No please, tell me I'm pretty.
Depression
- Thread starter Jea Song
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No please, tell me I'm pretty.
Call me traditional, but I would say "you're pretty," instead of "I want to have sex with you." I guess I'm just old-fashioned...
Tell me about your philosophy. I'm interested.
Femmeworth
Banned
I believe that in the parlance of our times the best phrase to use is, "Let me touch you, girl."
Almond
Member
This. ^
I'm not saying I know how Leeness thinks, but we have similar issues. She is an attractive person, and every person on GAF could tell her, but she still probably wouldn't believe it. She has to believe it herself first.
I don't know if she does it the same way I do, but on the very rare occasion someone calls me attractive, depending on the situation, I try to rationalize it as "Oh, you're just seeing a picture of me online. You haven't seen how disgusting I am in person." "They're just being nice and not trying to hurt my feelings." "They're just trying to be nice so they can get something from me." "They're desperate and that's the only reason they're saying I'm attractive."
I know these things probably aren't true, but it's so hard to get them out of your head and not compare yourself to others.
Don't give up, Leeness. Good luck.
User 100115
Banned
Since my personal philosophy is stolen from a tv show and is is just one line, I'd be highly interested in yours.
"If nothing we do matters, all that matters is what we do." Bonus point if anyone knows the show!
Edit:
I have lots of self esteem issues. I know I CAN be pretty, but I don't think I AM pretty, if that makes any kind of sense. I also love to sing, and constantly second guess it, thinking people only tell me I am not horrible at it because they are too nice. I know I can write, and have been paid to do it in the past, but when I sit down and try to do it these days I just...I hate the words that come out. I get depressed about my other art work too. Again, think people say its good only because they are being nice. It's something I struggle a lot with, especially since I am no longer as skinny as I was in high school or before I had kids. Even though I know I am not over weight, I feel over weight.
And I know it's stupid. But it still gets me every day.
Well I wouldn't normally walk up to someone and say, "I want to have sex with you." That was just a response to her saying, "Nobody would ever want to have sex with me." Unless I am nobody, I have now proven that statement false.
Well, I do a bit of the personal philosophy thing. But, since everyone circumstances are different, it certainly won't apply to must of you. I need to tame my tyrannical perfectionist self, so my philosophy is "What you did or are doing is enough to advance steadily towards your goals? It is, so it's good! Calm down and enjoy a movie, pal". Not always works 
.
.
Collete
Member
I don't know what philosophy I go by now that I think about it.
However, a book idea I have for a "theme" but I guess also rings true with depression in my life goes something like this: "Even though there's immense pain that can't be stopped, there is great beauty and life that cannot be replaced no matter what you might do."
However, a book idea I have for a "theme" but I guess also rings true with depression in my life goes something like this: "Even though there's immense pain that can't be stopped, there is great beauty and life that cannot be replaced no matter what you might do."
User 100115
Banned
That is lovely. Makes way more sense than mine does, hee.
And much more poetical and better redacted that mine! I have to work on it! ... Oh, wait a minute...
Collete
Member
Aww, thanks, it's too cliched though unfortunatly, haha.
Nah yours made sense after I read it a few times.
(I'm not very good at reading deep meaningful phrases)...
And much more poetical and better redacted that mine! I have to work to do! ... Oh, wait a minute...
Oh cmon it's not that great guys D:
User 100115
Banned
Hey, I said you were cute! You are little bit overweight, but that is something you could work on.
My philosophy of life has to do with just being super nice to people. Although my depression and anxiety makes this really hard most of time. Usually people assume I'm not interested in them because I have a hard time connecting on an emotional level. Heck, I have a hard time having a casual conversation because I get so fed up in thinking about what I'm going to say. I wish I could learn to connect with people and have natural conversations.
User 100115
Banned
I can relate. I'm not longer anxious around people, but I still got nothing to say, just look:
Looks like my attempt to a little joke about myself failed horribly.
Hey me too! I go out of my way to try and be exceedingly nice
What ways have you found to come off as generally more friendly? I know body language has a lot to do with it. Whenever I ask a waiter/barista how they're doing and a conversation starts I always assume I'm bugging them and end the conversation. I guess I see my own problem.
User 100115
Banned
I can relate. I'm not longer anxious around people, but I still got nothing to say, just look:
Looks like my attempt to a little joke about myself failed horribly.
I giggled
It helps that I grew up in an area where if you didn't strike up a conversation with the cashier/waitress or what have you it was incredibly rude. Now that I am not in that area anymore, more people give me weird looks when I attempt to strike up a conversation, but I leave it at dropping a random compliment.
Collete
Member
This is almost word for word how I am with people on most cases.
However I can't make a casual conversation without freezing thinking I said something wrong or I'm bothering them.
Looks like my attempt to a little joke about myself failed horribly.
Oh it was a joke?
Sorry I'm not exactly good at detecting them
I can relate. I'm not longer anxious around people, but I still got nothing to say, just look:
Looks like my attempt to a little joke about myself failed horribly.
Feeling like you have nothing to say is common with depression. More specifically, inhibited cognitive function. Which is basically the 'nothing' that I feel when exchanging words with people. This, mixed with negative feelings towards self, is just not a good combination. :/
"when pizza's on a bagel, you can have pizza anytime (TM)."
This interview is intentionally very different in tone from the last one. There's a very serious story in here, and one that I think a lot of people can relate to and draw inspiration from, but we also got way off topic and joked around a lot. As such, I've broken it into 6 parts.
Part 1: A goofy introduction
Part 2: The downward spiral of depression
Part 3: Getting better
Part 4: Conclusion and alternate ending
Part 5: sidebar on pectus excavatum, a chest wall deformity that Piano and I both have
Part 6: sidebar on genetic screening in psychiatry
If you just want the "meat" of the interview without all the toppin's, stick to parts 2 and 3, maybe part 6 if you're interested.
Enjoy! Your feedback is always appreciated! If you hate this, please let me know. Each one of these things is still sort of an experiment.
[Special thanks to Oomikami for helping me make the editing easier!]
GAF Bagels: I'm really excited to talk to you because, 1) your avatar is incredible. It's like Ray Charles dropped acid and thought he was a cat! and 2) you're very knowledgeable about psych meds
Piano: Haha. I stole the glasses from Snuggler in whatever thread that was.
GAF Bagels: I thought we'd begin with a psychopharmacology throwdown. I'll name a med, you say yes or no if you've taken it, maybe add a word if you have, and then shoot back a med at me. Then we'll get to the "getting to know you" stuff.
Piano: Alright.
GAF Bagels: Okay. Celexa.
Piano: No, but I'm on Lexapro. Similar, I believe?
GAF Bagels: Never tried Lexapro. Wellbutrin?
Piano: Yes. Made me feel happy. TOO happy. Which became a problem. Zoloft.
GAF Bagels: Used it for several years before it was generic. Prozac?
Piano: No, that's a bit too old for me. Cymbalta, however.
[GAF Bagels: Nope. Effexor?
Piano: Have not. Switching gears - Xanax?
GAF Bagels: Nope. The docs hate it here. Klonopin?
Piano: Am on it right now. Lamictal?
GAF Bagels: Did not like it. Remeron?
Piano: It's an AAP, right? Or do I just think that because it's associated with weight gain?
Considered it but soured on antipsychotics because of my experience with: Seroquel?
GAF Bagels: Off-label for insomnia. Shot my cholesterol through the roof. (Remeron is a tetracyclic AD). Any tricyclic?
Piano: Yes, Amitryptilyne. Impossible to spell - I believe the brand name was Elavil? Generic, of course, considering that the drug is from the 1970's It was an interesting foray into intense dehydration.
Mood stabilizers?
GAF Bagels: i was on nortriptyline for years. Same thing - terrible dry mouth
Piano: Oh man it was brutal.
Piano: Had to keep gum or ice around at all times.
GAF Bagels: No mood stabilizers besides lamictal. Lithium is on the "might try next" list. How about ritalin et al.?
Piano: Well, having just finished college, I did try ritalin and adderal 'unofficially' a few times. For academic purposes.
GAF Bagels: heh
Piano: Interesting, actually, because they've on and off considered adderal as an AD. Which, after trying it....is a horrible idea.
GAF Bagels: I had good luck with Ritalin + Nortriptyline. It did augment the AD, but anxiety became an issue.
Piano: Is Ritalin less stimulating? Only had that one once.
GAF Bagels: I honestly don't know ; never tried any other stims. How about St. Johns wort or other alternative therapies?
Piano: I wouldn't recommend them. Especially if you're prone to anxiety or depression.
GAF Bagels: How about buspar?
Piano: First: St John's Wort, no. I have discussed alternative therapies with my doctor. Some of them are efficacious, but just because it's 'natural' doesn't mean it's better.
GAF Bagels: Bingo.
Piano: After reading extensively about the cognitive benefits of Omega 3's in Fish Oil I started taking two teaspoons a day. I made it about four weeks. My mood absolutely did improve...but it fueled my anxiety and gave me insomnia. Alas, I had to admit that just because the internet says it's good for me, it isn't.
GAF Bagels: Finally, MAOIs?
Piano: No. That's a class of drugs that sort of scares me.
Looping back to Buspar - Buspirone: best drug I've ever taken. Changed my life, no joke. But, from what I hear, it's not prescribed all that often before because for many it's a placebo
Piano: It wiped out my constant anxiety, which had unbelievably far reaching effects on my quality of life. Eliminated IBS. Made me less irritable and nicer. Allowed me to keep a consistent sleep schedule.
GAF Bagels: Let's come back to your current meds in a bit.
Piano: You got it.
GAF Bagels: First, who are you and what do you do?
Piano: Well, I'm a 22 year old male. Just finished university last summer. Got a bit behind because of my issues so I had to finish up summer semester. For now I'm working a retail job just to pay expenses and save up money until I can learn to be at peace with my day to day existence.
GAF Bagels: What did you study?
Piano: Initially Journalism. Then Film. Finally, Media Journalism. Well, more Media Criticism. Of course they all had more impressive sounding official titles.
GAF Bagels: haha. It does sound pretty cool...Was there a focus on a particular form of media?
Piano: Not bad, but the topics that float through GAF now and then about how useless liberal arts degrees are and how glad everyone is they went into engineering can make me second guess my time at school.
I studied all types of media, really. Internet culture, film, television. Actually wrote a paper about the Portal 2 Potato Sack ARG.
GAF Bagels: Interesting! Get a good grade?
I did. A paper I was really proud of.
GAF Bagels: Favorite game or games?
Piano: Hard to pick one, but I can name a few. Team Fortress 2. Super Mario Galaxy 2. Resident Evil 4. Metal Slug games. And finally...Super Punch-Out!!
GAF Bagels: Love Metal Slug(s)!
Haha!
Why Super Punch-Out?
Piano: My cousins gave me their SNES when I was in my teens (this being around...2004?). I had played Punch-Out!! on the NES they gave me prior but didn't know anything about the sequel. Popped it in and got hooked. So fun to figure out all of the patterns. Learned to beat the whole game without a KO. Used to come home from school and go through it once just to unwind. Game doesn't get NEARLY enough love.
GAF Bagels: some games just get you at just the right time and it's just total love
Piano: So true.
GAF Bagels: River City RANSOM (why did i say Rampage?!) which is properly awesome, has a special place in my heart
Piano: NES Beat-em-up? Never played it. But I enjoyed TMNT and Double Dragon.
GAF Bagels: It's amazing [There's a GBA version, too]
Piano: So I'll have to try that out.
GAF Bagels: Absolutely!
GAF Bagels: so tell me about your tag. I had one for about 5 minutes and regretted it immensely.
Piano: I had only been a member of GAF for a few months, so I didn't really get how the whole 'tag' thing worked yet. Some moderator posted a topic in OT that was just titled '...' (if I remember correctly). The post was just a picture of someone fishing. So I replied 'what?' And I guess it was a tag fishing thread, so I got a random tag that relates to nothing at all. I didn't even know what it meant...had to google it.
GAF Bagels: haha
Piano: Right? Anticlimactic.
GAF Bagels: I didn't want to say it...but yeah.
This interview is intentionally very different in tone from the last one. There's a very serious story in here, and one that I think a lot of people can relate to and draw inspiration from, but we also got way off topic and joked around a lot. As such, I've broken it into 6 parts.
Part 1: A goofy introduction
Part 2: The downward spiral of depression
Part 3: Getting better
Part 4: Conclusion and alternate ending
Part 5: sidebar on pectus excavatum, a chest wall deformity that Piano and I both have
Part 6: sidebar on genetic screening in psychiatry
If you just want the "meat" of the interview without all the toppin's, stick to parts 2 and 3, maybe part 6 if you're interested.
Enjoy! Your feedback is always appreciated! If you hate this, please let me know. Each one of these things is still sort of an experiment.
[Special thanks to Oomikami for helping me make the editing easier!]
GAF Bagels: I'm really excited to talk to you because, 1) your avatar is incredible. It's like Ray Charles dropped acid and thought he was a cat! and 2) you're very knowledgeable about psych meds
Piano: Haha. I stole the glasses from Snuggler in whatever thread that was.
GAF Bagels: I thought we'd begin with a psychopharmacology throwdown. I'll name a med, you say yes or no if you've taken it, maybe add a word if you have, and then shoot back a med at me. Then we'll get to the "getting to know you" stuff.
Piano: Alright.
GAF Bagels: Okay. Celexa.
Piano: No, but I'm on Lexapro. Similar, I believe?
GAF Bagels: Never tried Lexapro. Wellbutrin?
Piano: Yes. Made me feel happy. TOO happy. Which became a problem. Zoloft.
GAF Bagels: Used it for several years before it was generic. Prozac?
Piano: No, that's a bit too old for me. Cymbalta, however.
[GAF Bagels: Nope. Effexor?
Piano: Have not. Switching gears - Xanax?
GAF Bagels: Nope. The docs hate it here. Klonopin?
Piano: Am on it right now. Lamictal?
GAF Bagels: Did not like it. Remeron?
Piano: It's an AAP, right? Or do I just think that because it's associated with weight gain?
Considered it but soured on antipsychotics because of my experience with: Seroquel?
GAF Bagels: Off-label for insomnia. Shot my cholesterol through the roof. (Remeron is a tetracyclic AD). Any tricyclic?
Piano: Yes, Amitryptilyne. Impossible to spell - I believe the brand name was Elavil? Generic, of course, considering that the drug is from the 1970's It was an interesting foray into intense dehydration.
Mood stabilizers?
GAF Bagels: i was on nortriptyline for years. Same thing - terrible dry mouth
Piano: Oh man it was brutal.
Piano: Had to keep gum or ice around at all times.
GAF Bagels: No mood stabilizers besides lamictal. Lithium is on the "might try next" list. How about ritalin et al.?
Piano: Well, having just finished college, I did try ritalin and adderal 'unofficially' a few times. For academic purposes.
GAF Bagels: heh
Piano: Interesting, actually, because they've on and off considered adderal as an AD. Which, after trying it....is a horrible idea.
GAF Bagels: I had good luck with Ritalin + Nortriptyline. It did augment the AD, but anxiety became an issue.
Piano: Is Ritalin less stimulating? Only had that one once.
GAF Bagels: I honestly don't know ; never tried any other stims. How about St. Johns wort or other alternative therapies?
Piano: I wouldn't recommend them. Especially if you're prone to anxiety or depression.
GAF Bagels: How about buspar?
Piano: First: St John's Wort, no. I have discussed alternative therapies with my doctor. Some of them are efficacious, but just because it's 'natural' doesn't mean it's better.
GAF Bagels: Bingo.
Piano: After reading extensively about the cognitive benefits of Omega 3's in Fish Oil I started taking two teaspoons a day. I made it about four weeks. My mood absolutely did improve...but it fueled my anxiety and gave me insomnia. Alas, I had to admit that just because the internet says it's good for me, it isn't.
GAF Bagels: Finally, MAOIs?
Piano: No. That's a class of drugs that sort of scares me.
Looping back to Buspar - Buspirone: best drug I've ever taken. Changed my life, no joke. But, from what I hear, it's not prescribed all that often before because for many it's a placebo
Piano: It wiped out my constant anxiety, which had unbelievably far reaching effects on my quality of life. Eliminated IBS. Made me less irritable and nicer. Allowed me to keep a consistent sleep schedule.
GAF Bagels: Let's come back to your current meds in a bit.
Piano: You got it.
GAF Bagels: First, who are you and what do you do?
Piano: Well, I'm a 22 year old male. Just finished university last summer. Got a bit behind because of my issues so I had to finish up summer semester. For now I'm working a retail job just to pay expenses and save up money until I can learn to be at peace with my day to day existence.
GAF Bagels: What did you study?
Piano: Initially Journalism. Then Film. Finally, Media Journalism. Well, more Media Criticism. Of course they all had more impressive sounding official titles.
GAF Bagels: haha. It does sound pretty cool...Was there a focus on a particular form of media?
Piano: Not bad, but the topics that float through GAF now and then about how useless liberal arts degrees are and how glad everyone is they went into engineering can make me second guess my time at school.
I studied all types of media, really. Internet culture, film, television. Actually wrote a paper about the Portal 2 Potato Sack ARG.
GAF Bagels: Interesting! Get a good grade?
I did. A paper I was really proud of.
GAF Bagels: Favorite game or games?
Piano: Hard to pick one, but I can name a few. Team Fortress 2. Super Mario Galaxy 2. Resident Evil 4. Metal Slug games. And finally...Super Punch-Out!!
GAF Bagels: Love Metal Slug(s)!
Haha!
Why Super Punch-Out?
Piano: My cousins gave me their SNES when I was in my teens (this being around...2004?). I had played Punch-Out!! on the NES they gave me prior but didn't know anything about the sequel. Popped it in and got hooked. So fun to figure out all of the patterns. Learned to beat the whole game without a KO. Used to come home from school and go through it once just to unwind. Game doesn't get NEARLY enough love.
GAF Bagels: some games just get you at just the right time and it's just total love
Piano: So true.
GAF Bagels: River City RANSOM (why did i say Rampage?!) which is properly awesome, has a special place in my heart
Piano: NES Beat-em-up? Never played it. But I enjoyed TMNT and Double Dragon.
GAF Bagels: It's amazing [There's a GBA version, too]
Piano: So I'll have to try that out.
GAF Bagels: Absolutely!
GAF Bagels: so tell me about your tag. I had one for about 5 minutes and regretted it immensely.
