Friday, August 8, 2014

Major Depressive Disorder - Denial and Facing the Truth


Denying Depression’s Return

As I mentioned in my previous post, it had never occurred to me that depression would return. So even when it was glaringly obvious that it had, rather than recognise or acknowledge this, and therefore take steps to deal with it, my initial reaction was to be perplexed and to live in denial of its return. Here are some extracts from some of my diary entries during that period that illustrate the denial and resulting confusion. The first diary entry is from the 13th of Sept ‘10. It was from this day and onwards that the symptoms of severe depression, or major depressive disorder, were clearly evident,

13.9.10 – This was Hell day, literally. I spent the day stuck in hellish panic attacks like the ones I had when I had severe depression back in 1990. My perspective was black, my view of everything completely distorted, my mind was stuck in churning fear/terror cycles all day. I hope I never have a day like this one again.

26.9.10 – Okay Jesus, I’ve got to admit being perplexed about this...It’s been weird because it [feeling very disturbed] has stopped every day (normally around early to mid afternoon) except that first Monday, but comes back every morning. When it stops I feel completely normal. And apart from that first Monday, my mind has mostly been OK. I have refused to submit to the fears, whatever they have been, and have resisted them and waited for the feeling of anxiety to go away. I mean, it is normal for me to have one or two panic attack/anxiety episodes a year, which lasts maybe 5 days and in one case, three weeks. But it always stops. This time, although I have (mostly) mental peace, my body just continues to manufacture negative adrenalin. Sometimes my stomach feels bad, or my chest does, or my face feels spiked, and overall everything feels very dark and beyond what I can cope with. Oh Lord, let me rest in You, take refuge in You.

18.10.10 – Well, I don’t know what is happening to me, but my nervous system is still malfunctioning. I don’t know why this is all happening...the amazing thing in all this is that I have not been fighting or fearing all of this, but just waiting on Jesus, trying to rest in Him, and waiting each day for it to stop. And today’s devotional had this wonderful verse: Isaiah 26:3 "You will keep him in perfect peace, whose mind is stayed on you ..." (v.3, NKJV)

(At the end of October I changed back to my old epilepsy medication, as I suspected that the new one may have been somehow contributing to what was happening. For one thing, everything seemed so heavy, so overwhelmingly black.)

3.11.10 – Here I am, making lists again.
I believe the primary cause of what I’m going through now is a combination of the following:
1. Was not eating properly for a few months due to throat problems, and lost 6kgs
2. Add to that getting sick repeatedly throughout winter, perhaps seven illnesses in a row
3. As a result of getting sick so many times, did not exercise regularly.
4. Pushed myself way too hard practising piano for the new church.

Though of course, it could be my damaged, epilepsy ridden brain simply misfiring for the heck of it, with no rhyme or reason at all.

And the “what do I do now list?”
1. Eat properly and put those 6kg back on (working on that, 2kg back on already)
2. Exercise regularly (doing that, back to weekly aerobics and frequent walks)
3. Find a hobby and pursue it (hmmm, almost no idea on that one)
4. Get more sleep

8.11.10 - I hate the confusion that is afflicting me these days - could be from the epilepsy, or from the epilepsy meds, or from these panic attack symptoms that keep hitting me.

19.11.10 - As the day wore on I felt worse today, like a panic attack was blazing away in my nervous system, even though there was no trigger, and my mind is at peace. Yet all the same, it still feels much weaker than what happened in Oct and Sept, and also, the terrible suffocating blackness that accompanied me through Sept and Oct is not present. Still, I want it to stop and go away. Why Lord Jesus, why am I like this? What has changed? I got home from the school carnival tonight and collapsed on the floor for twenty minutes. My chest felt heavy, squashed, wrong somehow, and my head like it weighed a ton. I had to lie down, I had no choice. After that I went and waited on You in prayer, and felt a lot better after that and the rest.

Facing the Truth that Depression had Returned

The day for my bi-yearly check-up with the neurologist for epilepsy was due on the 26th of Nov, so I decided to tell him what I had been going through. This is the day that I finally faced the truth and accepted that depression had returned. Here are some extracts from my diary entry.

26.11.10 - I went to see the neurologist today, and told him what I've been dealing with, especially since early September. He confirmed my suspicions, the very thing that I had refused to admit to myself, even in secret - I am depressed again. It was sixteen years ago that I pretty much fully recovered from depression, and it was in late 1990 that I recovered from being disturbed or ill at ease all the time. Yet here I am again, feeling disturbed again, or as I used to call it, having lost my peace. Sept and Oct were worst, because the feeling of being ill at ease was accompanied by a horrid blackness that distorted my world view and made everything seem unbearable. Still, in spite of that, I persisted with normal day to day activities. (well, mostly, it was hard to meet people and talk to them.)
            When I changed back to my old epilepsy meds in late October, the blackness went away, although the lack of peace continued, on for 5 days, off for 5 days. The neurologist said that the old medication is a mood stabiliser, can prevent depression coming on, and can be used to treat it.
            As nothing triggered this new bout of depression, he said that it was genetic, ie, inherited from my parents.
I have to see him again in three months, and report on what my mood has been like during those three months. He preferred not to give me anti-depressants as these reduce the effectiveness of the anti-seizure meds, increasing the chance of seizures. (I also told him that I was willing to continue on without anti-depressants, as I felt a lot better than I had in Sept/Oct, and forgetting the timeline of my previous bout of depression, thought it would fade away soon. Considering my previous history with depression, this would turn out to be an error.)

