something that comes and goes. I do have a good understanding and much empathy for the mental suffering that some people live with daily. I always thought most people have one time or other where they feel deep despair. You were blessed to only go through this recently. I hope it's your one and only time. I'm sorry you had to experience feeling so crummy but glad you know what it's like. Hope that makes sense.

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  3. I hope you realize that if it only lasted 36 hours then it wasn't a "bout of depression" but simply a normal mood variation or what a doctor might call a depressed mood.

    I'm sure it must have felt really awful but it wasn't "DEPRESSION" per se. It's probably really good that you responded as you did in order to prevent it developing into a true depressive episode, especially if you already know you have a biological vulnerability to depression

    Depression as I am sure you are aware is a serious psychiatric illness and it would include a period of at least 2 weeks of depressed mood among other symptoms (and probably last much longer).

    Sorry to seem so picky about terms but it is frustrating when people toss around clinical psychiatric terms so loosely and it detracts from people's genuine understanding of depression as a medical illness and that it cannot be compared to someone just having a bad day. Please be aware that Depression is as misunderstood as ED in the general population. Do you think a person could truly understand an ED based on having had the experience of being really really hungry for a whole weekend. Probably not.

    Brains that bounce back that fast as yours did aren't really truly "depressed" in a clinical sense, just like lots of people can go on extreme crash diets and not develop ED as a result

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  4. Anon - Surely what Laura has done was an effective early intervention to stop a bout of depression taking permanent hold - a sort of Tamiflu for the brain.

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  5. Remember, they sometimes refuse to recognize an ED if the criteria such as below a certain weight hasn't been met yet all the other symptoms are there.
    Surely there is a term for this, be it nervous breakdown or some other term, still it is misery. And the worst part is that even if it goes unrecognized because of it's duration, it's what happens in this time that matters most. It's what it feels like inside that matters most to myself.
    At any rate I am glad that your painful episode of sadness has lifted Laura.
    BTW, I found I was exceptionally sensitive to alcohol...even a little wine or beer. So, I don't drink.
    And she carried on....

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  6. I think too for women there is a whole hormonal level to depression, although I am not a professional. I do know that once a month I get incredibly sad, weepy -- and everything takes on a gray tone. I also tend to be incredibly anxious during this time and I try not to go out.

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  7. Anonymous,

    Of course you are right. A DSM diagnosis doesn't kick in without a certain length of time and severity.

    But the analogy is flawed. A diet isn't an eating disorder - it is unrequited hunger. An eating disorder is a grueling brain problem that leads to dieting as a symptom.

    Until we have better instruments and biomarkers for brain symptoms, we have to use the DSM's blunt instrument. But that doesn't mean the symptoms don't exist until you meet those arbitrary standards.

    The whole idea behind what you seem to believe, and what I have devoted my work to, is that these are REAL illnesses with genuine and unchosen anguish. That depression can be crippling and eating disorders are not a matter of overvalued vanity.

    You're not just being picky, you are mistaking an ally for an enemy. We all need to be more aware of these symptoms BEFORE a loved one falls into the DSM bucket. We need to respect the prodromal stages as an opportunity to intervene.

    You are right about the diagnosis - but a Pyrrhic point indeed.

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  8. Actually, while it's true that a bout of depression symptoms lasting less than 2 weeks doesn't meet the DSM criteria for major depression, it could be encompassed in the "depressive disorder NOS" category. Clearly symptoms are depression are present, beyond what might be considered a "bad mood"--they just don't fit into the restrictive definitions of major depression/dysthymia. And I agree that it's important to recognize that just because an illness doesn't meet the full criteria (often, just doesn't meet it YET) doesn't mean it's not a problem requiring attention and early intervention, both because it causes suffering & because treating sub-threshold syndromes might help prevent development of the disorder at the level of so-called clinical significance.

    The DSM diagnoses are averages--they encompass what is understood and what is most commonly seen, but that doesn't mean that all the varied manifestations of mental/brain illnesses are included, nor that those not included are unimportant and don't cause pain. A lot of what goes into the DSM is based on politics and tradition, and a good clinician should know that it's only a guide/general rubric to help know what treatments are most likely to work, the usual course, how to bill insurance (disturbingly true!), etc. Just because a person doesn't match it perfectly doesn't mean they don't have a problem requiring attention.

    This is not to minimize depression that DOES meet the full criteria--I've experienced subclinical depressive episodes and severe depressive episodes, and I feel that they are best understood as existing on a spectrum. To an extent, however, I do feel that my severe episodes are a different beast, but I think this is in part due to their duration and the way they rob me of so much else in my life...the difference isn't the inherent nature, but all the crap that comes along with them.

    Anyway...I'll stop rambling, but the failings of the DSM is a topic near and dear to my heart!!!

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