Piano: I had only been a member of GAF for a few months, so I didn't really get how the whole 'tag' thing worked yet. Some moderator posted a topic in OT that was just titled '...' (if I remember correctly). The post was just a picture of someone fishing. So I replied 'what?' And I guess it was a tag fishing thread, so I got a random tag that relates to nothing at all. I didn't even know what it meant...had to google it.
GAF Bagels: haha
Piano: Right? Anticlimactic.
GAF Bagels: I didn't want to say it...but yeah.
Dice
Pokémon Parentage Conspiracy Theorist
Yours is similar to mine, it just needs some elaboration.
We live in a universe where everything is cyclical, perhaps even the universe itself. It's hard to describe the scale of this.
I guess, first look at this image and then try to consider it goes nearly as far in the opposite direction as well. From the smallest particles to largest galaxies, everything comes into form, exists, and passes. Go far enough in either direction and our conventional concepts of time and space break down.
On the human level, this means that what we tend to try and make our lives about is only slightly more significant than our experience. Humans of 20,000 years ago are not remembered. Humans 20,000 years from now will not remember us, not even the most famous. You, the impact of all you do, and the memory of you and all you did will fade out, and even the ripple effect of your actions will dissipate. This sounds a bit depressing, so why is it encouraging? The pressure is off.
See, when you place your significance in these things larger than your life, you put a great deal of pressure on yourself. I understand this all too well after having spent 15 years in ministry, yet now being atheist. You give yourself room to get down on yourself, to say that you are lesser. Fact is, whether you are Gandhi or Hitler, it all passes away. Whether you are the most beautiful or the most ugly, the smartest or dumbest, the richest or poorest, it all passes, from impact and from memory, and we are equal in the end.
Some would say this invalidates morality, but that is absurd because things are still experienced as they exist, and that is where the beauty comes in. First of all, nothing that is will ever be again. While all things end in equality so nothing is special in that light, all things are unique in their moments to exist, to they are special and beautiful in their time. Absolutely everything in the universe, every single thing you get to experience. A deep breath, the latte in your cup, the crafted wood of the table. It's all marvelous.
Furthermore, you are something rather rare and fragile in the universe. You're a living being capable of being aware of all this. You are the manifestation of the universe looking at itself. You have an opportunity that is not only quite rare, but so far as we know, rather new to the universe. To be alive, conscious, literate and educated. You experience it and have your share in it. Your moments involving this awareness and having any sort of feelings at all are a miracle.
Living happily or depressed, the meaning is in what you are, not how you measure up to an expectation. It's in the fact that you experience and act, not in what you experience and how you act. Now, if you would rather be happy, you can try. If you want to do certain things, you can try. However, failure is only your natural limitations manifested, just as your lifespan. It doesn't change the opportunity you have in each new moment or the beauty and unique temporal significance held within them.
I'll be honest that sometimes this view does enable me to slack off, but I think it also helps me to be more productive, and often the slacking off is simply me functioning within the bounds of my capacity to handle anxiety and remain a stable person. The significance of these things to me would make more sense if you have knowledge of how my life has been and is different from common models of society.
User 100115
Banned
Piano did a paper on ARGs? That is awesome, I used to write for ARGs! Catching the Wish was my favorite I wrote for.
GAF Bagels: so here's where I go Barbara Walters and suddenly put on my serious face. So you've struggled with depression. Tell us about that.
Piano: Well, I'll start by saying it's difficult to categorize depression under one large umbrella because it can vary so wildly. Not just for me, but for everyone.
GAF Bagels: Absolutely. Major Depressive Disorders, not Disorder.
Piano: Precisely.
I've always been the depressive 'type' or something like that. Get it from both sides of the family, unfortunately. So I spent varying periods of middle school and high school down on myself with low self-esteem. Of course, it's impossible to say what of that is normal teenage angst. But I was prescribed Zoloft for all of it, so I suppose the idea is that it was at least slightly problematic.
GAF Bagels: did you decide to see a doctor or did your parents make you?
Piano: My parents. When I was 11 years old.
I was diagnosed with Social Anxiety Disorder and took Zoloft for the next 8 or 9 years.
GAF Bagels: Did it help?
Piano: I think so. Of course, that was so young in my life that it's sort of tough to do a crystal clear before / after comparison.
GAF Bagels: sure
Piano: But I remember it smoothing me out.
Piano: Somewhere along the line my dose got changed to a sliding scale that I was able to manipulate, so I could raise or lower the dose slightly (within an approved range) to accommodate for how I was feeling.
GAF Bagels: that's interesting
Piano: Right? Seems stupid to allow a 15 year old that sort of decision making power.
Not that Zoloft is something you'd abuse.
GAF Bagels: you don't think of that with ADs
Piano: Not at all.
GAF Bagels: true, but it's not like a benzo that acts right away. Is taking a little less today going to change things in any meaningful time frame?
Piano: Well, I felt like it did. Or at least, it did within a few days. I wouldn't change how much I took each and every day. Rather, it would trend up and down with how things were going.
GAF Bagels: gotcha. That makes a little more sense
Piano: So I stayed on that through going to university.
By senior year of high school I was (mostly) over the hump of angst. Really self-actualizing. Hyper involved in extra-curriculars, mostly music and theatre. Busy every day, but happily so.
So I went into college with the wind in my sails. Had some normal pangs of homesickness but nothing all that difficult. Of course, freshman year of college made me a prick, but that sort of personal growth was happening on a separate axis. At least at the time.
I noticed my first strange mood fluctuation when I traveled home for winter break. I didn't want to leave my house for the first four or five days I was in town. It wasn't awful. I was totally content to just sit at home (having just bought Fallout 3). But I had no initiative. Everything was blunted. And I didn't know why.
GAF Bagels: And no precipitating event that you could identify?
Piano: No. Well, maybe. There's always a precipitating event. There was obviously a trigger.
GAF Bagels: I couldn't find one when I became depressed.
Piano: Having gone to school far from home, I think it was the culture shock of returning home and seeing that nothing had changed, and that all of my experiences from first semester were just stories. Well, that wasn't a smoking gun but it was the best guess I had at the time.
GAF Bagels: that's really interesting. I went to college in the town I grew up in, so I didn't have that experience.
Piano: Do you regret not getting out?
GAF Bagels: Not at all. I love me hometown. Love my University. Saw my family basically every weekend. I'm lame like that, but I love my family.
Piano: No way man, I love my family too. Before I gallivant off into whatever career path I'm going to pursue I'm going to move back home for at least a couple of years. When I was in the hospital (much later in this saga) I had an old man, a Vietnam vet tell me that while it was great that I was in school far from home I would never die wishing I had spent less time with family. That wrecked me. I've hardly seen my family for the past four years. My parents are getting old. I have to go back. It's more important than career bullshit.
GAF Bagels: I moved away in 2004 and I miss it, too.
Piano: Anyways, one thing did happen that winter break that I didn't understand a couldn't explain. One night, having finally been pulled from the clutches of my television and my home I was heading out with some friends. It's a vivid memory - I was in the back of my friend's car when all of a sudden the floor of my emotion dropped out from under me. Completely. Suddenly, and I mean suddenly, everything was hopeless. My feelings were in free-fall and the pain was palpable. I didn't say anything to my friends because I had no idea what was going on. And within a minute, it was done.
GAF Bagels: Like a panic attack, but a depression attack?
Piano: Something like that. Panic without the hysteria. Just, hopelessness. Like I had never felt it before.
GAF Bagels: did it happen just the one time?
Piano: Well, just that one time until way, way later. Almost three years before it happened again. And it wasn't until then that I finally was able to begin connecting the dots.
GAF Bagels: What did you do after the first episode? Anything?
Piano: Went on Wikipedia and searched 'depression'. Sort of sad, right? I didn't know what a panic attack was.
I bet [using Wikipedia to self-diagnose] is not really that uncommon nowadays.
Piano: I had long since stopped seeing a therapist or psychiatrist and had my Zoloft prescription transferred to my PCP
GAF Bagels: PCP = Primary Care Provider, in case people are confused
Piano: Yes.
GAF Bagels: The first time I read "patient transferred to PCP" I did a double-take.
Piano: Hah!
GAF Bagels: So you read about depression...
Piano: Yep. Didn't really illuminate anything. I mean...it's a Wikipedia article. An aggregate of general knowledge. Not a tool for diagnosis. Plus it didn't happen again. My mood lightened up in the few days after that so I stopped caring.
GAF Bagels: So things just got better. Then what happened?
Piano: I went back to school and had what I still consider the highest functioning period of my life ever. Perfect attendance. Social yet hardworking. Worked out consistently. Had such a rock solid sleep schedule that I woke up without an alarm. Self-actualizing to the extreme. It was great, and I felt great.
GAF Bagels: How long did it last?
Piano: 4 months?
GAF Bagels: and then?
Piano: I went home for the summer. That transition already bogged me down, like it had last time, and I didn't know why. And then the real punch in the gut was getting home and finding out my girlfriend from the summer before didn't want to get back together. SHE Started dating another dude instead. (thanks to Oomikami again for pointing out that it sounds like Piano decided to try his luck with dudes!)
GAF Bagels: I was going to get around to asking about relationships. It's a general theme in the thread.
Piano: She had every right to dump my ass. I spent freshman year of college staying in touch with her and saying I still loved her while messing around with other girls. And she's two years younger than me. So as a (then) junior in high school...It didn't translate.
GAF Bagels: Was it embarrassing dating a high schooler?
Piano: Sort of. Well, I had just graduated high school and not yet gone off to college when we dated. We technically 'broke up' when I left. But none of my friends 'got it'.
GAF Bagels: I wonder how many of those relationships make it.
Piano: Very few, judging by the kids in my dorm who showed up to college with relationships in tow.
Piano: It wasn't until she went to college that [my GF] understood how I could have turned into such a prick. But really, I was lost. I was getting drunk every weekend, trying to outdo myself and pick up as many girls as possible. I was lonely. I was homesick. I wanted to feel attractive. And as much as free-wheeling college hookups are idolized in our society they're awful. I ended up feeling terrible about myself. I cried in my common room one night because I felt like such a disgusting creep.
GAF Bagels: did you have any actual relationships or just hookups?
Piano: I 'dated' a couple of girls. As in, hooked up with them and hung out for a few weeks. The first one I broke up with over the phone and told her it was because I wanted to hook up with more girls. She rightfuly hated me for about a year after that.
GAF Bagels: I'm going to have to redact this shit. Depression-GAF is going to hate you for being good with the ladies!
Piano: Are you kidding?
GAF Bagels: "good" with the ladies, as in “terrible”.
Piano: It was awful. Meaningless. Empty.
GAF Bagels: It's good to have someone point that out.
GAF Bagels: Too many people think getting laid is somehow going to fix them.
Piano: Of course. It didn't make me feel any better. Having other people feel I was attractive (or, at least, feel like I was good enough while wasted) did nothing to mend how I felt about myself. It's impossible to have others opinions override your own.
GAF Bagels: it really didn't help?
Piano: Otherwise I'd tell the people in the depression thread they're actually happy and all would be right in the world.
GAF Bagels: Being insecure, any interest from girls gave me a little ego boost
Piano: Little. And fleeting. But then it was followed by feeling scummy.
GAF Bagels: So was the time in the common room kind of the end of that phase?
Piano: No, the next weekend was when I tried to top myself. Took 10 shots of cheap vodka. Puked all over myself, some girls bed, the bathroom and the hallway.
GAF Bagels: nice
Piano: And that was on Halloween. My friends weren't able to go out because they had to stay to take care of me. And that was about enough to convince me I was a raging douche. Especially after spending a week making my own costume, only to not even get out of the dorms.
GAF Bagels: Your honesty and self-awareness is refreshing. A lot of people would be laughing it off still
Piano: Well, it definitely is funny in retrospect. But I'd rather be matter of fact about it instead of repress or regret it.
GAF Bagels: yeah, I didn't mean it can't be funny, just admitting you were a douche is a pretty big deal
Piano: Well, that was four years ago. Time heals all wounds. Or something like that.
GAF Bagels: So what happened after you came out of the closet as a douche?
Piano: Well, we're sort of jumping around here, but this does allow me to loop back around to the end of my freshman year of college when I showed up back at home.
GAF Bagels: Call me a bigot, but I don't think douches should have the right to marry each other.
Piano: As long as they don't reproduce. (eek!)
GAF Bagels: that is terrifying
Piano: There's a joke about Mitt Romney in there somewhere.
Piano: So when I got back in town she let me have it. I was a prick. I was unfaithful. It was unfair of me to expect her to wait around for me while I was fooling around with other girls. I got angry, sure, but I had to swallow it. I mean...she was right.
Piano: This sent me into my first real deep, deep period of depression. I still loved her, so it wrecked me.
GAF Bagels: what were your symptoms?
Piano: Always tired. No will to do anything. Cried regularly. Felt hopeless.
GAF Bagels: At the time, did you realize it was your fault, or did that come later?
Piano: I knew it was my fault. Which made it worse.
GAF Bagels: Sure. Did you go back into treatment?
Piano: I did. Just therapy, not psychiatry. I was still on Zoloft at the time and adjusted it up to the max dose allowed on my sliding scale. For your reference, that was 50mg - a really minimal dose. I'm very sensitive to medications. It was the first time I noticed that it sort of...numbed me out instead of made me feel any better. Zombifying, rather than uplifting. But for where I was at, that wasn't a terrible thing. Without that edge taken off I would have killed myself.
GAF Bagels: I know that feeling all too well.
Piano: Zombification via SSRI?
GAF Bagels: yup
Piano: It's not great. It kept me around, though...
GAF Bagels: so this was...the end of Freshman year?
Piano: Summer before sophomore.
I heavily considered suicide for the first time. For two reasons. One: I couldn't enjoy anything. I mean, nothing. My birthday happened in the midst of this. I didn't want to leave my house but two of my friends came over and forced me to organize a birthday dinner. I have pictures of this birthday and they're painful to look at. I'm smiling but all I can remember is how much it hurt me to smile, to fake feeling okay because I felt like I had to.
Two: I wanted revenge. I wanted her to be at my funeral and know it was her fault.
GAF Bagels: Here's my doctor question: did you have a plan?
Piano: I got to the point of figuring out how I could obtain a license to purchase a firearm and thinking about what possessions I'd sell to afford it.
GAF Bagels: so that's pretty far along
Piano: Yep. Two things kept me from going over. One: Zoloft. It took just enough of the edge off to make things bearable. I would be dead without it.
Two: I didn't want to be 'that guy'. I didn't want to be the idiot who ended it all over a breakup. Especially as a teenager. That just felt like a terrible way to go out.
GAF Bagels: How aware of any of this was your family?
Piano: My parents knew I was suffering. I would wake them up in the night to cry and talk to them about it. But I never mentioned suicide. They still don't know that was ever in the cards.
GAF Bagels: did you tell anybody?
Piano: Not until months later. I was in therapy but didn't even tell my therapist.
GAF Bagels: how long did this period last?
Piano: About...6 weeks. Until I convinced my ex to ditch the other guy and get back with me. I swallowed my pride and spent weeks leaving her flowers and notes and trying to woo her back. It was humiliating. But it was my only hope. I got almost nothing out of therapy because I put so little into it. I didn't want to be honest. I didn't want to explain 'hey, I was a huge dick so this girl is rightfully ditching me but I feel so absurdly shitty about that I'm considering putting a gun in mouth and blowing my brains out'
We got back together but at that point I was heavily damaged. Our relationship was completely different. I never picked back up completely. A lot of the time I needed her to be a mother, not a girlfriend. She'd come over and spend an hour trying to get me out of bed. Somewhere I knew that it wasn't the same as it had been the summer before and never would be. But I couldn't admit it.
GAF Bagels: that's really sad
Piano: Yep. So, I'm sure you can guess what dumb decision we made when it came time for me to go off to college again...
GAF Bagels: oh no.
Piano: oh yes.
Long distance.
GAF Bagels: How far away was college?
Piano: Home is [a state]. College is [a state pretty far away].
Piano: So very, very far.
GAF Bagels: So that worked perfectly, I'm guessing.
Piano: Well, it did for a little while when I totally neutered my social life and spent all of my time on Skype talking to my girlfriend about how much it sucked not to be together. Yeah, so we broke up. I was down. The whole period is pretty hazy. When I went home for winter break the same shit happened again, and I still didn't know why - got really down, didn't leave the house for four or five days.
Piano: So, my sophomore year of college…Sophomore year doesn't have the same distinct quality in my memory as my freshman year. I was 'down' so I suppose that fogged my perception. But when I went home for winter break, I had the same sort of strange mood fluctuation. Didn't leave the house for four or five days. Didn't want to. Wasn't miserable. Was content just escaping into video games. Escapism became a bigger part of my life. Without my ex-girlfriend to mother me and boost me up I didn't really know how to elevate myself. I was always slightly 'down'. Low energy. Little initiative. I would go out to parties hoping to hit it off with women like I had my freshman year but would just lurk in a corner the whole time. I couldn't figure out what had changed. I started becoming bitter. You know, girls are bullshit, being social means being fake, fuck that, etc.
GAF Bagels: did your schoolwork suffer?
Piano: My second semester, yes.
Piano: I was still on Zoloft at the time. In about...maybe Feb? over a few days my mood suddenly pitched downward.
Piano: Not quite where it was when I was going through my break-up but damn close.
GAF Bagels: What a lame question. You're talking about girls and I'm like, "what about your grades?!"
Piano: Lame, but wise!
GAF Bagels: Like a celibate owl
Piano: That's a 10/10 analogy.
GAF Bagels: thank you
So your mood goes down...
Piano: Yes. It dropped over the course of a few days. So I did the only thing I knew how to do to rectify this - I upped my dose of Zoloft. And it did nothing. It made me numb, but not any better. For the first time I noticed it was making me impotent. Which was no fun. I couldn't get school work done. I had a paper to write. I couldn't get it done in my room so I went to the library. I spent four solid hours in the library with my laptop open in front of me staring at a wall. Wondering why I was so miserable. What it was connected to. What I could have done. How I could fix it.
Obviously there were few easy answers.
GAF Bagels: And even with the move to an incredibly erotic place like the library, still no erection.
Piano: Thank god, no.
GAF Bagels: We had an epidemic of people flashing girls in the stacks at the main library. All the damn time!
Piano: What on earth.
Wasn't me.
