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Depression Update

It’s been a bit over three years since I was officially diagnosed with depression and started with therapy and medication. I can say without hesitation that overall, my life is much improved over 3+ years ago.

Lucy and Charlie Brown: Psychiatric Help Five CentsI can say with equal certainty that I haven’t been “cured” of depression, any more than insulin and regular visits to the endocrinologist cured my diabetes.

#

I mentioned Christine Miserandino’s spoon theory over on Twitter earlier today. Spoon theory is an analogy about living with chronic sickness or disability. I know the analogy doesn’t work for everyone, but I’ve found it helpful in understanding and talking about and explaining some things.

“I explained that when you are healthy you expect to have a never-ending supply of ‘spoons’. But when you have to now plan your day, you need to know exactly how many ‘spoons’ you are starting with. It doesn’t guarantee that you might not lose some along the way, but at least it helps to know where you are starting.”

What I’ve been finding in recent months is that I don’t actually know how many spoons I’ve got when I wake up in the morning. On any given day, I might be able to deal with the pressure of a looming book deadline, a crisis at work, a puppy destroying something important, an unexpected bill, a family argument, and whatever else comes my way. On another day with similar troubles, I could end up burning out like Biggs Darklighter over the Death Star.

I’ve gotten a bit better at recognizing when it’s happening. Just like I can generally feel when my blood sugar starts to drop too low, I can feel when I’m all out of cope.

It’s not a pleasant feeling, mind you. It’s a cold, congealed soup of anger and despair and exhaustion and shame. And recognizing it doesn’t necessarily mean I can do anything to fix it.

#

My wife took me out for dinner and Jurassic World on Sunday. This was a good thing. I needed to get away, to relax and recharge and just enjoy myself for a few hours. It’s self-care, and as such, it’s something I wouldn’t necessarily have done on my own.

Medication is one thing. I’m pretty good at remembering to pop a pill every night, checking my blood sugar regularly and doing the math to match insulin to carb counts. But self-care is a murkier kind of medicine, one that takes more time and effort than programming an insulin pump. It’s also one I’m more likely to assume I can blow off.

Oh sure, I haven’t been getting enough sleep, but I’ll catch up on the weekend. I’ve missed some exercise, but I had other important things to do. I haven’t socialized much, but I’ll get to that as soon as the book is turned in.

How do you quantify self-care? How do you prescribe a given dose to be taken daily? (Those questions are rhetorical, by the way — I’m not asking for advice right now.)

And of course, there’s that other voice arguing that your self-care isn’t as important as those other people’s needs. It’s not as important as Doing All the Things.

I know self-care is important. As Morpheus said, there’s a difference between knowing the path and walking the path. But here comes Red Riding Hood to remind you that walking the path is all well and good, but it’s even harder to stay on that path once you’ve started.

#

I remember growing up without email. I think email is an amazing tool, one that’s made my life so much better and simpler in so many ways. I remember getting my first email account as a college student, and how amazing it was to reconnect with a friend who’d moved to MIT.

I also hate email. I hate the neverending inbox, and that nibbling sense of failure that comes with every message that sits there waiting too long for a response. I hate that it takes spoons to answer some fucking emails, and knowing if I don’t, people will feel disappointed or hurt, or will wonder why I answered one email but not the next, and will start to second-guess whether they did something wrong when it’s just me trying to juggle a bunch of damn spoons without dropping any.

#

We’re going on vacation soon. That will be a good thing. It won’t be 100% stress-free, but the stresses will be different, and hopefully fewer.

I’m also looking at some potentially big changes later this year. Stressful and anxiety-making, but potentially very good in the long term.

In the meantime, I was Guest of Honor at a convention last weekend, did a radio interview last night, was part of a Baen podcast recording today, and am getting ready for my 11th novel to come out in just over a month. All wonderful, amazing things I only dreamed about when I was younger.

Good things can use up spoons too.

#

It’s easy to take progress for granted.

I’m not fine. I am, however, doing a hell of a lot better than I was three years ago.

I just need to remember that it took a lot of work to get here, and that if I want to stay here — which I do — I need to keep doing the work.

