Well shoot. I fall into the severe depression category on the self-inventory, just barely.32
That information will be important to your shrink. They'll want to see trends over time, they'll want an initial estimate of the severity of your symptoms. Without biomakers, these inventories are sort of the best tool we have.If you're at "severe," you really need some help ASAP. Having lived with a solid diagnosis of severe depression, I can tell you exactly how that felt as compared to times when I was moderately on minorly depressed. Really sever depression leaves you in an almost comatose state where you physically cannot walk, or speak about a whisper. The internal med docs were frustrated because the patient wasn't cooperating, but I knew what kind of effort it took for this patient to do ANYTHING.
Check out the album "Pink Moon" by Nick Drake. He eventually killed himself with tricyclic antidepressants. What's important is, as you hear him sing, you can sense the struggle he has in saying each word. You can tell it's painful and exhausting. People who haven't been on our side, haven't been depressed or find our irrational behavior infuriating just don't get it.
Maybe the best analogy I've come up with is, what if everyday you woke up feeling that your best friend died. That's how it feels. But even worse, you'll see that friend and your brain gets totally fucked up. So you have this overwhelming, irrational fear that your best friend has died.
There's a common refrain of "get up and do something, get a job, etc. etc." That's all greata dvice, but depression can be just as debilitating as any number of other disease. And with the dramatically increased risk of suicide, I think it's appropriate to think of mood disorders as potentially life threatening. People don't like to talk about it, but suicide is a leading cause of death among the quite young and among the elderly. You need to get this thing under control and find your reasons too live. It will probably be a mix of medical therapies, counseling, introspection, and turning things around and being an advocate for the depressed. It's a powerful message to tell someone who basically can't function at all, "I can really empathize with you. I suffer from depression and I know what it can be like. I can't pretend to know what you're going though, but I've been severely depressed and here I am today. I have my ups and downs, but the downs aren't as low and I can fight them with CBT." I had patients who were shocked that I lived with depression for ten years and here I was a medical student. I thought that was a powerful message.
When you recover, you need to remember what it was like and try to find a way to help other people with depression or anorexia or whatever. The only way we're all going to make our peace with this disease is to band together and fight it out as a team. Ultimately, it's a solo journey, but you'll hear us yelling from the top of the cave, pushing you forward.
Did any of that help? You can PM me, or I can give you my phone number. I am surviving depression. Not every day is amazing, but at least on bad days I feel nad and on good days I feel good. Before, everything just felt bad, so the whole risk-reward structure broke down.
Anyway, don't be afraid to really throw yourself at this problem. It will take time and energy, but you need to find people who have be there, are there, who can tell you that there is a future. I'm certainly happy to be one of those people. Just ask and I can give you my cell#. We're team depression, and we need to watch each others' backs, you know? And I have plenty of psych residents and consulting physicians who I can ask about really difficult questions. For me, this is a way to pay back all of the nice things people did for me, I can't hep bu be empathetic, and ultimately, it'll make me a better shrink. So never feel like you're wasting my time.
I really want you to feel better and step into my shoes. Next time there's a depression thread, I want tot see you in there saying, "I beat this and so can you!"
As always, if there's anything I can do to help - looking up meds, reading about diagnoses and the care thereof, sending articles your way, recommending books, just say the work.
Bagels