GAF Bagels: haha. You seem awfully defensive…
Piano: At this point I had no psychiatrist and no therapist. So I went home for spring break and decided to ask my primary care doctor for a new anti-depressant. Of course, having seen this doctor once or twice a year while living half the world away this was a terrible idea. He prescribed me Wellbutrin. I weaned off of Zoloft and switched over.
GAF Bagels: PCPs fucking love Wellbutrin! I don't know why.
Piano: Yeah he was sure it was the best choice. Who knows why.
GAF Bagels: it does have the fewest sexual side effects
Piano: Right. I mentioned that I was impotent. That's probably why he went with it.
GAF Bagels: You can even add it to other drugs to decrease the sexual side effects.
Piano: Yes! When I switched over, I felt like I was going through puberty again.
GAF Bagels: hahaha
Piano: It was unbelievable. And I felt GREAT. Better than I ever had before. A good friend of mine recalls me saying at the time, no joke, that I had never felt so good.
Of course, I'm sure you have an inkling of what was going on.
GAF Bagels: uh oh.
Piano: But at the time I had no idea. I did notice that I couldn't sleep. That I was irritable. I got headaches. And had one of the most bizarre side effects I've ever had. Every time I tried to fall asleep I would get to the precipice of slumber when this painful, loud, reverberating noise would fill my head and wake me back up. It was a wall keeping me from sleep and I couldn't get past it for hours.
GAF Bagels: weird!
Piano: Right? That's one I've never found an explanation for.
GAF Bagels: that's new to me
Piano: Needless to say, within a few weeks I started erupting into anxiety. I couldn't sleep. My mind would race. I'd cry over school work and other commitments.
GAF Bagels: I’m finding tons of papers about bupropion-induced mania on PubMed...
Piano: I didn't know what mania was at the time. And having no consistent psychiatrist...there was no one there to put the pieces together.
GAF Bagels: this is a great case for having a psychiatrist manage your care
Piano: Absolutely. Find a good one and stick with them.
GAF Bagels: I wish more people had the option
Piano: I'll also say combination psychiatrist / therapist is by far the best option.
GAF Bagels: absolutely
Piano: So they can prescribe medications as needed based on your therapeutic issues, not assume you need pills and figure it out from there.
So I took a medical leave from school to figure out what was going on. Found a psychiatrist, finally, who put me on Cymbalta to balance out the agitation from the Wellbutrin. And Xanax as needed in the meantime to get me through the transition.
GAF Bagels: uh oh (again).
Piano: Luckily I didn't pick up a habit. But I did enjoy taking Xanax and playing Team Fortress for some reason...
GAF Bagels: I do enjoy benzos, so I know to stay away from Xanax
Piano: It's a miracle drug. It's TOO good at what it does. But if you need it, or if you're in the midst of panic...it's unbelievable.
GAF Bagels: true. It's just WAY overprescribed.
Piano: Yes, considering how dangerous it is.
GAF Bagels: so at this point you're on Wellbutrin, Cymbalta, and Xanax...
Piano: Yep. I managed to finish out the school year just fine, with some deadline extensions.
GAF Bagels: how were the side effects?
Piano: Not bad, at the time. The Cymbalta seemed to dampen down the Wellbutrin without eliminating its mood elevation. I decided to work at a summer camp out west for the summer because I wanted to avoid ending up back home again...
GAF Bagels: So you had serotonin, dopamine, norepi, and GABA agents on board
Piano: Yep. All grinding up against one another.
GAF Bagels: There's some though that that's the future. Triple or quadruple reuptake inhibitors.
Piano: Not when one of them is inducing hypomania, though.
GAF Bagels: Yup. So are you still a bit manic at this point, when you go off to camp?
Piano: Well, I'll start by saying it's difficult to categorize depression under one large umbrella because it can vary so wildly. Not just for me, but for everyone.
GAF Bagels: Absolutely. Major Depressive Disorders, not Disorder.
Piano: Precisely.
I've always been the depressive 'type' or something like that. Get it from both sides of the family, unfortunately. So I spent varying periods of middle school and high school down on myself with low self-esteem. Of course, it's impossible to say what of that is normal teenage angst. But I was prescribed Zoloft for all of it, so I suppose the idea is that it was at least slightly problematic.
GAF Bagels: did you decide to see a doctor or did your parents make you?
Piano: My parents. When I was 11 years old.
I was diagnosed with Social Anxiety Disorder and took Zoloft for the next 8 or 9 years.
GAF Bagels: Did it help?
Piano: I think so. Of course, that was so young in my life that it's sort of tough to do a crystal clear before / after comparison.
GAF Bagels: sure
Piano: But I remember it smoothing me out.
Piano: Somewhere along the line my dose got changed to a sliding scale that I was able to manipulate, so I could raise or lower the dose slightly (within an approved range) to accommodate for how I was feeling.
GAF Bagels: that's interesting
Piano: Right? Seems stupid to allow a 15 year old that sort of decision making power.
Not that Zoloft is something you'd abuse.
GAF Bagels: you don't think of that with ADs
Piano: Not at all.
GAF Bagels: true, but it's not like a benzo that acts right away. Is taking a little less today going to change things in any meaningful time frame?
Piano: Well, I felt like it did. Or at least, it did within a few days. I wouldn't change how much I took each and every day. Rather, it would trend up and down with how things were going.
GAF Bagels: gotcha. That makes a little more sense
Piano: So I stayed on that through going to university.
By senior year of high school I was (mostly) over the hump of angst. Really self-actualizing. Hyper involved in extra-curriculars, mostly music and theatre. Busy every day, but happily so.
So I went into college with the wind in my sails. Had some normal pangs of homesickness but nothing all that difficult. Of course, freshman year of college made me a prick, but that sort of personal growth was happening on a separate axis. At least at the time.
I noticed my first strange mood fluctuation when I traveled home for winter break. I didn't want to leave my house for the first four or five days I was in town. It wasn't awful. I was totally content to just sit at home (having just bought Fallout 3). But I had no initiative. Everything was blunted. And I didn't know why.
GAF Bagels: And no precipitating event that you could identify?
Piano: No. Well, maybe. There's always a precipitating event. There was obviously a trigger.
GAF Bagels: I couldn't find one when I became depressed.
Piano: Having gone to school far from home, I think it was the culture shock of returning home and seeing that nothing had changed, and that all of my experiences from first semester were just stories. Well, that wasn't a smoking gun but it was the best guess I had at the time.
GAF Bagels: that's really interesting. I went to college in the town I grew up in, so I didn't have that experience.
Piano: Do you regret not getting out?
GAF Bagels: Not at all. I love me hometown. Love my University. Saw my family basically every weekend. I'm lame like that, but I love my family.
Piano: No way man, I love my family too. Before I gallivant off into whatever career path I'm going to pursue I'm going to move back home for at least a couple of years. When I was in the hospital (much later in this saga) I had an old man, a Vietnam vet tell me that while it was great that I was in school far from home I would never die wishing I had spent less time with family. That wrecked me. I've hardly seen my family for the past four years. My parents are getting old. I have to go back. It's more important than career bullshit.
GAF Bagels: I moved away in 2004 and I miss it, too.
Piano: Anyways, one thing did happen that winter break that I didn't understand a couldn't explain. One night, having finally been pulled from the clutches of my television and my home I was heading out with some friends. It's a vivid memory - I was in the back of my friend's car when all of a sudden the floor of my emotion dropped out from under me. Completely. Suddenly, and I mean suddenly, everything was hopeless. My feelings were in free-fall and the pain was palpable. I didn't say anything to my friends because I had no idea what was going on. And within a minute, it was done.
GAF Bagels: Like a panic attack, but a depression attack?
Piano: Something like that. Panic without the hysteria. Just, hopelessness. Like I had never felt it before.
GAF Bagels: did it happen just the one time?
Piano: Well, just that one time until way, way later. Almost three years before it happened again. And it wasn't until then that I finally was able to begin connecting the dots.
GAF Bagels: What did you do after the first episode? Anything?
Piano: Went on Wikipedia and searched 'depression'. Sort of sad, right? I didn't know what a panic attack was.
I bet [using Wikipedia to self-diagnose] is not really that uncommon nowadays.
Piano: I had long since stopped seeing a therapist or psychiatrist and had my Zoloft prescription transferred to my PCP
GAF Bagels: PCP = Primary Care Provider, in case people are confused
Piano: Yes.
GAF Bagels: The first time I read "patient transferred to PCP" I did a double-take.
Piano: Hah!
GAF Bagels: So you read about depression...
Piano: Yep. Didn't really illuminate anything. I mean...it's a Wikipedia article. An aggregate of general knowledge. Not a tool for diagnosis. Plus it didn't happen again. My mood lightened up in the few days after that so I stopped caring.
GAF Bagels: So things just got better. Then what happened?
Piano: I went back to school and had what I still consider the highest functioning period of my life ever. Perfect attendance. Social yet hardworking. Worked out consistently. Had such a rock solid sleep schedule that I woke up without an alarm. Self-actualizing to the extreme. It was great, and I felt great.
GAF Bagels: How long did it last?
Piano: 4 months?
GAF Bagels: and then?
Piano: I went home for the summer. That transition already bogged me down, like it had last time, and I didn't know why. And then the real punch in the gut was getting home and finding out my girlfriend from the summer before didn't want to get back together. SHE Started dating another dude instead. (thanks to Oomikami again for pointing out that it sounds like Piano decided to try his luck with dudes!)
GAF Bagels: I was going to get around to asking about relationships. It's a general theme in the thread.
Piano: She had every right to dump my ass. I spent freshman year of college staying in touch with her and saying I still loved her while messing around with other girls. And she's two years younger than me. So as a (then) junior in high school...It didn't translate.
GAF Bagels: Was it embarrassing dating a high schooler?
Piano: Sort of. Well, I had just graduated high school and not yet gone off to college when we dated. We technically 'broke up' when I left. But none of my friends 'got it'.
GAF Bagels: I wonder how many of those relationships make it.
Piano: Very few, judging by the kids in my dorm who showed up to college with relationships in tow.
Piano: It wasn't until she went to college that [my GF] understood how I could have turned into such a prick. But really, I was lost. I was getting drunk every weekend, trying to outdo myself and pick up as many girls as possible. I was lonely. I was homesick. I wanted to feel attractive. And as much as free-wheeling college hookups are idolized in our society they're awful. I ended up feeling terrible about myself. I cried in my common room one night because I felt like such a disgusting creep.
GAF Bagels: did you have any actual relationships or just hookups?
Piano: I 'dated' a couple of girls. As in, hooked up with them and hung out for a few weeks. The first one I broke up with over the phone and told her it was because I wanted to hook up with more girls. She rightfuly hated me for about a year after that.
GAF Bagels: I'm going to have to redact this shit. Depression-GAF is going to hate you for being good with the ladies!
Piano: Are you kidding?
GAF Bagels: "good" with the ladies, as in “terrible”.
Piano: It was awful. Meaningless. Empty.
GAF Bagels: It's good to have someone point that out.
GAF Bagels: Too many people think getting laid is somehow going to fix them.
Piano: Of course. It didn't make me feel any better. Having other people feel I was attractive (or, at least, feel like I was good enough while wasted) did nothing to mend how I felt about myself. It's impossible to have others opinions override your own.
GAF Bagels: it really didn't help?
Piano: Otherwise I'd tell the people in the depression thread they're actually happy and all would be right in the world.
GAF Bagels: Being insecure, any interest from girls gave me a little ego boost
Piano: Little. And fleeting. But then it was followed by feeling scummy.
GAF Bagels: So was the time in the common room kind of the end of that phase?
Piano: No, the next weekend was when I tried to top myself. Took 10 shots of cheap vodka. Puked all over myself, some girls bed, the bathroom and the hallway.
GAF Bagels: nice
Piano: And that was on Halloween. My friends weren't able to go out because they had to stay to take care of me. And that was about enough to convince me I was a raging douche. Especially after spending a week making my own costume, only to not even get out of the dorms.
GAF Bagels: Your honesty and self-awareness is refreshing. A lot of people would be laughing it off still
Piano: Well, it definitely is funny in retrospect. But I'd rather be matter of fact about it instead of repress or regret it.
GAF Bagels: yeah, I didn't mean it can't be funny, just admitting you were a douche is a pretty big deal
Piano: Well, that was four years ago. Time heals all wounds. Or something like that.
GAF Bagels: So what happened after you came out of the closet as a douche?
Piano: Well, we're sort of jumping around here, but this does allow me to loop back around to the end of my freshman year of college when I showed up back at home.
GAF Bagels: Call me a bigot, but I don't think douches should have the right to marry each other.
Piano: As long as they don't reproduce. (eek!)
GAF Bagels: that is terrifying
Piano: There's a joke about Mitt Romney in there somewhere.
Piano: So when I got back in town she let me have it. I was a prick. I was unfaithful. It was unfair of me to expect her to wait around for me while I was fooling around with other girls. I got angry, sure, but I had to swallow it. I mean...she was right.
Piano: This sent me into my first real deep, deep period of depression. I still loved her, so it wrecked me.
GAF Bagels: what were your symptoms?
Piano: Always tired. No will to do anything. Cried regularly. Felt hopeless.
GAF Bagels: At the time, did you realize it was your fault, or did that come later?
Piano: I knew it was my fault. Which made it worse.
GAF Bagels: Sure. Did you go back into treatment?
Piano: I did. Just therapy, not psychiatry. I was still on Zoloft at the time and adjusted it up to the max dose allowed on my sliding scale. For your reference, that was 50mg - a really minimal dose. I'm very sensitive to medications. It was the first time I noticed that it sort of...numbed me out instead of made me feel any better. Zombifying, rather than uplifting. But for where I was at, that wasn't a terrible thing. Without that edge taken off I would have killed myself.
GAF Bagels: I know that feeling all too well.
Piano: Zombification via SSRI?
GAF Bagels: yup
Piano: It's not great. It kept me around, though...
GAF Bagels: so this was...the end of Freshman year?
Piano: Summer before sophomore.
I heavily considered suicide for the first time. For two reasons. One: I couldn't enjoy anything. I mean, nothing. My birthday happened in the midst of this. I didn't want to leave my house but two of my friends came over and forced me to organize a birthday dinner. I have pictures of this birthday and they're painful to look at. I'm smiling but all I can remember is how much it hurt me to smile, to fake feeling okay because I felt like I had to.
Two: I wanted revenge. I wanted her to be at my funeral and know it was her fault.
GAF Bagels: Here's my doctor question: did you have a plan?
Piano: I got to the point of figuring out how I could obtain a license to purchase a firearm and thinking about what possessions I'd sell to afford it.
GAF Bagels: so that's pretty far along
Piano: Yep. Two things kept me from going over. One: Zoloft. It took just enough of the edge off to make things bearable. I would be dead without it.
Two: I didn't want to be 'that guy'. I didn't want to be the idiot who ended it all over a breakup. Especially as a teenager. That just felt like a terrible way to go out.
GAF Bagels: How aware of any of this was your family?
Piano: My parents knew I was suffering. I would wake them up in the night to cry and talk to them about it. But I never mentioned suicide. They still don't know that was ever in the cards.
GAF Bagels: did you tell anybody?
Piano: Not until months later. I was in therapy but didn't even tell my therapist.
GAF Bagels: how long did this period last?
Piano: About...6 weeks. Until I convinced my ex to ditch the other guy and get back with me. I swallowed my pride and spent weeks leaving her flowers and notes and trying to woo her back. It was humiliating. But it was my only hope. I got almost nothing out of therapy because I put so little into it. I didn't want to be honest. I didn't want to explain 'hey, I was a huge dick so this girl is rightfully ditching me but I feel so absurdly shitty about that I'm considering putting a gun in mouth and blowing my brains out'
We got back together but at that point I was heavily damaged. Our relationship was completely different. I never picked back up completely. A lot of the time I needed her to be a mother, not a girlfriend. She'd come over and spend an hour trying to get me out of bed. Somewhere I knew that it wasn't the same as it had been the summer before and never would be. But I couldn't admit it.
GAF Bagels: that's really sad
Piano: Yep. So, I'm sure you can guess what dumb decision we made when it came time for me to go off to college again...
GAF Bagels: oh no.
Piano: oh yes.
Long distance.
GAF Bagels: How far away was college?
Piano: Home is [a state]. College is [a state pretty far away].
Piano: So very, very far.
GAF Bagels: So that worked perfectly, I'm guessing.
Piano: Well, it did for a little while when I totally neutered my social life and spent all of my time on Skype talking to my girlfriend about how much it sucked not to be together. Yeah, so we broke up. I was down. The whole period is pretty hazy. When I went home for winter break the same shit happened again, and I still didn't know why - got really down, didn't leave the house for four or five days.
Piano: So, my sophomore year of college…Sophomore year doesn't have the same distinct quality in my memory as my freshman year. I was 'down' so I suppose that fogged my perception. But when I went home for winter break, I had the same sort of strange mood fluctuation. Didn't leave the house for four or five days. Didn't want to. Wasn't miserable. Was content just escaping into video games. Escapism became a bigger part of my life. Without my ex-girlfriend to mother me and boost me up I didn't really know how to elevate myself. I was always slightly 'down'. Low energy. Little initiative. I would go out to parties hoping to hit it off with women like I had my freshman year but would just lurk in a corner the whole time. I couldn't figure out what had changed. I started becoming bitter. You know, girls are bullshit, being social means being fake, fuck that, etc.
GAF Bagels: did your schoolwork suffer?
Piano: My second semester, yes.
Piano: I was still on Zoloft at the time. In about...maybe Feb? over a few days my mood suddenly pitched downward.
Piano: Not quite where it was when I was going through my break-up but damn close.
GAF Bagels: What a lame question. You're talking about girls and I'm like, "what about your grades?!"
Piano: Lame, but wise!
GAF Bagels: Like a celibate owl
Piano: That's a 10/10 analogy.
GAF Bagels: thank you
So your mood goes down...
Piano: Yes. It dropped over the course of a few days. So I did the only thing I knew how to do to rectify this - I upped my dose of Zoloft. And it did nothing. It made me numb, but not any better. For the first time I noticed it was making me impotent. Which was no fun. I couldn't get school work done. I had a paper to write. I couldn't get it done in my room so I went to the library. I spent four solid hours in the library with my laptop open in front of me staring at a wall. Wondering why I was so miserable. What it was connected to. What I could have done. How I could fix it.
Obviously there were few easy answers.
GAF Bagels: And even with the move to an incredibly erotic place like the library, still no erection.
Piano: Thank god, no.
GAF Bagels: We had an epidemic of people flashing girls in the stacks at the main library. All the damn time!