Mirrored from Jim C. Hines.

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Comments

( 27 comments — Leave a comment )
deborahblakehps
Jul. 1st, 2015 12:20 am (UTC)
I am *mostly* over depression these days, despite wrestling with it for most of the first 30-odd (very odd, some of it) years of my life.

I'm also 30+ years into dealing with fibromyalgia (which has depression as one of its components)and other chronic pain issues and some days I can't even find my f-ing spoons, none the less bend over and pick them up. So I get it.

And yes, self-care is a particular struggle, especially since there is no one to do it for me if I don't do it for myself. Especially with deadlines and email and such. I swear, I'm going to exercise tonight. Probably.

On the bright side, I know some pretty cool people *looks pointedly at Jim* and tonight I sent in a completed manuscript. So, booyah.
jimhines
Jul. 1st, 2015 12:36 am (UTC)
I've watched my wife coping with chronic pain for a long time. It can be so incredibly *draining*.

::Lends Deborah some anti-gravity spoons::

And wait, which manuscript was this? Another Baba book???
deborahblakehps
Jul. 1st, 2015 12:51 am (UTC)
Yup. Baba Yaga #3, WICKEDLY POWERFUL. And I have an entire 15 minutes before I have to start work on #4. :-)
jimhines
Jul. 1st, 2015 12:54 am (UTC)
Booya! Go you!!! :-)
deborahblakehps
Jul. 1st, 2015 02:10 am (UTC)
The cover for #3 is set, but don't be surprised to get a request to blurb #4 :-) You know, as soon as I write it...
cereta
Jul. 1st, 2015 03:51 am (UTC)
I could go on at length about how much this resonates for me. I have fibromyalgia and get migraines, so I get trapped in a pain=depression=more pain=..you get the idea. In a cycle like that, self-care can be hard to prioritize, because your various responsibilities get little enough of you as it is. But you know, I'm mostly just commenting to use this icon ;).
jimhines
Jul. 1st, 2015 02:27 pm (UTC)
It is a most excellent icon! :-)
angela_n_hunt
Jul. 1st, 2015 04:33 am (UTC)
This.
I'm about two and half years behind you. Diagnosed last year in August on the verge of a breakdown that nearly hospitalized me. I had this fantasy that with a few months, I'd be "well" again.

I'm starting to realize that it's not about cure or well, it's about maintenance and faith, which is really weird for me to say, because faith is something I struggle with.

Your honesty in posting these things helps me more than I can say. Bless you.
jimhines
Jul. 1st, 2015 02:30 pm (UTC)
Re: This.
Actually, the comment about faith makes sense to me. I can recognize much better these days when the brain-weasels of depression are screwing with me. That intellectual recognition doesn't really change anything in the moment, unfortunately ... but it does allow me to step back and tell myself that things will get better, and to trust that this is temporary. That feels like a kind of faith.
angela_n_hunt
Jul. 1st, 2015 05:41 pm (UTC)
Re: This.
Exactly. A kind of faith. Not so much centered in an external force as in myself. That if I do the work...I can survive? But I mean that in a truly positive way.

Glarg. I keep telling my therapist that English is a truly deficient language when trying to talk about these sorts of things.
mt_yvr
Jul. 1st, 2015 08:32 am (UTC)
Manic depression diagnosis at 18. Now referred to as bipolar.
Diagnosed as HIV positive on June 4, 2004.

Dude.

(hug)

Despite the unending media of "a pill for that" what gets lost is that there is a disconnect between the messages we're told and the sense we get "and the next day".

In classes I talk about this, a lot. That we're approached with the model of going to a doctor because something's broken. And we get a pill or a test or a support and things heal. And there's an endpoint. The day after that we're fine.

With things like depression or diabetes or whatever? There's no day after the moment it's all better. It sucks, it's hard because people want that to be either cleared up as "oh, ONLY chronic" or "but you have a pill now". As if either of those things are packed away forever. It's a constant journey, is what we're really saying. Never stopping, never being in the same place twice, never ending.

It can sound depressing or hard or even like a good thing. Depending.

