Lamictal 300 mgs: Dark Thoughts

Several months ago, I wrote about why I didn't realize my depression was worsening: because I was nowhere near The Pit.  Like a lot of depressives, when I get depressed I feel like I'm falling, as if I'm circling a dark pit, as if I'm falling into it.  Or at least I used to.  Before my psychotic episode I had no such feeling, and it didn't occur to me that I was headed for trouble.

I've been at a loss to describe what did happen to me last year.  But last night I had just a brief glimpse of it.  This horrible feeling welled up for a few minutes, kind of like what happened last year but nowhere near as serious ... it felt like ... like ...

It felt like I was being engulfed by a wave of devouring darkness.  It's not falling into The Pit.  Trust me, they're totally different.  Believe me, the devouring darkness is worse.  But this being me and all, I felt better immediately when I could assign a dramatic metaphor to what I was feeling.

And yes.  If it happens again, or lasts more than five minutes, I'll be calling my shrink.

Day 50: My Mood Disorder Action Plan

Tonight is my final MCBT class.  Our homework for this week was to come up with an action plan in the event that, in spite of our best meditative efforts, our depression recurs.  We were told to make a list of our usual depression symptoms (because they're usually the same in each person), write down three things we like about ourselves that we might forget when we become depressed, and create an action plan -- if we become more depressed, what will we do to care for ourselves?

As I've written before, the symptoms I'd long ago learned to identify have changed.

Here are the symptoms I used to have when my depression was getting worse:

• Feeling the edge of The Pit
• Feeling of “falling”
• Feelings of excessive sadness
• Excessive tearfulness
• Irrational guilt
• Catastrophizing thoughts
• Taking things too personally
• Anhedonia
• Lassitude/lack of motivation
• Insomnia
• Overeating
• Oversleeping

And here is what was going on with me last fall and winter:

• Troughs or crashes in mood between the times of 4 and 8 pm become more frequent
• Troughs or crashes in mood between the times of 4 and 8 pm become worse (tearfulness, paranoia about relationships, pessimism running to despair)
• Troughs or crashes in mood lengthen beyond the 4 to 8 pm range
• Tearfulness, sadness, or anxiety due to trivial or nonexistent things (such as cheezy songs, movies, tv)
• Excessively bizarre thoughts or anxieties (such as worrying about the balance or destruction of photons in the universe)
• Feeling the need to act on excessively bizarre thoughts, or take action on the basis of bizarre anxieties (needing to turn all the lights in the house on to keep it "balanced")
• Increased irritability
• Sudden, frenzied activity, especially late at night (such as suddenly feeling the need to clean the house at 11 pm)
• Dramatic upsurge in energy after 10 or 11 pm

Hmmm. Not only are those nothing like my previous symptoms, but they don't look much like depression at all, do they? Good thing I'm seeing my pdoc in two weeks. I will bring this to him and show him it.

For kicks, here's the rest of my Action Plan:

Three Things I Like About Myself (that I tend to forget when I get depressed):

• My sense of humor
• My curiosity
• My creativity

My Action Plan for Mood Symptoms Consists of the Following Steps:

• Breathing Space (use breathing space to check in: would meditation be helpful or harmful at this time?  What is the best self-care I can give myself right now? What steps do I need to take next?)
• Make a choice of what practices are most helpful to me and start using them (be nice to know what these are …)
• Take specific actions, including the following steps:

1. Inform spouse
2. Inform pdoc *** if spouse is traveling, this is Step 1 ***
3. Determine what would be the best action toward self-care and do it immediately

As you can see, my "action plan" is not much of an action plan.  That last one is pretty non-specific, and might not be enough to go on in a crisis.  

Do you have an action plan?  Do you have comments about mine?  Please let me know in the comments!

Still More About Psychotic Depression: Why I Didn't See It Coming

My psychotic depressive episode happened after several fairly stressful months.  When it happened, and in the months since, I've been blaming myself -- I knew I was getting stressed!  Why didn't I take better care of myself!

The stress involved money and employment.  Early in the year, my husband had taken a job at a startup that entailed a significant pay cut.  To make a long story short, I had believed that I would be able to make up at least some of the lost income, and it turned out that I couldn't.  My husband's job is far from where we live, and he was trying to make a go on public transit, but the time this took was truly ridiculous.  He was getting stressed and snappish.

I was also getting stressed.  I could see my thoughts heading into depressive territory: I'm just unemployable.  I'll never find work.  How did I think I could find work, with my spotty work record and 10% local unemployment?  Who in their right minds would hire me? Et cetera.

The Difference Between "Sadness" and "Depression": The Pit

The players in the current backlash against brain drugs are asking a lot of very important questions that need to be asked.  Are we, as a society, medicating things that don't need to be medicated?  Are we pathologizing perfectly normal parts of the human experience, like stress over losing a job, or bereavement over losing a loved one?  Has the reliance on medications encouraged people to look for a "quick fix" to their problems??

The short version of my opinion is that we probably are.  Sometimes.  Maybe.

One of the examples of this that's often proffered is that of "normal" sadness being pathologized and medicated as a depressive mental illness.  I haven't done a ton of research on this topic.  I don't know how many people take medications, having been told they're "depressed", when they're really "sad".

I do know the difference, in my own life, between sadness (a feeling) grief (also a feeling, more painful than sadness) and depression (a hideous mental illness, which I experience as The Pit).