Piano: What on earth.
Wasn't me.
GAF Bagels: haha. You seem awfully defensive…
Piano: At this point I had no psychiatrist and no therapist. So I went home for spring break and decided to ask my primary care doctor for a new anti-depressant. Of course, having seen this doctor once or twice a year while living half the world away this was a terrible idea. He prescribed me Wellbutrin. I weaned off of Zoloft and switched over.
GAF Bagels: PCPs fucking love Wellbutrin! I don't know why.
Piano: Yeah he was sure it was the best choice. Who knows why.
GAF Bagels: it does have the fewest sexual side effects
Piano: Right. I mentioned that I was impotent. That's probably why he went with it.
GAF Bagels: You can even add it to other drugs to decrease the sexual side effects.
Piano: Yes! When I switched over, I felt like I was going through puberty again.
GAF Bagels: hahaha
Piano: It was unbelievable. And I felt GREAT. Better than I ever had before. A good friend of mine recalls me saying at the time, no joke, that I had never felt so good.
Of course, I'm sure you have an inkling of what was going on.
GAF Bagels: uh oh.
Piano: But at the time I had no idea. I did notice that I couldn't sleep. That I was irritable. I got headaches. And had one of the most bizarre side effects I've ever had. Every time I tried to fall asleep I would get to the precipice of slumber when this painful, loud, reverberating noise would fill my head and wake me back up. It was a wall keeping me from sleep and I couldn't get past it for hours.
GAF Bagels: weird!
Piano: Right? That's one I've never found an explanation for.
GAF Bagels: that's new to me
Piano: Needless to say, within a few weeks I started erupting into anxiety. I couldn't sleep. My mind would race. I'd cry over school work and other commitments.
GAF Bagels: I’m finding tons of papers about bupropion-induced mania on PubMed...
Piano: I didn't know what mania was at the time. And having no consistent psychiatrist...there was no one there to put the pieces together.
GAF Bagels: this is a great case for having a psychiatrist manage your care
Piano: Absolutely. Find a good one and stick with them.
GAF Bagels: I wish more people had the option
Piano: I'll also say combination psychiatrist / therapist is by far the best option.
GAF Bagels: absolutely
Piano: So they can prescribe medications as needed based on your therapeutic issues, not assume you need pills and figure it out from there.
So I took a medical leave from school to figure out what was going on. Found a psychiatrist, finally, who put me on Cymbalta to balance out the agitation from the Wellbutrin. And Xanax as needed in the meantime to get me through the transition.
GAF Bagels: uh oh (again).
Piano: Luckily I didn't pick up a habit. But I did enjoy taking Xanax and playing Team Fortress for some reason...
GAF Bagels: I do enjoy benzos, so I know to stay away from Xanax
Piano: It's a miracle drug. It's TOO good at what it does. But if you need it, or if you're in the midst of panic...it's unbelievable.
GAF Bagels: true. It's just WAY overprescribed.
Piano: Yes, considering how dangerous it is.
GAF Bagels: so at this point you're on Wellbutrin, Cymbalta, and Xanax...
Piano: Yep. I managed to finish out the school year just fine, with some deadline extensions.
GAF Bagels: how were the side effects?
Piano: Not bad, at the time. The Cymbalta seemed to dampen down the Wellbutrin without eliminating its mood elevation. I decided to work at a summer camp out west for the summer because I wanted to avoid ending up back home again...
GAF Bagels: So you had serotonin, dopamine, norepi, and GABA agents on board
Piano: Yep. All grinding up against one another.
GAF Bagels: There's some though that that's the future. Triple or quadruple reuptake inhibitors.
Piano: Not when one of them is inducing hypomania, though.
GAF Bagels: Yup. So are you still a bit manic at this point, when you go off to camp?
Piano: No, I actually went into a bit of a down period. I hated it for the first four weeks. Couldn't make friends. Was forever anxious about fitting in and becoming friends with others. Not to mention being a good counselor...
GAF Bagels: but it turned around?
Piano: Yep, around week five or six. This is where it gets difficult to say what caused what. Did I begin to enjoy myself and fit in because my mood began to lift? Or did my mood begin to lift because I started to make friends and relax? I'm not sure.
GAF Bagels: that's a tough one. And what drug was doing what?
Piano: Exactly!
GAF Bagels: It's a poorly controlled experiment, but that's medicine.
Piano: Even more so when you're jumping between doctors. Nobody had a view of the 'big picture'. Just 'oh, I feel this way right now' followed by 'well, I have a pill for that...'
GAF Bagels: Continuity is so very, very important. Ideally, that's what a psych doc should give you. That's why I love psych.
Piano: The opportunity to piece together these sorts of puzzles?
GAF Bagels: yeah - to follow someone as they deal with their illness; not just apply bandaids; to do the hard work of "fixing" a complete person; having a relationship
Piano: That's exactly it. I had simply been applying bandaids. I was impotent, so one doctor gave me something for that. I was anxious, so a different doctor gave me something for that But you've got to have a direction in order to reach a destination. But at the time I was doomed to wander.
I returned to school for junior year beginning to suffer from anxiety again. Or rather, agitation. It would go in and out. And it came and went so gradually that I had a tough time figuring out what was going on. I was seeing a therapist at the time, but one separate from my psychiatrist. They didn't communicate with one another.
My attendance to classes began to tank. I couldn't get work done. I would stay up for hours avoiding an assignment only to skip class the next day anyways. Then I'd have to go talk to my teachers. I really had no explanation, though. Other than 'I didn't get it done...I don't really know why'
GAF Bagels: there's that irrationality
Piano: I told them I suffered from depression but that's about as specific as I was able to get.
GAF Bagels: Depressed people just don't always make sense, even to themselves.
Piano: Not at all. The agitation only got worse. Nights of racing thoughts, insomnia, couldn't get things done, became irritable to others. Started getting into smoking weed....
GAF Bagels: did it help?
Piano: It helped me escape. Same with video games. While that's obviously not a healthy reason to use either of those things I am glad, at least, that I didn't turn to alcohol. Cymbalta left me with VICIOUS hangovers, so that wasn't an option.
GAF Bagels: True. Alcohol comes up a bit too often in the depression thread. And it can really screw with the meds, aside from all the other problems
Piano: It's wildly dangerous. It's so normalized into our culture that we often forget that.
GAF Bagels: I had the same effect - I had to stop drinking because the meds made the hangovers terrible.
Piano: Oh yeah! Brutal stuff. So I went back to my psychiatrist for my once a month appointment. Told him I was agitated and that it was probably from the Wellbutrin. Again, you can probably guess what the solution was.
GAF Bagels: i see a pattern
Piano: Drop the Wellbutrin. Another band aid. Another very circumstantial decision with no basis in past history.
GAF Bagels: add this, drop that, tweak this, add this back in...
Piano: Just based on what I said that one day when I went in. That's it.
So I went home for winter break and weaned off of the Wellbutrin. Again, I got depressed when I went home. Much more palpably this time. When the end of winter break rolled around I didn't want to leave. At all. I just wanted to stay at home, smoke weed and play video games. I had ceased to derive much meaning from anything else. Of course, I had to return.
I remember almost nothing from the two months I was only on Cymbalta. All a big haze. Until one day I tried to have sex with a friend of mine and discovered...Oh hey. I'm completely impotent. Again. I mean, completely. Literally zero body response to sexual stimuli. So, naturally, I called my doctor again, who at this point I hadn't seen in two months. I made an emergency appointment. I showed up, said 'hey, this 30mg dose of Cymbalta makes me impotent' He had me cut the dose in half - take it every other day. Another senseless short term solution that took nothing into consideration.
GAF Bagels: This is some fine healthcare.
Piano: At least he was cheap.
(ish)
So I halved the Cymbalta dose. That period, Spring of 2011, is the least medication I've been on in the recent past and therefore the best idea I have of what my actual problems are. For that, at least, I'm grateful.
GAF Bagels: it's interesting to get that baseline.
Piano: Yes, very interesting. The changes crept up slowly. My mood began going up and down again, though not as violently or extremely as when I was on Wellbutrin. I became paralyzed with anxiety. So paralyzed that I was blind to it. I began having symptoms of irritable bowel syndrome, as many with anxiety disorders do, so I went to a clinic and explained my symptoms. The very first question the doctor asked me was: 'are you anxious?' I confidently replied 'no'
GAF Bagels: oops
Piano: Right? But there was no one there to see beyond my skewed perception. My friends didn't get it. To them I had just slowly become an asshole. I began dating one of my best friends and she didn't get it. I would justify away my anxiety and excessive marijuana usage with any circumstance I could come up with.
GAF Bagels: jeez
Piano: My therapist didn't get it. I cut my appointments to every other week and lied to her about how much weed I smoked and how much turmoil I was having with my friendships. I couldn't risk telling her and having her suggest that I give up my escapes. I would spend two to three days at a time not leaving my apartment, only smoking weed and playing video games. Primarily JUST Team Fortress - I was so anxious that I couldn't generally try new games lest they didn't let me escape into them.
GAF Bagels: that's pretty grim
Piano: At least TF2 is a great game.
I didn't know what had changed. I became really, really bitter and obsessive. I couldn't get over that I felt like I had peaked my freshman year of college. I didn't know why I couldn't get school work done, why I couldn't keep a sleep schedule, why I had terrible attendance, or why my friends didn't like me as much.
GAF Bagels: In hindsight...
Piano: Yes, so obvious. On some level, I knew. I got it. But I couldn't admit it. Because admitting it meant admitting I wasn't doing well and having to give up the few things I still enjoyed.
I took a lot of this out on my girlfriend. I obsessed over everything about our relationship that wasn't perfect. So...just about everything, naturally. But my unhappiness was always because of something. Always because something wasn't good enough. Always external, never because of my broken perception.
I finished the school year miserable. Planned to go off and work again at the same summer camp. I got home and, of course, I didn't want to leave. Even more so this time. Going to camp meant giving up weed and video games. Giving up my escapes. I couldn't deal with it. I put off packing until 12 hours before my flight. And cried while I was doing it. Still, I didn't get it. Or I didn't WANT to get it. I had enjoyed myself the summer before, so why not now? What was different? I showed up and was a complete wreck. I cried 6 hours after getting there. I went to dinner with my best friend from the year before and didn't talk the whole time. : I didn't unpack my things. I couldn't. I couldn't get settled in. I couldn't deal with it, and I didn't know why.
Without any escapes, I broke down. Had to find secluded places to cry every night. The only person I informed of what was going on was the camp nurse, who was the same as the year before and had been tremendously helpful at that time helping me deal with anxiety. I finally admitted that I had a huge problem. I wasn't able to enjoy anything. I was horribly unhappy. I talked to my parents, to the nurse and to the camp directors and decided it was best for me to quit and fly home to get help. I had to stand up in front of the whole staff and announce I was leaving due to emotional issues. On the one hand, I knew I needed to go home because I was fundamentally broken and needed help to become whole again. On the other hand, I wanted to smoke weed and play video games. Simple as that. I was willing to quit a wonderful job and fly home. To escape. That's how unhappy I was. I got back home and knew I had to find a good doctor. Luckily, one of my best friend's mother is a therapist. She referred me to the best doctor she knew in the area. Combination therapist / psychiatrist.
GAF Bagels: why did you have to announce it to everyone? That seems...cruel.
Piano: Because I wanted them to hear it from me. It was my choice. I was afraid of the stigma. The sort of mysterious, under-the-breath 'oh...he's DEPRESSED' Because a lot of people don't get it.
GAF Bagels: a lot of my classmates don't get it, unfortunately
Piano: Probably because they've never asked. Were someone to come up to me and say 'hey, I'm sick with this disease you've never heard of' I would say 'wait, what is that? Explain it to me'. But nobody does that with mental health issues. Everyone's afraid to just speak up and say "I don't get it"
GAF Bagels: It's still weird though because EVERYBODY knows several people with depression. They just might not know it...
Piano: But they try to generalize it against their own experiences with unhappiness. If they DO know.
GAF Bagels: That's a good point - being bummed is so very different. Even grief is very different
Piano: Yes! But emotion is so hard to convey accurately. It affects us all so, so differently. But we can never see through anyone else's eyes. So the best we have is verbal articulation. Which is pretty inadequate when it comes to explaining an entire state of mind.
GAF Bagels: That's actually why depression-GAF is so...nice isn't the word, but comforting? The fact that you don't have to start by explaining what depression is and what it feels like and how it's not like being bummed...You can cut right to the actual issues.
Piano: That's a great observation. I hadn't thought about it that way. The foundation is already laid.
GAF Bagels: When you talk about getting zombified by SSRIs, I knew exactly what you meant. You don't have to try to explain it. We can speak the language of depression
Piano: Plus you and I have had some wildly similar experiences with these things!
GAF Bagels: exactly! That's why this interview is tough. I feel like we're very similar, so it's more like chatting with a good friend than interviewing someone I kind of, but don't really know
Piano: I'm very interested to see how you edit this to be cohesive. Rather than me and you going back and forth saying 'whoa man like me too'
GAF Bagels: but it turned around?
Piano: Yep, around week five or six. This is where it gets difficult to say what caused what. Did I begin to enjoy myself and fit in because my mood began to lift? Or did my mood begin to lift because I started to make friends and relax? I'm not sure.
GAF Bagels: that's a tough one. And what drug was doing what?
Piano: Exactly!
GAF Bagels: It's a poorly controlled experiment, but that's medicine.
Piano: Even more so when you're jumping between doctors. Nobody had a view of the 'big picture'. Just 'oh, I feel this way right now' followed by 'well, I have a pill for that...'
GAF Bagels: Continuity is so very, very important. Ideally, that's what a psych doc should give you. That's why I love psych.
Piano: The opportunity to piece together these sorts of puzzles?
GAF Bagels: yeah - to follow someone as they deal with their illness; not just apply bandaids; to do the hard work of "fixing" a complete person; having a relationship
Piano: That's exactly it. I had simply been applying bandaids. I was impotent, so one doctor gave me something for that. I was anxious, so a different doctor gave me something for that But you've got to have a direction in order to reach a destination. But at the time I was doomed to wander.
I returned to school for junior year beginning to suffer from anxiety again. Or rather, agitation. It would go in and out. And it came and went so gradually that I had a tough time figuring out what was going on. I was seeing a therapist at the time, but one separate from my psychiatrist. They didn't communicate with one another.
My attendance to classes began to tank. I couldn't get work done. I would stay up for hours avoiding an assignment only to skip class the next day anyways. Then I'd have to go talk to my teachers. I really had no explanation, though. Other than 'I didn't get it done...I don't really know why'
GAF Bagels: there's that irrationality
Piano: I told them I suffered from depression but that's about as specific as I was able to get.
GAF Bagels: Depressed people just don't always make sense, even to themselves.
Piano: Not at all. The agitation only got worse. Nights of racing thoughts, insomnia, couldn't get things done, became irritable to others. Started getting into smoking weed....
GAF Bagels: did it help?
Piano: It helped me escape. Same with video games. While that's obviously not a healthy reason to use either of those things I am glad, at least, that I didn't turn to alcohol. Cymbalta left me with VICIOUS hangovers, so that wasn't an option.
GAF Bagels: True. Alcohol comes up a bit too often in the depression thread. And it can really screw with the meds, aside from all the other problems
Piano: It's wildly dangerous. It's so normalized into our culture that we often forget that.
GAF Bagels: I had the same effect - I had to stop drinking because the meds made the hangovers terrible.
Piano: Oh yeah! Brutal stuff. So I went back to my psychiatrist for my once a month appointment. Told him I was agitated and that it was probably from the Wellbutrin. Again, you can probably guess what the solution was.
GAF Bagels: i see a pattern
Piano: Drop the Wellbutrin. Another band aid. Another very circumstantial decision with no basis in past history.
GAF Bagels: add this, drop that, tweak this, add this back in...
Piano: Just based on what I said that one day when I went in. That's it.
So I went home for winter break and weaned off of the Wellbutrin. Again, I got depressed when I went home. Much more palpably this time. When the end of winter break rolled around I didn't want to leave. At all. I just wanted to stay at home, smoke weed and play video games. I had ceased to derive much meaning from anything else. Of course, I had to return.
I remember almost nothing from the two months I was only on Cymbalta. All a big haze. Until one day I tried to have sex with a friend of mine and discovered...Oh hey. I'm completely impotent. Again. I mean, completely. Literally zero body response to sexual stimuli. So, naturally, I called my doctor again, who at this point I hadn't seen in two months. I made an emergency appointment. I showed up, said 'hey, this 30mg dose of Cymbalta makes me impotent' He had me cut the dose in half - take it every other day. Another senseless short term solution that took nothing into consideration.
GAF Bagels: This is some fine healthcare.
Piano: At least he was cheap.
(ish)
So I halved the Cymbalta dose. That period, Spring of 2011, is the least medication I've been on in the recent past and therefore the best idea I have of what my actual problems are. For that, at least, I'm grateful.
GAF Bagels: it's interesting to get that baseline.
Piano: Yes, very interesting. The changes crept up slowly. My mood began going up and down again, though not as violently or extremely as when I was on Wellbutrin. I became paralyzed with anxiety. So paralyzed that I was blind to it. I began having symptoms of irritable bowel syndrome, as many with anxiety disorders do, so I went to a clinic and explained my symptoms. The very first question the doctor asked me was: 'are you anxious?' I confidently replied 'no'
GAF Bagels: oops
Piano: Right? But there was no one there to see beyond my skewed perception. My friends didn't get it. To them I had just slowly become an asshole. I began dating one of my best friends and she didn't get it. I would justify away my anxiety and excessive marijuana usage with any circumstance I could come up with.
GAF Bagels: jeez
Piano: My therapist didn't get it. I cut my appointments to every other week and lied to her about how much weed I smoked and how much turmoil I was having with my friendships. I couldn't risk telling her and having her suggest that I give up my escapes. I would spend two to three days at a time not leaving my apartment, only smoking weed and playing video games. Primarily JUST Team Fortress - I was so anxious that I couldn't generally try new games lest they didn't let me escape into them.
GAF Bagels: that's pretty grim
Piano: At least TF2 is a great game.
I didn't know what had changed. I became really, really bitter and obsessive. I couldn't get over that I felt like I had peaked my freshman year of college. I didn't know why I couldn't get school work done, why I couldn't keep a sleep schedule, why I had terrible attendance, or why my friends didn't like me as much.
GAF Bagels: In hindsight...
