It's difficult to be objective about your mental health. Thus, for years, I believed that my main mental issue was anxiety. And certainly, I was anxious. Since childhood, I worried like I was getting paid for it. I've been aware that I felt depressed at times, but the depression seemed more transient - would last for a few weeks and then lift - but the anxiety was ever-present. Indeed, I was convinced that my anxiety caused me to be depressed.
I lived like that for over forty years, with my anxiety becoming markedly worse when I started my nursing career. I felt some relief when I quit bedside nursing, but then a series of family crises that occurred between 2011 - 2015 left me in a shattered state. I was "functioning" in the sense that I went to work every day, and attended to my household responsibilities, and in public maintained a cheerful face at least some of the time, but all that time I was crushed under a black cloud of dread. As with any illness, there are good days and bad days, so I felt OK for some periods during that time, but I never fully escaped the black cloud.
Late in 2015, I moved to a new position in my department - a more technical job with a steep learning curve. With my mental state being what it was, trying to master the skills of my new job was too much and I broke down. I still went to work every day, but I couldn't handle even the slightest mishap. Once, dropping a spoon between the stove and the wall reduced me to tears. I cried when I walked the dog, indeed, I cried nearly every day. I felt disassociated from myself - like I was protectively carrying the most vulnerable part of myself in a teacup because I literally could not stand even the smallest crisis. And still, I thought my main problem was anxiety.
My panic about a minor difficulty related to cosigning my younger daughter's lease led her to make me promise to see a doctor. I didn't want to see a doctor because I was afraid of being put on anti-depressants, which I was convinced would make me fat and I knew I'd rather be miserable than be fat but I kept my promise and I saw my PCP in June. That day started out badly because I'd tried to work from home before the appointment and had been unable to connect to the work network, which of course made me cry - not crying because computer failures are annoying, crying because I felt I was literally too stupid to work from home. That is the thought trough my brain was stuck in. These are the lies that depression tells you.
I'd rehearsed in my head what I would say, "I'm only here because my daughter made me promise," but I did give him an accurate picture of how awful I felt. The doctor listened sympathetically and prescribed citalopram, an SSRI, which I agreed to take. Despite my fear of weight gain, I knew I couldn't go on like I had been. He also gave me a list of therapists and advised me to shop around for the one who felt right.
An SSRI is a relatively new type of anti-depressant. I believe the first one available was Prozac. Since then, newer, more selective SSRIs like citalopram have been developed. SSRI stands for Selective Serotonin Reuptake Inhibitor. Serotonin is a neurotransmitter that affects mood. Our brains have receptors that mop up any excess serotonin (because GOD FORBID anyone become too happy) so SSRIs help prevent these receptors from eating your serotonin, so you feel happier.
They say it takes three to four weeks before you feel the effects of an SSRI, but I swear I started to feel a tiny bit better on day two. After a couple of weeks, Jon - who I didn't know I was taking an antidepressant - commented that I seemed happier and less anxious.
The first month or so on citalopram was like a honeymoon period. I felt great and I lost weight, which boosted my mood even more. Naturally, the dramatic lessening of a pain that you've lived with for years will make you feel pretty good. Then you adjust to the absence of pain and you have to start working on what was making you sad in the first place. Antidepressants don't solve your problems, but they do help you gain the strength to deal with them.
I found a therapist and it has been helpful to have an objective listener. I have a lot to work on and some serious decisions to make as to how I want to proceed with the rest of my life. I've also realized that my main problem was depression, and that depression made me anxious, which is the opposite of what I'd believed all along.
After the honeymoon period ended, I continued to feel better. This was the first Christmas in nearly twenty years that I didn't have a sobbing meltdown at some point. I saw my doctor in early January and told him I felt fine. And then the depression came back. Not as bad as it had been, but suddenly the old "I'm stupid" thoughts were popping into my head. I was profoundly irritated with everyone, and I cried over nothing for the first time in months. I had an idea it was related to the winter lack of light (I've always known I had a touch of SAD) but I couldn't understand why it was affecting me now, when the days are markedly longer than they are around the holidays.
I told my therapist and she said seasonal depression worsens with the cumulative exposure to darkness, and that there are the most suicides in April because that's when people tend to feel worst. Hearing that was an epiphany. For as long as I can remember, I've hated and dreaded spring, and April is when my anxiety seems to peak. (I impulsively bought my solo ticket to Iceland in April because I felt so strongly that I had to get away from everyone.) The cumulative effect seems to work in reverse as well. I've always had the greatest feeling of well-being in the fall - now, I realize because from the effect of months of summer light.
My therapist suggested that I buy a full spectrum lamp, which I did. All of this is a recent development and I've only had the light for a few days, but I did feel happier and more energized this weekend after having used it. I lived for years with depression, thinking that if this was how I was, I didn't want to change, but now, after experiencing life without depression, I don't want to go back to it.