Yesterday was my first post in a short series on how I am attempting to manage my depression. One of the key steps I have taken is working to understand my particular diagnosis, Dysthymia, now known since the DSM-5 came out in 2013 as Persistent Depressive Disorder, and its treatment. I am a very research oriented individual, so I was stunned when I realized I had never so much as Googled it. The internet wasn't as ubiquitous when I first got my diagnosis, and in the years since then I have done a lot to try to distance myself from that label. When I finally sat down and read about it, boy did this sentence from the Wikipedia entry strike me: "As dysthymia is a chronic disorder, sufferers may experience symptoms for many years before it is diagnosed, if diagnosis occurs at all. As a result, they may believe that depression is a part of their character, so they may not even discuss their symptoms with doctors, family members, or friends." Uhhhh, yeah. *Raises hand sheepishly*
The short story on Persistent Depressive Disorder, is that you feel low energy, low self-esteem, have a hard time concentrating, difficulty making decisions, a hard time making and maintaining friendships, and may struggle with regulating your food intake, sleep, or both. It's like running a low-grade depression all the time. It often co-occurs with occasional episodes of major depression, anxiety, and/or substance abuse disorders. Periods of relief last no longer than two months at a time. Most people describe having "always felt this way" which is absolutely the case for me.
One of the first steps I took when I finally accepted my depression (almost 12 years after I first was diagnosed) was to start exercising, every single weekday, and getting out of the house 5 out of 7 days a week. There is a ton of research that shows that regular exercise can be a very effective tool for managing a wide range of mental health disorders. When I read about Persistent Depressive Disorder, all the case studies and treatment suggestions I found mentioned medication. I decided that I would give myself a month of trying to tweak my neurochemistry with exercise, and if it wasn't enough I'd consider medication. Fresh air and exercise have helped a great deal, and as a side effect seem to have lessened my dependency on caffeine, but you know what? It's. Not. Enough. Just like lots of people with diabetes can't manage their illness with diet alone, and need the help of insulin, not everyone with depression or attention issues can manage it with sunshine and regular exercise alone. I feel better about a lot of things in my life, but I still feel chest crushing inertia a lot of the time, and generally feel like I am interacting with the world through some kind of fuzzy, murky cloud that I can't quite shake off. I feel like I am shouting across a canyon of awkwardness to my loved ones, instead of really being able to be present with them. I just can't quite get where I need to be on my own, which is why I am asking my therapist for a referral to a psychiatrist.
Getting a therapist and making weekly appointments is one of the best things I have ever done for myself. I spent hours and hours reading the descriptions on all their websites before I reached out and called one that sounded right to me. Finding the right mental health professional isn't like finding the right dentist, it's someone you are going to need to trust and develop a relationship with. (Shout out to my friend Kae who wrote this great article on finding a health provider when you're queer, poly, or a sex worker, it can be especially hard to find the right therapist if you fall into one of those categories.) Now that I am building a relationship with the right therapist, I am learning things about myself every session that I can't believe I didn't know before, that each open up a million new lines of thought that keep me moving forward towards my goals. At first I had no idea how I was going to fit regular therapy sessions into my days caring for my son, but my therapist had a weekly noon slot available, so my husband and son meet for a special lunch date every week while I see my therapist. Get creative, make yourself a priority, ask for backup, there are even online therapy services now.
There is so much stigma attached to getting help for depression, whether that help be a therapist, a doctor, or something else. You feel like you should be able to just get it together. I have seen many people describe their own thoughts about possibly needing to get help for depression as pathetic. That word comes up over and over again. There is nothing pathetic about getting help. To me, getting help means a few different things:
It means taking my own needs seriously. I think 90% of women (and a lot of the men) I know struggle with this, and that's bananas. You can't pour from and empty cup, put your own oxygen mask on before helping others, you've heard and probably repeated all the platitudes, but what are you doing about it?
It means letting many of the 'character flaws' I have always beat myself up for move into the category of 'mental health stuff I need help with and is probably in part due to a chemical imbalance.' And that, my friend, is a big f'ing deal. The idea that I could heal from many the ways in which I feel like I'm sh*tty is powerful, scary, and exhilarating.
It means I am taking care of my husband's wife, my son's mom, my parent's kid, my sister's sister, and my friend's friend. Sometimes doing something for yourself isn't enough motivation to keep you moving. There are many ways in which I am working on my depression for me, but I am also doing it because I want to be my best for my loved ones.
So there you go. Part II in my series about my attempts to manage my depression. Did anything here strike a chord for you? I would love to hear from you. If you are wondering if you may also have Persistent Depressive Disorder, I would encourage you to talk to your doctor or make an appointment with a mental health professional.