Piano: Yes, so obvious. On some level, I knew. I got it. But I couldn't admit it. Because admitting it meant admitting I wasn't doing well and having to give up the few things I still enjoyed.
I took a lot of this out on my girlfriend. I obsessed over everything about our relationship that wasn't perfect. So...just about everything, naturally. But my unhappiness was always because of something. Always because something wasn't good enough. Always external, never because of my broken perception.
I finished the school year miserable. Planned to go off and work again at the same summer camp. I got home and, of course, I didn't want to leave. Even more so this time. Going to camp meant giving up weed and video games. Giving up my escapes. I couldn't deal with it. I put off packing until 12 hours before my flight. And cried while I was doing it. Still, I didn't get it. Or I didn't WANT to get it. I had enjoyed myself the summer before, so why not now? What was different? I showed up and was a complete wreck. I cried 6 hours after getting there. I went to dinner with my best friend from the year before and didn't talk the whole time. : I didn't unpack my things. I couldn't. I couldn't get settled in. I couldn't deal with it, and I didn't know why.
Without any escapes, I broke down. Had to find secluded places to cry every night. The only person I informed of what was going on was the camp nurse, who was the same as the year before and had been tremendously helpful at that time helping me deal with anxiety. I finally admitted that I had a huge problem. I wasn't able to enjoy anything. I was horribly unhappy. I talked to my parents, to the nurse and to the camp directors and decided it was best for me to quit and fly home to get help. I had to stand up in front of the whole staff and announce I was leaving due to emotional issues. On the one hand, I knew I needed to go home because I was fundamentally broken and needed help to become whole again. On the other hand, I wanted to smoke weed and play video games. Simple as that. I was willing to quit a wonderful job and fly home. To escape. That's how unhappy I was. I got back home and knew I had to find a good doctor. Luckily, one of my best friend's mother is a therapist. She referred me to the best doctor she knew in the area. Combination therapist / psychiatrist.
GAF Bagels: why did you have to announce it to everyone? That seems...cruel.
Piano: Because I wanted them to hear it from me. It was my choice. I was afraid of the stigma. The sort of mysterious, under-the-breath 'oh...he's DEPRESSED' Because a lot of people don't get it.
GAF Bagels: a lot of my classmates don't get it, unfortunately
Piano: Probably because they've never asked. Were someone to come up to me and say 'hey, I'm sick with this disease you've never heard of' I would say 'wait, what is that? Explain it to me'. But nobody does that with mental health issues. Everyone's afraid to just speak up and say "I don't get it"
GAF Bagels: It's still weird though because EVERYBODY knows several people with depression. They just might not know it...
Piano: But they try to generalize it against their own experiences with unhappiness. If they DO know.
GAF Bagels: That's a good point - being bummed is so very different. Even grief is very different
Piano: Yes! But emotion is so hard to convey accurately. It affects us all so, so differently. But we can never see through anyone else's eyes. So the best we have is verbal articulation. Which is pretty inadequate when it comes to explaining an entire state of mind.
GAF Bagels: That's actually why depression-GAF is so...nice isn't the word, but comforting? The fact that you don't have to start by explaining what depression is and what it feels like and how it's not like being bummed...You can cut right to the actual issues.
Piano: That's a great observation. I hadn't thought about it that way. The foundation is already laid.
GAF Bagels: When you talk about getting zombified by SSRIs, I knew exactly what you meant. You don't have to try to explain it. We can speak the language of depression
Piano: Plus you and I have had some wildly similar experiences with these things!
GAF Bagels: exactly! That's why this interview is tough. I feel like we're very similar, so it's more like chatting with a good friend than interviewing someone I kind of, but don't really know
Piano: I'm very interested to see how you edit this to be cohesive. Rather than me and you going back and forth saying 'whoa man like me too'
GAF Bagels: So we last left you smoking more weed...
Piano: Right. I went home, started getting therapy. Finally, finally, finally, FINALLY found a doctor with whom I could be comfortable and honest. Who could see beyond my words and figure me out. It changed my life. I can't thank him enough, or recommend him to enough friends. He didn't ask me 'are you anxious'? Instead, after a few sessions he told me: 'you're anxious' and prescribed me Buspar. Of course, I was weary of more medication. I said I didn't want to be drugged up, and that I didn't know what I was looking for in taking more pills. His explanation was simple and so, so powerful. Completely changed the way I think about the whole psychopharmocology gambit: The goal is for you to feel the most yourself.
Needless to say, Buspar DID make me feel more myself.
GAF Bagels: I was told the exact same thing! It is powerful.
Piano: So, so powerful.
GAF Bagels: the idea of "happy pills" is BS
Piano: Right!
GAF Bagels: A good AD makes it possible for you to feel normal
Piano: And he was very clear that they're a tool, not a solution.
GAF Bagels: Man, a good psychiatrist is absolutely amazing
Piano: Yes.
GAF Bagels: Cleaning up YEARS of spotty, inconsistent care...
Piano: He also was the first person I was honest with about smoking weed multiple times every day and, again, had the most level-headed opinion about it: "Well, I wouldn't RECOMMEND it." But in the meantime he knew there were bigger fish the fry. That I had to address WHY I did such things, not just try to stop them. Of course, this sort of attitude made it possible to get back on course after years of wandering.
GAF Bagels: So you've got a good doc, things are going better...but we haven't gotten to your hospitalization
Piano: That's a few months yet. The doctor was amazing. First of all, Buspar made me feel the most myself I had in a long time. I literally realized after a few days 'wow, this is...how I used to feel'. Before I worried about everything, all the time. I was still pretty down and depressed - but I was no longer anxious about being depressed. Which was a huge, huge load off of my back. As we jiggered with medications he also showed me how skewed my perception was.
Now, was this because of my mood issues, or were my mood issues because of skewed perception? A bit of both. The perceptual issues went far back to high school or earlier, but had been dug back up and inflated by brutal anxiety and depression. I saw everything in black and white. If something wasn't a complete success it was a horrible failure. I was horribly bitter and regretful about an endless number of things. Most primarily having waited so long to get help...I couldn't get over that I had wasted a year of my life being miserable and treading water. A year I can't get back.
Honestly, I still can't get over that sometimes. Whenever I see something, ANYTHING, dating from the spring of 2011, all I can think about is how that happened during that period of time when I was anxious and miserable.
GAF Bagels: That's something I think we all have to come to terms with - the lost time.
Piano: But that's why I implore people to force themselves to get help. Once you're out of the fog you'll be glad you didn't spend any more time inside of it.
GAF Bagels: very, very true. There's nothing to gain by waiting.
Piano: I hate that I waited so long, but I'm glad that my life now is enough of a contrast that I'm able to regret the period of time when I was a broken mess. Not that it's perfect. So I did have an agenda that summer. It was to get off of Cymbalta and never take another SSRI. Having had two of them not make me less depressed and make me impotent I was convinced they were useless. I got moved from Cymbalta onto Amitriptyline (Elavil). A tricyclic from the 1970s.
Around this time, my doctor floated the bipolar theory for the first time. He wasn't completely sure, but it was the first diagnosis I had received since I was initially given Zoloft at age 11.
GAF Bagels: type I or II? [Type I is the classic type with alternating episodes of mania and depression. In type II, you have more depression and episodes of hypomania, but no true full-blown manic states]
Piano: Type II, or perhaps 'atypical bipolar'. With an additional anxiety disorder.
GAF Bagels: I was briefly diagnosed as bipolar II as well. That's where the lamictal came in.
Piano: Lamictal enters the picture very soon. But first I tried, of all medications, Gabapentin (Neurontin is the brand name)
Piano: Ever heard of it?
GAF Bagels: I used it off-label for sleep. We're basically the same person.
Piano: Yes.
Right around the time I dropped the Cymbalta and switched to Amitriptyline & Gabapentin I began having severe mood fluctuations again - the first since my freshman year of college. This time, however, they lasted hours. It started happening every night. Some nights panic. Other nights just suffocating hopelessness. It would begin over the course of about 5-10 minutes and generally run 2-4 hours. In both circumstances, my perception would suddenly change and it would just be me face to face with the brutal reality that it's all completely meaningless. That life is pointless. I couldn't escape it. Weed, video games, nothing, they were all skewed through this view. It was as if...
GAF Bagels: You really have very PTSD-like symptomatology. Iatrogenic PTSD...
Piano: Let's say life is generally softly lit, with a warm light. The shadows are soft, everything sort of blends together into a cohesive whole. When the panic happened, it was as if someone had very suddenly turned on a harsh, cold work light, dividing everything into black and white, making all of the shadows jagged and sharp.
Piano: What does that mean?
GAF Bagels: iatrogenic = caused by your physician (psychologist, nurse, etc.). It's like the meds gave you PTSD-like symptoms, with these sudden attacks. It's an unusual presentation for depression…
Piano: Wild. That's actually the current theory - that I'm atypical bipolar, subject to wild mood fluctuations because of medications.
So you're a genius.
GAF Bagels: I'll go ahead and bold that in the transcript
Piano: Bold, underline, italics.
GAF Bagels: modesty forbids...
Piano: So this began happening every night. Some nights, it would hysterical. I would cry, claw at my walls, walk laps around my room. Other nights, it would just be emptiness. I couldn't cry. I couldn't feel. It was just me, face to face with inescapable hopelessness.
GAF Bagels: how long did this go on? It sounds like hell
Piano: Every night for about a week, until my medications got suddenly increased all at once in a bid to keep me from going over the edge. It looked like I wasn't going to be able to go back to school if it continued. After that it happened maybe...every third day or so. Always at night. Generally alone.
I can see now, though - if I began feeling that way all day, every day...I wouldn't make it more than a month. For the second time, I began to understand why someone would commit suicide - this time in a completely different way.
GAF Bagels: Good God. You do get a sense for why some people commit suicide and you can understand why that would become a rational choice
Piano: Yes. And I understand now that saying it's due to 'depression' means only one of a million things. This was completely different, but could have ended in the same result.
So, the week before I was to go back to school, still not sure if I would or not, my doctor decided to put me on a fifth medication - Buspar, Amitriptyline, Gabapentin, Xanax every night to stave off panic and be able to sleep. And we added Abilify.
GAF Bagels: For someone who's 20?
Piano: 21 at the time. But yep.
GAF Bagels: That's a shit-ton of meds
Piano: Yes. Though all at low doses. He added Abilify at one half of the lowest dose. 1mg a day. And it made me feel...great. Like, amazing.
GAF Bagels: it's an interesting strategy
Piano: Suddenly, I was psyched to go back to school. I became insanely creative.
GAF Bagels: That's some amazing psychopharmacological insight
Piano: ...but I couldn't sleep. I overspent money. I began grinding my teeth. I was irritable. Seeing a pattern here?
GAF Bagels: it's a nice pendulum effect...
Piano: Yep. Luckily I caught it before a huge crash. Actually, I only caught it because I stopped being able to focus my eyes properly. Another bizarre side effect. I tend to get all of the strange side effects. Especially since Abilify, for many people, is very sedating. For me, at half of the lowest dose it made me manic (people take up to 30mg/day, I took 1mg).
B]GAF Bagels[/B]: Have you done any genetic testing?
GAF Bagels: you could be an ultra-slow metabolizer
Piano: Not sure that I've tested for that. What are the ramifications?
[see Part VI]
Piano: So I discontinued Abilify. The mania was actually kind of perfect, though. Made moving into a new apartment a BREEZE.
GAF Bagels: haha
Piano: Not to mention...it does feel incredible. I was high on life.
GAF Bagels: mania is the one medical symptom that's kind of like a super power.
GAF Bagels: it annoys the fuck out of everyone else, but from the inside, it feels amazing [I’ve had hypomania induced by medications].
Piano: Oh yeah. Friends and girlfriend said I was really strange and aggressive. But words can't describe how incredible I felt. Luckily, I bailed before the crash...which I'm sure would have been BRUTAL.
GAF Bagels: yeah. Kay Jamison is a psychologist at Johns Hopkins who is bipolar.
Piano: Is she the one who wrote An Unquiet Mind?
GAF Bagels: Her autobiography "An Unquiet Mind" gives great descriptions of mania and the crashes afterwards
Ha!
I should have guessed. If I've read it, you've obviously read it.
Piano: Not all of it. But my parents read it while I was going through all of this.
Piano: Plus, she's like...full on manic depressive.
GAF Bagels: Great book. Oh yeah. She would go weeks without sleeping. Just creative and productive as fuck.
GAF Bagels: Also, she'd sleep with anything that moved. Then she'd crash and try to kill herself.
Piano: Quite the contrast!
GAF Bagels: Yeah. But she talks about not wanting to be treated for mania, because why wouldn't you want to feel like that?
Piano: No! You don't want to give up that creative brilliance and that intoxicating happiness.
GAF Bagels: For her, it was worth putting up with the crashes, at least for a while.
Piano: It certainly doesn't allow you to keep on a stable lifestyle...
GAF Bagels: it's like Xanax. Too much of a good thing is actually a really bad thing.
So you got off the Abilify..
Piano: I did. I started seeing a new doctor up around my school. Unfortunately, this one was a miss. Way too pill happy. I'd go in and say 'oh hey, shit is messed up,' and he'd say 'ohhh don't worry, these things take time, etc etc etc'. I began phasing in Lamictal. Again, at first it was great. Every time I upped my dose by 25mg I'd feel incredible for two days...and then crash. Hypomania, again. We began to realize these problems had only happened when I HADN'T been on an SSRI, so I was forced to accept that they do help me. I called my sister to see which one had worked best for her. And was put on Lexapro.
But the mood swings kept happening and getting worse. My attendance to class suffered. I dropped one of classes and became a part time student. I had to switch my major so I could take more solitary work rather than group work classes (media criticism rather than film production) so I could keep up. I began having panic attacks again, at this point on six different medications. Most of them in some process of being phased in or out. As I moved into November things only got worse. In the two weeks before I went into the hospital I honest to god had no idea day to day how I would feel. It was a gamble. On day, I was mildly psychomotor depressed - tired, disinterested, but fine to play video games. The next day I'd feel great, followed by a panic attack in the evening. The day after that I'd just be wildly anxious and have to hit the Xanax to function.
So on and so on.
Ultimately I made the call to go into the hospital. I realized that my doctor was bullshit and my treatment was directionless at that point - something I knew I had wasted years before not addressing.
It was a tough call for several reasons:
One: It's the hospital.
Two: I felt like I hadn't suffered enough. That my problems weren't 'real' enough. Generally people go into the hospital once they're suicidal. I wasn't, I just knew that I was going down and had no idea how to get back up. I felt guilty for taking a spot, taking a bed when there might be people who were suffering more than me.
It was my father (who also spent time in the psych ward way back when) who put some sense into me. He pointed out that it was nonsense to wait to get worse in order to seek treatment for getting better.
GAF Bagels: you're lucky to have parents like that
Piano: On the one hand, yes. On the other hand, they passed along crazy mood and anxiety disorders.
Worth it, still! They've been wildly supportive. Partly because they've been through all of this. My sister also spent time in the hospital. It's almost a family rite of passage.
It is unfortunate, though, that so many people neglect getting treatment because there doesn't seem to be a middle ground between 'I see someone once a week' and 'I'm locked up in the hospital'. A middle ground between being sort-of bad and suicidal.
GAF Bagels: That's a great observation.
Piano: That's where I was stuck. I didn't go in because I was almost dead. I went in because we had no more ideas for my treatment. I needed someone to say 'hey, no, go that way'. I went in over Thanksgiving break in order to avoid getting more behind in school. Also because I was afraid to return home, where I hadn't been since I had brutal panic almost every night. Too many bad associations. I was in for about a week. It was...everything I needed. Didn't fix all of my problems. But, being on six medications at the time, it was amazing to show up and have them say "hmm...stop these two immediately"
GAF Bagels: haha
Piano: Since I was in a controlled environment they felt confident doing so. Finally pulling the plug on drugs that weren't doing anything for me (Amitriptyline and Gabapentin)
GAF Bagels: We learned in medical school that once you hit four medications, essentially 0% of your patients will be able to take them all as prescribed anyway.
Piano: Yeah, I also had days I'd forget a medication...which would generally create more panic. My experience in the hospital was incredible. I got to drop EVERYTHING and focus on my recovery. All I could do all day was talk to people, play board games or my DS and attend workshops.
GAF Bagels: it's great to hear a positive story! I've heard some real hospital horror stories lately.
My stay was very therapeutic as well
Piano: There were some amazing people in there. And it was great to see them slowly get better alongside myself. At least, most of them.
GAF Bagels: that part is great
Piano: I was at [a hospital!] - I suppose it's supposed to be a really good one? Connected to [the rest of the hospital!].
GAF Bagels: So they say.
Piano: Of course, I wasn't in the ritzy, $50,000, you've got a team of doctors working on you 24/7 part of the hospital. But it was still good.
So after a week, I got discharged with a clear plan for treatment. They were finally able to say okay, do this next, followed by this. And these are the medications we think you should end up on, along with our best guess at a diagnosis.
GAF Bagels: which was?
Piano: That diagnosis being general anxiety disorder alongside mood spectrum disorder, most likely atypical bipolar. They took the time to hear the whole story, to hear what every doctor had done and put it all together. I didn't even realize until I got out how closely they had been analyzing me. For every meeting there was a detailed description - like 'gripped handles of chair very tightly, seems nervous and eager to talk about medications but avoids therapeutic issues' etc.
GAF Bagels: I'll just say that it's amazing that your illness is atypical in so many ways, yet your experience is actually pretty typical (not to diminish it) - the spotty treatment, the long time-course, the uncertainty about what was going on, the broken relationships, the swings up and down...
[break]
Piano: So where did we leave off?
GAF Bagels: [The hospital!] fixed you?
Piano: Well, not quite that simple. But they were able to take all of the nonsense, process it, and say hey: Here's where we think you are, here's where we think you should end up and here's our best suggestion for how to get there. Certainly didn't fix all of my problems, but pointed me in the correct direction and gave me a confidence in my treatment I had long since lost. All in all, a very positive experience. The worst part of it was the anxiety beforehand. I had no idea what to expect. But the second I got there and a doctor sat down with me for a while and had me go through everything, from the beginning, and then tell me that they could help me...it was a huge relief.
Other than getting a lot of my stuff confiscated, naturally. Didn't take my DS, which was nice.
GAF Bagels: So how long ago was that?