Conclusion

For over two months I had charted what was wrong with me, and while doing so I recognised that it was the same as what had happened to me back in 1989/90. However, I continued to deny the truth and avoid reaching the conclusion I needed to reach. Because of this I prevented myself from taking the action necessary to deal with depression’s return while it was still in its early stages.

I should have gone to my doctor in back in September/October as soon as the anxiety/panic attacks and other symptoms persisted for longer than two to three weeks. He would have requested weekly checkups and I would have been put on antidepressants much sooner. (I was eventually put on them in Feb,2011, which was five months too late. More about this in another post.)

By denying that depression had returned for so long, and then delaying in getting it treated, resulted in the depression becoming deeply entrenched in every area of my life. (Admittedly, in my case the epilepsy was a complication, but it was one that the neurologist and doctor worked around when they had to.)

For the Future

For those like me who have major depressive disorder:
a) if depressions symptoms have returned and remained for at least two weeks, we need to accept the truth that it has, or may have, returned,
b) we should then immediately go to see our doctor or professional health care worker, so that we can be placed on weekly check-ups,
c) and if the doctor advises it, we should then return to medication as soon as possible.
d) these steps, combined with other coping techniques, strategies, counselling/therapy, should reduce the severity and duration of the bout of depression.



10 comments:

  1. You are such an inspiration. I do hope you understand what a blessing your blogs are. I don't know what I would have done had I not found your articles. I come here every day many times a day. Reading the same articles over and over again. I do wish we didn't have to suffer this illness. But God is with us, always. I pray you came through this cycle of depression/anxiety easier and faster than the last.

    I thank God for you and hope you write more soon!

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    1. Dear Anonymous,
      Thank you so much for the encouraging feedback :) and I praise the Lord that He is using my writings in this way. And I'm with you in not wanting to suffer this illness, but I too thank Jesus daily for being with me, comforting and helping me through it. I shudder to think what it would be like without Him, who is my very life.
      Hopefully another article soon.
      God bless you heaps
      Peter

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  2. This comment has been removed by a blog administrator.

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  3. Dear Peter
    I am a Christian in the midst of a severe depression complete with lack of faith and doubts I am hanging on please pray for me
    Love in Christ Rod ireland

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    1. Dear Rod
      Thanks for your prayer request, I will remember you in my prayers.

      Have you seen a doctor about medication, and are you receiving counseling/therapy? Please do not go through this alone or without getting help.

      God bless
      Peter

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  4. Peter, thanks. I started to have panic attacks at a very young age. Severe ones. Rapid heartbeat, could not breath, going to hospital thinking it was a heart attack kind. Came out of nowhere. Depression came later in life. Never really dealt with my issues, just tried to fight through them. I'm fifty now, sold a partnership business who was a demeaning, stealing, narcissist. I have been dealing with depression for about 5 straight years now after many years of off and on depression. I have always blamed it on my lack of faith and God punishing me. I feel I am at a real crossroads in my life and my faith. I want to thank you for your insightful website. It has been a great blessing already for me.

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    1. Dear Anonymous,
      Thank you for your comment, and so glad the Lord has been helping you through the website. Can I please encourage you to download the booklet on this website, which has all the articles in a sequential order. Blog's booklet on depression Please be encouraged that depression is not God punishing you, and the Jesus is our great Comforter and healer, who is with you in and through this.
      God bless
      Peter

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  5. Bless you Peter !!!! Each day is a blessing ! I found your blogs and have started reading each one .

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  6. Dear Peter,

    Thank you for this blog. I'm so encouraged by it. Two weeks ago I plunged into my second horrible horrible depression: the first one was 7 years ago. Both have started with a nervous breakdown of sorts following a difficult decision which I felt I did not handle well. I am trying to hold on to Jesus. Did you ever feel completely unemotional - I suppose a side effect of anti-depressants? I have gone back on mine for two weeks now (after seeing the doc) and not feeling ANYTHING is worrying me a bit. Seeing a doctor in two days so I will mention it.

    I hope you are well at the moment - I haven't seen any recent comments from you. I am inspired by your patient and kind responses to so many people in desperate circumstances.

    Thank you again

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    1. Dear Anonymous,

      Depression itself can make us feel emotionally detached from what is going on around us, to the point that it makes us wonder if we still care about anything. I doubt this is a side effect of medication, but your doctor would have more knowledge in that regard. Please note that it typically takes around 3 weeks for the meds to work, and 6 weeks to get their full effect.

      If you haven't already done so, can you talk to a counsellor or minister about this difficult decision, and get their perspective on it too? That may bring you a great deal of relief.

      I am in my sixth year of my second major depressive episode, but I am seeing slow improvement, and have come a long way since the collapse/s. I'm clinging onto Jesus too, as He leads me through each day. By His grace, I am managing to live a mostly normal life. Thanks for asking :)

      God bless
      Peter

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