Piano: That was last November, over Thanksgiving break. Definitely the most interesting Thanksgiving I've ever had. Needless to say, it shaped me up enough to help me finish out the semester and begin treatment with a different doctor.
I still had panic attacks now and then for a while, but winter of last year is when things finally started picking up a bit, after slowly crawling downwards over the course of three years or so.
GAF Bagels: So how do you stand today?
Piano: Much better. Wildly imperfect, but much better. I haven't changed my medications for...8 months now? I still have my ups and downs. Tend to have a 3-ish day period of low mood every month or so. Have anxiety better and worse some nights. Though now I take Klonopin at night for that so the temptation for abuse is much lower. My substance use has naturally waned as I've found myself less and less needing an escape and being able to enjoy things quite enough sober.
With everything as stable as it is I've been able to begin probing the therapeutic issues that run parallel to all of this. What triggers some of my mood fluctuations.
GAF Bagels: That's very CBT...
Piano: I've accepted that I won't be as 'successful' in the career term as some of my friends who didn't struggle with these issues, at least for now.
Yes, though we've also investigated where some of these perceptions came from.
All intermingled. There's little use in sticking religiously to one form of treatment. At least in my opinion. You've got to mix and match as needed. And while I'm not going to be rich and accomplished in the very near future I've decided to spend this year concentrating on deriving enjoyment from day to day existence. I still struggle every day with how meaningless everything is, on the cosmic scale. For me at least, not being religious. It's tough to accept that. But once you do you can begin to create meaning. Between people. With things you enjoy…
GAF Bagels: If you're about to propose to me, I'm flattered...
Piano: Sometimes I'm able to do that, sometimes not. I'm trying my best to be less of a hermit. To let go of not being in control of social situations. I've been working on meditation and mindfulness.
Piano: I was going to do that via video chat, seems more formal.
GAF Bagels: I like that. You really know how to treat a girl.
Piano: Oh you.
GAF Bagels: *blush*
Sorry
Off the rails again
Piano: But, for love.
GAF Bagels: True. It's quite beautiful, really
B]Piano[/B]: Anyways. The most important lesson I picked up is the power of perception.
GAF Bagels: I wad actually going to ask if you were in a relationship, but it's awkward now
Piano: I am, but she doesn't know about you. Actually that's not true, she saw us chatting earlier. Oops.
->We're joking!<- (you can never be too sure...)
Piano: Right. I went home, started getting therapy. Finally, finally, finally, FINALLY found a doctor with whom I could be comfortable and honest. Who could see beyond my words and figure me out. It changed my life. I can't thank him enough, or recommend him to enough friends. He didn't ask me 'are you anxious'? Instead, after a few sessions he told me: 'you're anxious' and prescribed me Buspar. Of course, I was weary of more medication. I said I didn't want to be drugged up, and that I didn't know what I was looking for in taking more pills. His explanation was simple and so, so powerful. Completely changed the way I think about the whole psychopharmocology gambit: The goal is for you to feel the most yourself.
Needless to say, Buspar DID make me feel more myself.
GAF Bagels: I was told the exact same thing! It is powerful.
Piano: So, so powerful.
GAF Bagels: the idea of "happy pills" is BS
Piano: Right!
GAF Bagels: A good AD makes it possible for you to feel normal
Piano: And he was very clear that they're a tool, not a solution.
GAF Bagels: Man, a good psychiatrist is absolutely amazing
Piano: Yes.
GAF Bagels: Cleaning up YEARS of spotty, inconsistent care...
Piano: He also was the first person I was honest with about smoking weed multiple times every day and, again, had the most level-headed opinion about it: "Well, I wouldn't RECOMMEND it." But in the meantime he knew there were bigger fish the fry. That I had to address WHY I did such things, not just try to stop them. Of course, this sort of attitude made it possible to get back on course after years of wandering.
GAF Bagels: So you've got a good doc, things are going better...but we haven't gotten to your hospitalization
Piano: That's a few months yet. The doctor was amazing. First of all, Buspar made me feel the most myself I had in a long time. I literally realized after a few days 'wow, this is...how I used to feel'. Before I worried about everything, all the time. I was still pretty down and depressed - but I was no longer anxious about being depressed. Which was a huge, huge load off of my back. As we jiggered with medications he also showed me how skewed my perception was.
Now, was this because of my mood issues, or were my mood issues because of skewed perception? A bit of both. The perceptual issues went far back to high school or earlier, but had been dug back up and inflated by brutal anxiety and depression. I saw everything in black and white. If something wasn't a complete success it was a horrible failure. I was horribly bitter and regretful about an endless number of things. Most primarily having waited so long to get help...I couldn't get over that I had wasted a year of my life being miserable and treading water. A year I can't get back.
Honestly, I still can't get over that sometimes. Whenever I see something, ANYTHING, dating from the spring of 2011, all I can think about is how that happened during that period of time when I was anxious and miserable.
GAF Bagels: That's something I think we all have to come to terms with - the lost time.
Piano: But that's why I implore people to force themselves to get help. Once you're out of the fog you'll be glad you didn't spend any more time inside of it.
GAF Bagels: very, very true. There's nothing to gain by waiting.
Piano: I hate that I waited so long, but I'm glad that my life now is enough of a contrast that I'm able to regret the period of time when I was a broken mess. Not that it's perfect. So I did have an agenda that summer. It was to get off of Cymbalta and never take another SSRI. Having had two of them not make me less depressed and make me impotent I was convinced they were useless. I got moved from Cymbalta onto Amitriptyline (Elavil). A tricyclic from the 1970s.
Around this time, my doctor floated the bipolar theory for the first time. He wasn't completely sure, but it was the first diagnosis I had received since I was initially given Zoloft at age 11.
GAF Bagels: type I or II? [Type I is the classic type with alternating episodes of mania and depression. In type II, you have more depression and episodes of hypomania, but no true full-blown manic states]
Piano: Type II, or perhaps 'atypical bipolar'. With an additional anxiety disorder.
GAF Bagels: I was briefly diagnosed as bipolar II as well. That's where the lamictal came in.
Piano: Lamictal enters the picture very soon. But first I tried, of all medications, Gabapentin (Neurontin is the brand name)
Piano: Ever heard of it?
GAF Bagels: I used it off-label for sleep. We're basically the same person.
Piano: Yes.
Right around the time I dropped the Cymbalta and switched to Amitriptyline & Gabapentin I began having severe mood fluctuations again - the first since my freshman year of college. This time, however, they lasted hours. It started happening every night. Some nights panic. Other nights just suffocating hopelessness. It would begin over the course of about 5-10 minutes and generally run 2-4 hours. In both circumstances, my perception would suddenly change and it would just be me face to face with the brutal reality that it's all completely meaningless. That life is pointless. I couldn't escape it. Weed, video games, nothing, they were all skewed through this view. It was as if...
GAF Bagels: You really have very PTSD-like symptomatology. Iatrogenic PTSD...
Piano: Let's say life is generally softly lit, with a warm light. The shadows are soft, everything sort of blends together into a cohesive whole. When the panic happened, it was as if someone had very suddenly turned on a harsh, cold work light, dividing everything into black and white, making all of the shadows jagged and sharp.
Piano: What does that mean?
GAF Bagels: iatrogenic = caused by your physician (psychologist, nurse, etc.). It's like the meds gave you PTSD-like symptoms, with these sudden attacks. It's an unusual presentation for depression…
Piano: Wild. That's actually the current theory - that I'm atypical bipolar, subject to wild mood fluctuations because of medications.
So you're a genius.
GAF Bagels: I'll go ahead and bold that in the transcript
Piano: Bold, underline, italics.
GAF Bagels: modesty forbids...
Piano: So this began happening every night. Some nights, it would hysterical. I would cry, claw at my walls, walk laps around my room. Other nights, it would just be emptiness. I couldn't cry. I couldn't feel. It was just me, face to face with inescapable hopelessness.
GAF Bagels: how long did this go on? It sounds like hell
Piano: Every night for about a week, until my medications got suddenly increased all at once in a bid to keep me from going over the edge. It looked like I wasn't going to be able to go back to school if it continued. After that it happened maybe...every third day or so. Always at night. Generally alone.
I can see now, though - if I began feeling that way all day, every day...I wouldn't make it more than a month. For the second time, I began to understand why someone would commit suicide - this time in a completely different way.
GAF Bagels: Good God. You do get a sense for why some people commit suicide and you can understand why that would become a rational choice
Piano: Yes. And I understand now that saying it's due to 'depression' means only one of a million things. This was completely different, but could have ended in the same result.
So, the week before I was to go back to school, still not sure if I would or not, my doctor decided to put me on a fifth medication - Buspar, Amitriptyline, Gabapentin, Xanax every night to stave off panic and be able to sleep. And we added Abilify.
GAF Bagels: For someone who's 20?
Piano: 21 at the time. But yep.
GAF Bagels: That's a shit-ton of meds
Piano: Yes. Though all at low doses. He added Abilify at one half of the lowest dose. 1mg a day. And it made me feel...great. Like, amazing.
GAF Bagels: it's an interesting strategy
Piano: Suddenly, I was psyched to go back to school. I became insanely creative.
GAF Bagels: That's some amazing psychopharmacological insight
Piano: ...but I couldn't sleep. I overspent money. I began grinding my teeth. I was irritable. Seeing a pattern here?
GAF Bagels: it's a nice pendulum effect...
Piano: Yep. Luckily I caught it before a huge crash. Actually, I only caught it because I stopped being able to focus my eyes properly. Another bizarre side effect. I tend to get all of the strange side effects. Especially since Abilify, for many people, is very sedating. For me, at half of the lowest dose it made me manic (people take up to 30mg/day, I took 1mg).
B]GAF Bagels[/B]: Have you done any genetic testing?
GAF Bagels: you could be an ultra-slow metabolizer
Piano: Not sure that I've tested for that. What are the ramifications?
[see Part VI]
Piano: So I discontinued Abilify. The mania was actually kind of perfect, though. Made moving into a new apartment a BREEZE.
GAF Bagels: haha
Piano: Not to mention...it does feel incredible. I was high on life.
GAF Bagels: mania is the one medical symptom that's kind of like a super power.
GAF Bagels: it annoys the fuck out of everyone else, but from the inside, it feels amazing [I’ve had hypomania induced by medications].
Piano: Oh yeah. Friends and girlfriend said I was really strange and aggressive. But words can't describe how incredible I felt. Luckily, I bailed before the crash...which I'm sure would have been BRUTAL.
GAF Bagels: yeah. Kay Jamison is a psychologist at Johns Hopkins who is bipolar.
Piano: Is she the one who wrote An Unquiet Mind?
GAF Bagels: Her autobiography "An Unquiet Mind" gives great descriptions of mania and the crashes afterwards
Ha!
I should have guessed. If I've read it, you've obviously read it.
Piano: Not all of it. But my parents read it while I was going through all of this.
Piano: Plus, she's like...full on manic depressive.
GAF Bagels: Great book. Oh yeah. She would go weeks without sleeping. Just creative and productive as fuck.
GAF Bagels: Also, she'd sleep with anything that moved. Then she'd crash and try to kill herself.
Piano: Quite the contrast!
GAF Bagels: Yeah. But she talks about not wanting to be treated for mania, because why wouldn't you want to feel like that?
Piano: No! You don't want to give up that creative brilliance and that intoxicating happiness.
GAF Bagels: For her, it was worth putting up with the crashes, at least for a while.
Piano: It certainly doesn't allow you to keep on a stable lifestyle...
GAF Bagels: it's like Xanax. Too much of a good thing is actually a really bad thing.
So you got off the Abilify..
Piano: I did. I started seeing a new doctor up around my school. Unfortunately, this one was a miss. Way too pill happy. I'd go in and say 'oh hey, shit is messed up,' and he'd say 'ohhh don't worry, these things take time, etc etc etc'. I began phasing in Lamictal. Again, at first it was great. Every time I upped my dose by 25mg I'd feel incredible for two days...and then crash. Hypomania, again. We began to realize these problems had only happened when I HADN'T been on an SSRI, so I was forced to accept that they do help me. I called my sister to see which one had worked best for her. And was put on Lexapro.
But the mood swings kept happening and getting worse. My attendance to class suffered. I dropped one of classes and became a part time student. I had to switch my major so I could take more solitary work rather than group work classes (media criticism rather than film production) so I could keep up. I began having panic attacks again, at this point on six different medications. Most of them in some process of being phased in or out. As I moved into November things only got worse. In the two weeks before I went into the hospital I honest to god had no idea day to day how I would feel. It was a gamble. On day, I was mildly psychomotor depressed - tired, disinterested, but fine to play video games. The next day I'd feel great, followed by a panic attack in the evening. The day after that I'd just be wildly anxious and have to hit the Xanax to function.
So on and so on.
Ultimately I made the call to go into the hospital. I realized that my doctor was bullshit and my treatment was directionless at that point - something I knew I had wasted years before not addressing.
It was a tough call for several reasons:
One: It's the hospital.
Two: I felt like I hadn't suffered enough. That my problems weren't 'real' enough. Generally people go into the hospital once they're suicidal. I wasn't, I just knew that I was going down and had no idea how to get back up. I felt guilty for taking a spot, taking a bed when there might be people who were suffering more than me.
It was my father (who also spent time in the psych ward way back when) who put some sense into me. He pointed out that it was nonsense to wait to get worse in order to seek treatment for getting better.
GAF Bagels: you're lucky to have parents like that
Piano: On the one hand, yes. On the other hand, they passed along crazy mood and anxiety disorders.
Worth it, still! They've been wildly supportive. Partly because they've been through all of this. My sister also spent time in the hospital. It's almost a family rite of passage.
It is unfortunate, though, that so many people neglect getting treatment because there doesn't seem to be a middle ground between 'I see someone once a week' and 'I'm locked up in the hospital'. A middle ground between being sort-of bad and suicidal.
GAF Bagels: That's a great observation.
Piano: That's where I was stuck. I didn't go in because I was almost dead. I went in because we had no more ideas for my treatment. I needed someone to say 'hey, no, go that way'. I went in over Thanksgiving break in order to avoid getting more behind in school. Also because I was afraid to return home, where I hadn't been since I had brutal panic almost every night. Too many bad associations. I was in for about a week. It was...everything I needed. Didn't fix all of my problems. But, being on six medications at the time, it was amazing to show up and have them say "hmm...stop these two immediately"
GAF Bagels: haha
Piano: Since I was in a controlled environment they felt confident doing so. Finally pulling the plug on drugs that weren't doing anything for me (Amitriptyline and Gabapentin)
GAF Bagels: We learned in medical school that once you hit four medications, essentially 0% of your patients will be able to take them all as prescribed anyway.
Piano: Yeah, I also had days I'd forget a medication...which would generally create more panic. My experience in the hospital was incredible. I got to drop EVERYTHING and focus on my recovery. All I could do all day was talk to people, play board games or my DS and attend workshops.
GAF Bagels: it's great to hear a positive story! I've heard some real hospital horror stories lately.
My stay was very therapeutic as well
Piano: There were some amazing people in there. And it was great to see them slowly get better alongside myself. At least, most of them.
GAF Bagels: that part is great
Piano: I was at [a hospital!] - I suppose it's supposed to be a really good one? Connected to [the rest of the hospital!].
GAF Bagels: So they say.
Piano: Of course, I wasn't in the ritzy, $50,000, you've got a team of doctors working on you 24/7 part of the hospital. But it was still good.
So after a week, I got discharged with a clear plan for treatment. They were finally able to say okay, do this next, followed by this. And these are the medications we think you should end up on, along with our best guess at a diagnosis.
GAF Bagels: which was?
Piano: That diagnosis being general anxiety disorder alongside mood spectrum disorder, most likely atypical bipolar. They took the time to hear the whole story, to hear what every doctor had done and put it all together. I didn't even realize until I got out how closely they had been analyzing me. For every meeting there was a detailed description - like 'gripped handles of chair very tightly, seems nervous and eager to talk about medications but avoids therapeutic issues' etc.
GAF Bagels: I'll just say that it's amazing that your illness is atypical in so many ways, yet your experience is actually pretty typical (not to diminish it) - the spotty treatment, the long time-course, the uncertainty about what was going on, the broken relationships, the swings up and down...
[break]
Piano: So where did we leave off?
GAF Bagels: [The hospital!] fixed you?
Piano: Well, not quite that simple. But they were able to take all of the nonsense, process it, and say hey: Here's where we think you are, here's where we think you should end up and here's our best suggestion for how to get there. Certainly didn't fix all of my problems, but pointed me in the correct direction and gave me a confidence in my treatment I had long since lost. All in all, a very positive experience. The worst part of it was the anxiety beforehand. I had no idea what to expect. But the second I got there and a doctor sat down with me for a while and had me go through everything, from the beginning, and then tell me that they could help me...it was a huge relief.
Other than getting a lot of my stuff confiscated, naturally. Didn't take my DS, which was nice.
GAF Bagels: So how long ago was that?
Piano: That was last November, over Thanksgiving break. Definitely the most interesting Thanksgiving I've ever had. Needless to say, it shaped me up enough to help me finish out the semester and begin treatment with a different doctor.
I still had panic attacks now and then for a while, but winter of last year is when things finally started picking up a bit, after slowly crawling downwards over the course of three years or so.
GAF Bagels: So how do you stand today?
Piano: Much better. Wildly imperfect, but much better. I haven't changed my medications for...8 months now? I still have my ups and downs. Tend to have a 3-ish day period of low mood every month or so. Have anxiety better and worse some nights. Though now I take Klonopin at night for that so the temptation for abuse is much lower. My substance use has naturally waned as I've found myself less and less needing an escape and being able to enjoy things quite enough sober.
With everything as stable as it is I've been able to begin probing the therapeutic issues that run parallel to all of this. What triggers some of my mood fluctuations.
GAF Bagels: That's very CBT...
Piano: I've accepted that I won't be as 'successful' in the career term as some of my friends who didn't struggle with these issues, at least for now.
Yes, though we've also investigated where some of these perceptions came from.
All intermingled. There's little use in sticking religiously to one form of treatment. At least in my opinion. You've got to mix and match as needed. And while I'm not going to be rich and accomplished in the very near future I've decided to spend this year concentrating on deriving enjoyment from day to day existence. I still struggle every day with how meaningless everything is, on the cosmic scale. For me at least, not being religious. It's tough to accept that. But once you do you can begin to create meaning. Between people. With things you enjoy…
GAF Bagels: If you're about to propose to me, I'm flattered...
Piano: Sometimes I'm able to do that, sometimes not. I'm trying my best to be less of a hermit. To let go of not being in control of social situations. I've been working on meditation and mindfulness.
Piano: I was going to do that via video chat, seems more formal.
GAF Bagels: I like that. You really know how to treat a girl.
Piano: Oh you.
GAF Bagels: *blush*
Sorry
Off the rails again
Piano: But, for love.
GAF Bagels: True. It's quite beautiful, really
B]Piano[/B]: Anyways. The most important lesson I picked up is the power of perception.
GAF Bagels: I wad actually going to ask if you were in a relationship, but it's awkward now
Piano: I am, but she doesn't know about you. Actually that's not true, she saw us chatting earlier. Oops.
->We're joking!<- (you can never be too sure...)
GAF Bagels: How does she handle your depression, or has it been much of an issue?
Piano: Well, we began dating in the spring of 2011 when I was crippled with anxiety. She was about to call it quits when I finally entered treatment. I went to visit her for a week after starting Buspar and, by her judgment, was a completely different person. Or rather, was more myself. Was who she knew I was, and I knew I was, but I hadn't been able to be for quite some time.
GAF Bagels: How did you meet?
Piano: School. She was my best friend for a while. And then, of course, you realize there are feelings there. Then you dick each other around for a while before finally getting together.
GAF Bagels: That's...romantic?
Piano: Eh. I'm not much for pomp. And really, I hated it at first. Or rather, it wasn't good enough. Nothing was good enough. I was so anxious. I couldn't deal with the imperfections of her or our relationship. As I went through treatment our relationship went through the stratosphere. Not because anything changed all that particularly between us, but because my perception changed completely. All of the things about our relationship that used to make me angry - now I just accept them. They are what they are.
GAF Bagels: The power of perception again?
Piano: Absolutely. Depression is like a fog. It's impossible to see out when you're in the thick of it. But once you get up to higher ground everything becomes clear. And you're glad you stuck with it. I'm sure I'll dip back down again at some point. And while things were pretty bad for a while, after I finally entered treatment, began being honest with myself and stopped resisting the way I felt I started suffering much, much less. So did all of my relationships.
It's wild how things got worse, yet I got more content. Not that I'm a monk or anything. Acceptance and honesty are huge. When it comes to the relationship, communication is key. I just have to be sure to communicate thoroughly and clearly how I'm feeling and what can be done about it. Instead of resisting it or repressing it and letting it erupt, I let it flow through me as best as I can.
I tell whomever I'm with whether there's anything they can do to help. Sometimes there's nothing. Last year, trapped in my apartment in the midst of a panic attack, I had my roommate just hang around me. It helped. Having someone else establish the reason and normalcy of the reality when you're unable to do so is tremendously helpful, even when there's nothing else they can 'do'
GAF Bagels: You sort of preempted my "what can people do to help" question
Piano: I never know until something befalls my emotions what exactly would help. I just made sure to give my roommate a heads-up that I was struggling with x, y and z and that there may be a time when I track him down completely hysterical and need his help. He was nice enough to admit that he didn't understand these issues - depression, anxiety, panic and listen to my best explanation. Too many people are afraid to ask.
GAF Bagels: true
Piano: It's complex stuff. Just because I went through my troubles doesn't mean I understand anyone else's personal journey. Which is why I can't read about someone else's tribulations and say without reservation 'oh! that's easy - do these things, they worked for me'
GAF Bagels: sure
Piano: Instead you have to motivate people to begin the process of treatment, of self-exploration. Medications may be a tool that's needed for that. They may not. I don't want to be on medications my whole life. I may have to be. But after resisting for a while I realized that none of this is permanent. As soon as I feel I've grown enough to weather the storms of my mind with less assistance I can start phasing things out. With the help of a professional, of course.
GAF Bagels: that kind of long-term planning is usually seen as a great sign.
Piano: Well, whenever I don't really understand the situation on the ground it helps me a lot to think that in 10 years, I'll get it. I'll probably look back and appreciate the experience.
GAF Bagels: brb. In the meantime, you still need to comment on the depression thread!
Piano: Sure. I think the depression thread is wonderful. We all need somewhere to find support and find others who are going through a similar struggle. That being said, it can get bogged down sometimes because of just how broad it is. It really isn't a 'depression' thread at all, it's more of a catch-all for mood disorders. 'Depression' is just the cue word that lets people know there are others who understand inside.
That being said, GAF isn't an MD. We can all help each other point in the right direction, but, at some point, you have to move forward of your own volition. Not in the 'hey you stop being so sad get and go exercise lol its so easy i was sad once' way. Just enough to find a professional who can steer things in the right direction.
For me, that was a combination therapist/psychiatrist. Find one who isn't all about shoving pills down your throat. One who will consider what you need based on a deeper understanding of where you are, not just a shallower reading of how you feel. And, frankly, there's so much dumb shit going on these days that we ALL need therapy. Like, everyone. Seriously. Maybe there'd be less passive aggression going on...
GAF Bagels: Anything we haven't covered?
Piano: No, I think that's most of it.
Piano: Such a nebulous range of medicine.
GAF Bagels: haha
Piano: So personal.
GAF Bagels: We need a thread for something really specific.
Piano: Right, like PANIC W/ AGROAPHOBIA |OT|
Piano: Reading the GAF thread, it's tough for me to know what on earth I can say to a lot of people.
GAF Bagels: I think you've done great. You have a lot of experience to share.
Piano: or something.
GAF Bagels: haha
Piano: It is tough to escape the feeling like I haven't suffered enough, though.
Piano: That my problems aren't real. Because it's such a solitary struggle.
Piano: So, what has your mental health story been? Don't think I ever picked up the whole thing.
GAF Bagels: I haven't ever revealed the whole thing.
Piano: Well, I respect that.
GAF Bagels: I'm just trying to be mysterious.
Actually, I'm open about it. I just can't interview myself (or can I?)
Piano: Well, I'm wondering just how identical our experiences were.
GAF Bagels: There's a good amount of overlap.
But I had a few traumatic experiences, too.
Tell you what - ask me next time we talk. This is already ridiculously long
Piano: You got it.
GAF Bagels: You can interview me! It'll be another giggle-fest!
Piano: Hah.
Piano: I'm sure everyone in the thread will be jonesing to flip the script at some point.
I'd love to do the honors.
GAF Bagels: Gather some community questions!
I feel like it's only fair.
Piano: Ooo definitely.
GAF Bagels: I want to use the pseudonym "donut"
GAF Bagels: throw people off...
Piano: Try to play it off like you're concealing your identity.
GAF Bagels: I'm a medical student interested in psychiatry and I...fuck
GAF Bagels: I mean, I'm a truck driver?
[Alternate Ridiculous Ending]
Piano: (talking about other things)...I don't think a 50 year old going through a divorce would give much credence to the therapeutic advice of a 22 year old college grad
GAF Bagels: I had a classmate who had not seen a human vagina until we did our dissections
Piano: What the shit.
How?!
GAF Bagels: very, very conservative
Piano: Like, in person, or ever?!
GAF Bagels: ever
GAF Bagels: I cant figure out how you can use the internet and not accidentally see at least a vagina or two every week.
Piano: Damn. I don't get it.
GAF Bagels: That was awful
GAF Bagels: His first vagina he saw was on an old, preserved, dead woman.
Piano: Oh god. Did you tell him it gets better than that? Piano: Or is he going into his wedding night with that as his expectation?
GAF Bagels: I was too stunned. He has a kid now...
I feel kind of bad for his wife
Piano: Hahahaha.
GAF Bagels: I can't imagine he knew what to do....
Piano: I've always figured that for those who save themselves for marriage...they must have terrible shitty sex on their wedding night.
Piano: I can't even imagine if he was THAT naive. Maybe he googled what to do or something.
GAF Bagels: oh Lord
GAF Bagels: He did have to go through OB/GYN, so he at least saw some real live ones.
Piano: That's unbelievably awkward to think about.
GAF Bagels: Yes, yes it is.
Piano: Of course, not being a woman, I will never understand how that could be anything but awkward. With anyone.
GAF Bagels: My first OB/GYN patient asked me if her menstrual periods were normal. I thought, "how the fuck would I know?! You tell me!"
Piano: Well, we began dating in the spring of 2011 when I was crippled with anxiety. She was about to call it quits when I finally entered treatment. I went to visit her for a week after starting Buspar and, by her judgment, was a completely different person. Or rather, was more myself. Was who she knew I was, and I knew I was, but I hadn't been able to be for quite some time.
GAF Bagels: How did you meet?
Piano: School. She was my best friend for a while. And then, of course, you realize there are feelings there. Then you dick each other around for a while before finally getting together.
GAF Bagels: That's...romantic?
Piano: Eh. I'm not much for pomp. And really, I hated it at first. Or rather, it wasn't good enough. Nothing was good enough. I was so anxious. I couldn't deal with the imperfections of her or our relationship. As I went through treatment our relationship went through the stratosphere. Not because anything changed all that particularly between us, but because my perception changed completely. All of the things about our relationship that used to make me angry - now I just accept them. They are what they are.
GAF Bagels: The power of perception again?
Piano: Absolutely. Depression is like a fog. It's impossible to see out when you're in the thick of it. But once you get up to higher ground everything becomes clear. And you're glad you stuck with it. I'm sure I'll dip back down again at some point. And while things were pretty bad for a while, after I finally entered treatment, began being honest with myself and stopped resisting the way I felt I started suffering much, much less. So did all of my relationships.
It's wild how things got worse, yet I got more content. Not that I'm a monk or anything. Acceptance and honesty are huge. When it comes to the relationship, communication is key. I just have to be sure to communicate thoroughly and clearly how I'm feeling and what can be done about it. Instead of resisting it or repressing it and letting it erupt, I let it flow through me as best as I can.
I tell whomever I'm with whether there's anything they can do to help. Sometimes there's nothing. Last year, trapped in my apartment in the midst of a panic attack, I had my roommate just hang around me. It helped. Having someone else establish the reason and normalcy of the reality when you're unable to do so is tremendously helpful, even when there's nothing else they can 'do'
GAF Bagels: You sort of preempted my "what can people do to help" question
Piano: I never know until something befalls my emotions what exactly would help. I just made sure to give my roommate a heads-up that I was struggling with x, y and z and that there may be a time when I track him down completely hysterical and need his help. He was nice enough to admit that he didn't understand these issues - depression, anxiety, panic and listen to my best explanation. Too many people are afraid to ask.
GAF Bagels: true
Piano: It's complex stuff. Just because I went through my troubles doesn't mean I understand anyone else's personal journey. Which is why I can't read about someone else's tribulations and say without reservation 'oh! that's easy - do these things, they worked for me'
GAF Bagels: sure
Piano: Instead you have to motivate people to begin the process of treatment, of self-exploration. Medications may be a tool that's needed for that. They may not. I don't want to be on medications my whole life. I may have to be. But after resisting for a while I realized that none of this is permanent. As soon as I feel I've grown enough to weather the storms of my mind with less assistance I can start phasing things out. With the help of a professional, of course.
GAF Bagels: that kind of long-term planning is usually seen as a great sign.
Piano: Well, whenever I don't really understand the situation on the ground it helps me a lot to think that in 10 years, I'll get it. I'll probably look back and appreciate the experience.
GAF Bagels: brb. In the meantime, you still need to comment on the depression thread!
Piano: Sure. I think the depression thread is wonderful. We all need somewhere to find support and find others who are going through a similar struggle. That being said, it can get bogged down sometimes because of just how broad it is. It really isn't a 'depression' thread at all, it's more of a catch-all for mood disorders. 'Depression' is just the cue word that lets people know there are others who understand inside.
That being said, GAF isn't an MD. We can all help each other point in the right direction, but, at some point, you have to move forward of your own volition. Not in the 'hey you stop being so sad get and go exercise lol its so easy i was sad once' way. Just enough to find a professional who can steer things in the right direction.
For me, that was a combination therapist/psychiatrist. Find one who isn't all about shoving pills down your throat. One who will consider what you need based on a deeper understanding of where you are, not just a shallower reading of how you feel. And, frankly, there's so much dumb shit going on these days that we ALL need therapy. Like, everyone. Seriously. Maybe there'd be less passive aggression going on...
GAF Bagels: Anything we haven't covered?
Piano: No, I think that's most of it.
Piano: Such a nebulous range of medicine.
GAF Bagels: haha
Piano: So personal.
GAF Bagels: We need a thread for something really specific.
Piano: Right, like PANIC W/ AGROAPHOBIA |OT|
Piano: Reading the GAF thread, it's tough for me to know what on earth I can say to a lot of people.
GAF Bagels: I think you've done great. You have a lot of experience to share.
Piano: or something.
GAF Bagels: haha
Piano: It is tough to escape the feeling like I haven't suffered enough, though.
Piano: That my problems aren't real. Because it's such a solitary struggle.
Piano: So, what has your mental health story been? Don't think I ever picked up the whole thing.
GAF Bagels: I haven't ever revealed the whole thing.
Piano: Well, I respect that.
GAF Bagels: I'm just trying to be mysterious.
Actually, I'm open about it. I just can't interview myself (or can I?)
Piano: Well, I'm wondering just how identical our experiences were.
GAF Bagels: There's a good amount of overlap.
But I had a few traumatic experiences, too.
Tell you what - ask me next time we talk. This is already ridiculously long
Piano: You got it.
GAF Bagels: You can interview me! It'll be another giggle-fest!
Piano: Hah.
Piano: I'm sure everyone in the thread will be jonesing to flip the script at some point.
I'd love to do the honors.
GAF Bagels: Gather some community questions!
I feel like it's only fair.
Piano: Ooo definitely.
GAF Bagels: I want to use the pseudonym "donut"
GAF Bagels: throw people off...
Piano: Try to play it off like you're concealing your identity.
GAF Bagels: I'm a medical student interested in psychiatry and I...fuck
GAF Bagels: I mean, I'm a truck driver?
[Alternate Ridiculous Ending]
Piano: (talking about other things)...I don't think a 50 year old going through a divorce would give much credence to the therapeutic advice of a 22 year old college grad
GAF Bagels: I had a classmate who had not seen a human vagina until we did our dissections
Piano: What the shit.
How?!
GAF Bagels: very, very conservative
Piano: Like, in person, or ever?!
GAF Bagels: ever
GAF Bagels: I cant figure out how you can use the internet and not accidentally see at least a vagina or two every week.
Piano: Damn. I don't get it.
GAF Bagels: That was awful
GAF Bagels: His first vagina he saw was on an old, preserved, dead woman.
Piano: Oh god. Did you tell him it gets better than that? Piano: Or is he going into his wedding night with that as his expectation?
GAF Bagels: I was too stunned. He has a kid now...
I feel kind of bad for his wife
Piano: Hahahaha.
GAF Bagels: I can't imagine he knew what to do....
Piano: I've always figured that for those who save themselves for marriage...they must have terrible shitty sex on their wedding night.
Piano: I can't even imagine if he was THAT naive. Maybe he googled what to do or something.
GAF Bagels: oh Lord
GAF Bagels: He did have to go through OB/GYN, so he at least saw some real live ones.
Piano: That's unbelievably awkward to think about.
GAF Bagels: Yes, yes it is.
Piano: Of course, not being a woman, I will never understand how that could be anything but awkward. With anyone.
GAF Bagels: My first OB/GYN patient asked me if her menstrual periods were normal. I thought, "how the fuck would I know?! You tell me!"
User 100115
Banned
GAF Bagels: Slight sidetrack: I know you said you have pectus excavatum. What did [your GF] think about that?
Piano: She thought it was cute. I was able to get over my insecurities with that by about age 18. And once you own it, it becomes a novelty, not a burden.
GAF Bagels: (my wife thinks the pectus is cute, too. But I'm still pretty bothered by it.)
Piano: It only bothers me because I'll never be able to have a great physique. But I've settled for being 'lean' rather than muscular.
GAF Bagels: It's just lingering insecurity from being an awkward kid for me
Piano: I think I began to get over it when I was informed that my options were either get over it or have surgery where they break my sternum and reform it. I chose the former.
GAF Bagels: Yeah. They can fix it with magnets in kids now
Piano: WHAT?!
GAF Bagels: minimally invasive
Piano: Unfair.
GAF Bagels: Yeah, they insert one behind your sternum, and you wear increasingly powerful ones on your chest.
Piano: Damn it.
GAF Bagels: I know, right? The bones are soft so they just slowly bend
Piano: Insane.
GAF Bagels: Do you have any cardiovascular or pulmonary issues?
Piano: No. Or at least, nothing major. I got tested and told that I wouldn't have issues unless I played contact sports. That being said, I do have a sort of poor lung capacity. I discovered when I tried to play saxophone for a little while.
You?
GAF Bagels: No. It's purely cosmetic, which does make me feel a little better.
Piano: Definitely. From what I understand it can be quite devastating.
GAF Bagels: I'm going to break this out into a new Pectus-GAF thread...
Piano: Hahaha. There have got to be others out there.
GAF Bagels: it's pretty common, more common in girls, which has to suck much more.
Piano: Really?
GAF Bagels: it's the most common chest wall deformity.
Piano: Only person I've ever known to also have it was a girl actually. And she liked it because it made her cleavage more pronounced.
GAF Bagels: But I'd imagine it would look weird without a shirt
Piano: Wouldn't know.
GAF Bagels: Back to depression! We're getting sidetracked by breasts.
Piano: Typical male behavior, I suppose.
GAF Bagels: it's a metaphor, really.
Piano: She thought it was cute. I was able to get over my insecurities with that by about age 18. And once you own it, it becomes a novelty, not a burden.
GAF Bagels: (my wife thinks the pectus is cute, too. But I'm still pretty bothered by it.)
Piano: It only bothers me because I'll never be able to have a great physique. But I've settled for being 'lean' rather than muscular.
GAF Bagels: It's just lingering insecurity from being an awkward kid for me
Piano: I think I began to get over it when I was informed that my options were either get over it or have surgery where they break my sternum and reform it. I chose the former.
GAF Bagels: Yeah. They can fix it with magnets in kids now
Piano: WHAT?!
GAF Bagels: minimally invasive
Piano: Unfair.
GAF Bagels: Yeah, they insert one behind your sternum, and you wear increasingly powerful ones on your chest.
Piano: Damn it.
GAF Bagels: I know, right? The bones are soft so they just slowly bend
Piano: Insane.
GAF Bagels: Do you have any cardiovascular or pulmonary issues?
Piano: No. Or at least, nothing major. I got tested and told that I wouldn't have issues unless I played contact sports. That being said, I do have a sort of poor lung capacity. I discovered when I tried to play saxophone for a little while.
You?
GAF Bagels: No. It's purely cosmetic, which does make me feel a little better.
Piano: Definitely. From what I understand it can be quite devastating.
GAF Bagels: I'm going to break this out into a new Pectus-GAF thread...
Piano: Hahaha. There have got to be others out there.
GAF Bagels: it's pretty common, more common in girls, which has to suck much more.
Piano: Really?
GAF Bagels: it's the most common chest wall deformity.
Piano: Only person I've ever known to also have it was a girl actually. And she liked it because it made her cleavage more pronounced.
GAF Bagels: But I'd imagine it would look weird without a shirt
Piano: Wouldn't know.
GAF Bagels: Back to depression! We're getting sidetracked by breasts.
Piano: Typical male behavior, I suppose.
GAF Bagels: it's a metaphor, really.
GAF Bagels: Have you done any genetic testing? You could be an ultra-slow metabolizer.
Piano: Not sure that I've tested for that. What are the ramifications?
GAF Bagels: So they can test the DNA for your liver enzymes.
GAF Bagels: A lot of psych meds are metabolized by cytochrome P450 2D6. There are various P450s that metabolize various things. There are known mutations that can make your enzymes hyperactive or hypoactive. For example, I'm a moderately fast 2D6 metabolizer. So I need higher doses of meds to attain the same blood level as someone with the "normal" variant.
If you're super slow...a small dose of a drug can sit in your body for a very long time. So a tiny bit gets used over and over and over. 1mg for you may be like 20 or 30 mg for someone who breaks the med down at the usual rate.
Piano: That certainly sounds like it may be the case. I will absolutely look into getting tested for that...
GAF Bagels: I had the testing done years ago and it was something like 1000 bucks
Piano: Oh damn.
GAF Bagels: It should be way cheaper now, but not all insurance is going to cover it. You seem to have a strong indication for it. It would explain A LOT. And would help guide your treatment
Piano: Yes, I'm considered VERY sensitive to medications.
GAF Bagels: This is just one of the better understood reasons why that might be the case.
Piano: I have, at least, had my thyroid tested.
GAF Bagels: http://www.mayoclinic.com/health/cyp450-test/MY00135
Piano: Fascinating!
GAF Bagels: Genetics are really going to revolutionize psychiatry
Piano: Sadly, it does need a revolution.
GAF Bagels: You know how you can't drink grapefruit juice with some medications?
Piano: Yeah, I can't drink it with Buspar.
GAF Bagels: Grapefruit strongly inhibits cyp 3A4
Piano: Ahhhh.
GAF Bagels: aaaaand "Buspirone is a CYP 3A3/4 enzyme substrate,..."
Bingo
Piano: Whoa! Well that explains that.
GAF Bagels: This is known for tons of drugs.
Piano: Not that I cared much for grapefruits anyways.
GAF Bagels: It's the classic example of how chemicals can induce or inhibit your cyp P450s.
So when you're on lots of meds...they can fuck up the levels of each other.
Piano: Making specific dosing impossible, I assume.
GAF Bagels: Thats beyond having genetic mutations in your cyps already.
Piano: Right.
GAF Bagels: You can measure levels of just about anything. So you take the drugs for a while, get a blood draw, and they know the therapeutic range for most things.
Piano: Right. I know that's the procedure for Lithium.
GAF Bagels: yup
Piano: Which is one I have not been on yet.
Piano: Not sure that I've tested for that. What are the ramifications?
GAF Bagels: So they can test the DNA for your liver enzymes.
GAF Bagels: A lot of psych meds are metabolized by cytochrome P450 2D6. There are various P450s that metabolize various things. There are known mutations that can make your enzymes hyperactive or hypoactive. For example, I'm a moderately fast 2D6 metabolizer. So I need higher doses of meds to attain the same blood level as someone with the "normal" variant.
If you're super slow...a small dose of a drug can sit in your body for a very long time. So a tiny bit gets used over and over and over. 1mg for you may be like 20 or 30 mg for someone who breaks the med down at the usual rate.
Piano: That certainly sounds like it may be the case. I will absolutely look into getting tested for that...
GAF Bagels: I had the testing done years ago and it was something like 1000 bucks
Piano: Oh damn.
GAF Bagels: It should be way cheaper now, but not all insurance is going to cover it. You seem to have a strong indication for it. It would explain A LOT. And would help guide your treatment
Piano: Yes, I'm considered VERY sensitive to medications.
GAF Bagels: This is just one of the better understood reasons why that might be the case.
Piano: I have, at least, had my thyroid tested.
GAF Bagels: http://www.mayoclinic.com/health/cyp450-test/MY00135
Piano: Fascinating!
GAF Bagels: Genetics are really going to revolutionize psychiatry
Piano: Sadly, it does need a revolution.
GAF Bagels: You know how you can't drink grapefruit juice with some medications?
Piano: Yeah, I can't drink it with Buspar.
GAF Bagels: Grapefruit strongly inhibits cyp 3A4
Piano: Ahhhh.
GAF Bagels: aaaaand "Buspirone is a CYP 3A3/4 enzyme substrate,..."
Bingo
Piano: Whoa! Well that explains that.
GAF Bagels: This is known for tons of drugs.
Piano: Not that I cared much for grapefruits anyways.
GAF Bagels: It's the classic example of how chemicals can induce or inhibit your cyp P450s.
So when you're on lots of meds...they can fuck up the levels of each other.
Piano: Making specific dosing impossible, I assume.
GAF Bagels: Thats beyond having genetic mutations in your cyps already.
Piano: Right.
GAF Bagels: You can measure levels of just about anything. So you take the drugs for a while, get a blood draw, and they know the therapeutic range for most things.
Piano: Right. I know that's the procedure for Lithium.
GAF Bagels: yup
Piano: Which is one I have not been on yet.
Femmeworth
Banned
Yikes, Bagels might I suggest putting those interviews up on Google Docs and just quoting select portions?
Yes, yes, I know it's way too long!
But Piano gave a really cohesive story of initial symptoms to (hopefully) complete remission from his illness. His story reminds me of my own, in many ways (as we shall see), and I think there are some really important messages in there: get help earlier rather than later. Find a good doctor and stick with him or her. Spotty treatment can leave you on 10 different meds, half of which are there to counteract the effects of the other meds. And finally, there isn't one way to be cured of depression. You're going to have to find what works for you, and you'll probably need to do several different things.
I hope you found that interview at least half-way as helpful as I did! Many thanks to Piano for being an awesome guy to talk to and for being so open about his struggle.
Additional thanks to Oomikami again for providing some copy-editing and helping me speed up the editing process.
Next interview should be of a more reasonable length, in case this seems like it's not worth your time.
But Piano gave a really cohesive story of initial symptoms to (hopefully) complete remission from his illness. His story reminds me of my own, in many ways (as we shall see), and I think there are some really important messages in there: get help earlier rather than later. Find a good doctor and stick with him or her. Spotty treatment can leave you on 10 different meds, half of which are there to counteract the effects of the other meds. And finally, there isn't one way to be cured of depression. You're going to have to find what works for you, and you'll probably need to do several different things.
I hope you found that interview at least half-way as helpful as I did! Many thanks to Piano for being an awesome guy to talk to and for being so open about his struggle.
Additional thanks to Oomikami again for providing some copy-editing and helping me speed up the editing process.
Next interview should be of a more reasonable length, in case this seems like it's not worth your time.
User 100115
Banned
Piano, you sound like an awesome person. I love your sense of humor.
Dice
Pokémon Parentage Conspiracy Theorist
I like it because it's not just an idea or saying, it is grounded in reality. Unshakable. You look back at your parents think think "I came from them" and maybe look back to your ethnic ancestors and think "I came from them" so too you should look back to the earth and think "I came from it" and look up at the stars and think "I came from them"
Yet not only as a source of origin, but also in belonging. People often think of themselves as a part of the parents, a part of their ethnic people. So too should you then think of yourself as a part of the earth, a part of those stars. In this sense you are never lost, never a misfit, never out of place, but you are right in place, you fit right in. Where you are is your space and time and cannot be invalidated by anyone or some idea.
What this leads me to appreciate most is art. If you look at an ant and ask "what are you doing? why do you work so hard? don't you know you're just an ant? there are many ants, they come and go, and the hill you build will pass away" yet if the ant could reply, it would likely say "well what else would I do? I am an ant as you say, and so I will be an ant."
Ask yourself the same questions of significance and you will come to a similar conclusion, yet as humans we have unique capabilities. One is as I said before, to simply exist and be mindful of it all. Yet another is very special, where we can imagine something and make it reality. I have been musically inclined my whole life, so that is special to me, but it applies to anything. We can imagine something more beautiful, more grand, and actually make it real.
Be it but for a few moments in a song and dance, or handling something essential to us in a wonderful way like cooking something delicious, or working out something more lastingly helpful like a physics model theory. We experience life and know what is good of it, and we imagine a better life and make it happen. So we're not only the universe aware of itself, but we are the universe making itself better, even if only in small and passing ways when considering the full scale.
There is a freedom in it.
User 100115
Banned
To give you the more basic outline of where I got mine from, I'll link you this, and you can marvel at my hilarious inspiration:
The speech
It is incredibly similar to yours though, yours is just way more fleshed out.
Femmeworth
Banned
Now I feel like watching Angel.
Douglas Quaid
Member
This culture has forgotten the fundamentals of psychology. A pill will not help you integrate your past traumas and pains. It will only help you cope temporarily, which can be convenient and useful during certain periods, but it is not meant to help you actually cope with existing. Don't let the fucking corporatized psychiatrists prescribe you the latest drug companies' hot product. You will not heal. You will disempower yourself from living a real life. Please consider the fact that you deserve to live a real life. Don't give the men and women in white lab coats that much power, in fact, a lot of them are completely moronic. Please use psychoactive chemicals sparingly and only when absolutely necessary. You deserve a real life. You may have had a lot of negative things happen to you when you were a child, please consider dealing with these things and attempting to heal them. Numbing yourself will only help you to an extent. Pills won't untie your psychic knots of torment. They are best as a conjunctive treatment.
Surface of Me
I'm not an NPC. And neither are we.
I know some people are might dismiss this post as ignorant or something maybe, but I feel this way too as someone who probably has something wrong with him.
Femmeworth
Banned
What. If life without medication is "real life" then fuck it.
Collete
Member
Ok...Piano...Bagels...
I read the vast 80% of your speech (Sorry I have a terrible phobia of biological things so I can't say I can read into a dented chest...)
Anyways, I guess some highlights I should do for ya... I'm not sure what else to call it...I think it took me 2-3 hours just to read it.
First I want to say, TF2 is an awesome game. Why aren't you in the GAF TF2 server or are you already in it?
Not sure why, but I think the adding of Abilify is interesting to you becoming insanely creative.
I think Bagels should get onto this and make a theory of sorts, heh.
You have no idea how lucky you are in this.
I wish my parents would persuade me to get some help or go into a hospital...
You are so lucky to get the opportunity.
I thought this was really inspiring and heart warming for you to say.
It actually brings me hope over my own future.
Thank you.
I thought this is primary relationship advice that everyone needs to hear.
Communication is a primary factor if you want anything done in a relationship, as well as acceptance and honesty.
Thanks!
I wish my old roommate was understanding that you needed to talk about your problems and in time you might have needed him.
My old roommate believed she could have helped me even though she had no thought on what depression really is, and eventually caused me psychological scarring I don't really want to get into now.
I really wish I knew this when I went to my old psychiatrist, she just tossed pills at me.
I thought that's how it always works, so I never questioned it till now. Again thank you for enlightening me.
Now for a conclusion, all I can say is, you are a strong individual to go through hell and back multiple times than I can count.
Honestly your interview enlightened me (even though it's sooo long.) and I thank you for opening up to the depression GAF community.
It was detailed and a great insight.
Thank you.
I read the vast 80% of your speech (Sorry I have a terrible phobia of biological things so I can't say I can read into a dented chest...)
Anyways, I guess some highlights I should do for ya... I'm not sure what else to call it...I think it took me 2-3 hours just to read it.
First I want to say, TF2 is an awesome game. Why aren't you in the GAF TF2 server or are you already in it?
Not sure why, but I think the adding of Abilify is interesting to you becoming insanely creative.
I think Bagels should get onto this and make a theory of sorts, heh.
You have no idea how lucky you are in this.
I wish my parents would persuade me to get some help or go into a hospital...
You are so lucky to get the opportunity.
I thought this was really inspiring and heart warming for you to say.
It actually brings me hope over my own future.
Thank you.
I thought this is primary relationship advice that everyone needs to hear.
Communication is a primary factor if you want anything done in a relationship, as well as acceptance and honesty.
Thanks!
I wish my old roommate was understanding that you needed to talk about your problems and in time you might have needed him.
My old roommate believed she could have helped me even though she had no thought on what depression really is, and eventually caused me psychological scarring I don't really want to get into now.
I really wish I knew this when I went to my old psychiatrist, she just tossed pills at me.
I thought that's how it always works, so I never questioned it till now. Again thank you for enlightening me.
Now for a conclusion, all I can say is, you are a strong individual to go through hell and back multiple times than I can count.
Honestly your interview enlightened me (even though it's sooo long.) and I thank you for opening up to the depression GAF community.
It was detailed and a great insight.
Thank you.
Pectus excavatum GAFer checking in! Not sure if it's cosmetic or if it's harming my lung capacity/circulation in some way, as I've never been informed by a doctor one way or another.
For whatever reason, I never actually took notice of it until I was 16-17. I'm not sure if it wasn't there and just unpronounced, or if I actually didn't see my body comparatively to others. Honestly, the latter explanation would not at all surprise me, as it wasn't until the end of High School that I started taking notice of my appearance, and only during College that I actually thought seriously about how others see me while forcing myself to examine my own appearance in the mirror.
For whatever reason, I never actually took notice of it until I was 16-17. I'm not sure if it wasn't there and just unpronounced, or if I actually didn't see my body comparatively to others. Honestly, the latter explanation would not at all surprise me, as it wasn't until the end of High School that I started taking notice of my appearance, and only during College that I actually thought seriously about how others see me while forcing myself to examine my own appearance in the mirror.
Do you mind sharing those fundamentals of psychology that are going to fix my depression? All this time I've been listening to these damn scientists saying that depression has a strong genetic factor, is based in neurobiology, and causes physical changes in the brain that may need to be corrected. And to find that when I take this medication and feel like myself, and am able to cope with my problems and have appropriate emotional responses, it's all FAKE?! Research clearly demonstrates that medications and therapy together are the best approach (the meds don't "numb" you - their purpose is to restore your brain to a point where you're actually capable of making sense of things), but can you really trust these "corporatized" researchers and physicians? Can you trust anything I've said in this thread? I want to be a psychiatrist, so odds are I'm a moron.
This post brought to you by the good people of Eli Lilly and Co.
Douglas Quaid
Member
Thanks, Bagels, my initial post may have been a bit dramatic and exaggerated.
Yes, depression has a genetic factor, and has a neuro-biological corollary, and causes physical changes in the brain. Indeed this bio-physiological component is real! Yes, the fact that medication helps you feel like yourself and helps you cope with your problems is REAL. Apologies if my initial post seemed simplistically life-negating and derogatory. I agree with you, medications and therapy are the best approach! (I was saying this with my last sentence, "Drugs are best used conjunctively.")
Like, drugs are good as a springboard to help a brother out, but not as a crutch, because if you use drugs as a crutch you're not really diving into the reason that your brain chemistry got fucked up in the first place (chances are it was due to early childhood trauma, and yes, it could be just biological genetic mutation, but I want to argue that the probability that most people's mental illnesses are based on chemical imbalances is far slimmer than the drug companies want you to believe). I also want to bring up the studies that suggest that anti-depressants may be no more effective than placebo.
My point is that the initial methodology of psychology was to identify trauma and help the patient heal from it. In our quick-fix modern "efficiency-fetish" corporate interest dominated era, I think it is useful to question the prescription of powerful psychotropic drugs as a primary means to deal with psychological trauma. In the 1960s sedatives such as phenobarbital were used to deal with people with "nervous-disorders", and yet, now-a-days, we realize that this method was a method of overt repression of the actual symptoms.
So, the basics of my point are that the psychological methods of dealing with trauma are ways to heal underlying difficulties and integrate them into one's psyche, and the psychiatric methods of using drugs to attempt to balance so-called "chemical-imbalances" can be helpful in order to induce a sort of baseline so that one can work more efficiently towards integration.
Fundamentals of psychology? As a new discipline, psychology was founded over a lot of misconceptions and early guesses. I will keep betting in psychiatry, which at least has basis in chemistry and medicine. Identify trauma? I don't want a false memory inserted.
You sound just like me. I've actually dealt with this for a couple of years now...after a family member was diagnosed with cancer from nothing more than pain as a symptom, I have weeks straight of anxiety and depression when I get myself convinced that I'm exhibiting symptoms of something or other. Just today, I spent almost all day in bed because of a current fixation that I have when I'd promised to hang out with some friends for the day. I feel terrible about it, but for the past couple of weeks I've had what are almost certainly symptoms of an ulcer but my mind keeps freaking out and thinking that it's stomach, liver, or pancreatic cancer just because I have a stitch under my right ribs that won't go away. The irrationality of it all is so obvious, but hypochondriasis mirrors a lot of attributes of OCD and, as a compulsion, my thought process is trapped in a vicious, endless loop.
I just feel like a terrible person sometimes when I see so many stories of people who actually are gravely ill and endure everything with grace and maturity, and here I am healthy but almost non-functional and reduced to a blubbering child over imaginary illness. The aforementioned family member has a scant few months to live but has never lost the will to go on, and here on GAF the Scorcho thread...well, I could make an entire other post just about the self-examination and reflection that it forced me to think about. He was a bigger person than I'll ever be. I just wish that I could live my life and not be so hyper-attuned to every physical sensation I experience. I've had various forms of health-related OCD and phobias since I was a child, and I suppose that this is just the next level for me.
I can still get it off of my mind when I really want to, but usually when I'm like this I'm too depressed to engage in any sort of enjoyable distractions. I really just alternated between obsessively reading and re-reading GAF threads today and napping, which is ironically horrible for my health. I have a doctor's appointment for Wednesday and hopefully then my mind can be eased again at least for now. Thanks so much for your response, man.
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