The hard hard bit is that it's just that. A journey. A motion. We don't get to stop. We have to learn to live moving and having a next day, and next and next after that. It's weird because it doesn't really fit the model of "broken and then fixed".

(shrug) I'm still figuring out how to articulate it to people in such a way that they get that it's not about sitting down and giving up nor is it about just being better now. It's about both. And neither.

The thing that I'm trying to get at is that you are not alone out there. Not that you asked or are looking for that or I can validate you. Or make it better. Just... when you forget or it fades, come back and remember this. You're not alone.

Sorry, not trying to be an ass, just... I know there are days when I need that. It's what I can offer. Solidarity. If it's inappropriate right now, I apologize.
jimhines
Jul. 1st, 2015 02:33 pm (UTC)
You're not being an ass, and this makes sense. At least to me.

It reminds me a bit of the Zen saying, "Before Enlightenment: chop wood, carry water. After Enlightenment: chop wood, carry water." Only it's before/after diagnosis, instead.

It doesn't really work, because I wasn't chopping wood or carrying water before the diagnosis ... but I think it captures that sense of an ongoing journey.

I'll need to think about it a bit more to see if I can make that quote fit.
mt_yvr
Jul. 2nd, 2015 04:06 pm (UTC)
On one side you chopped cedar, stacked the wood.

On the other side you're chopping pine, stacking wood.

The point is life and all of the bits that happen on either side of the diagnosis. On one hand it's as profound as a shift in species of tree you're cutting, on the other... it's still wood.



Edited at 2015-07-02 04:08 pm (UTC)
martianmooncrab
Jul. 1st, 2015 08:56 am (UTC)
Good things can use up spoons too.

I prefer Sporks, because at the end of the day, you can use the last one as a weapon.
jimhines
Jul. 1st, 2015 12:26 pm (UTC)
That works too :-)
(no subject) - bbbbbaran - Jul. 1st, 2015 09:35 am (UTC) - Expand
notalwaysweak
Jul. 1st, 2015 11:38 am (UTC)
Good things can use up spoons too.

Which makes it such fun when the spoons do run out, because it could be during a con or out with friends and suddenly HI YOU'RE CRYING NOW.

Self-care is hard. It's why this year at Continuum if I had a half hour or so free I went up to my room (staying in the same hotel the con is in is the best best thing) and flopped on the bed and watched whatever was on TV. I didn't want a repeat of last year's last day of the con meltdown.

I really hope your vacation helps and that the stresses are fewer than the good things.

And I'm really glad that people like you, who are more in the public eye than I am, can talk about depression so openly (although I don't doubt this post required a lot of spoons). I think it really helps to decrease the stigma that surrounds mental illnesses when they are spoken about like this. So thank you. *hugs*
jimhines
Jul. 1st, 2015 02:36 pm (UTC)
I tend to do the same thing at conventions. I can run around playing extrovert and having a genuinely great time, but I also need to retreat to the hotel room from time to time to just crash and hide for a while.

And it can be hard to explain, "Yes I'm having an absolutely wonderful time hanging out and talking to you but I have to go away now and lock myself in my room but it's not you it's me!"
notalwaysweak
Jul. 12th, 2015 01:59 am (UTC)
'I can't pretend to be a social being any more right now, I need to go and respawn my spoons,' is one way I've had to put it.

We're lucky that spoon theory is becoming more ingrained in people's minds and the collective public awareness because it is so, so useful for explaining this.
cypherindigo
Jul. 1st, 2015 12:26 pm (UTC)
"It’s not a pleasant feeling, mind you. It’s a cold, congealed soup of anger and despair and exhaustion and shame. And recognizing it doesn’t necessarily mean I can do anything to fix it."

I know this, it has been my life for years. (Depression, Lupus, RA) Some days the best thing that can be done is minimalize the fallout on the innocent bystanders.

Enjoy your vacation.
jimhines
Jul. 1st, 2015 02:36 pm (UTC)
Yep. That was one of the first things I learned when I felt the stormcloud of cold soup settling in. I didn't know how to stop it, but I could at least retreat and try not to take it out on my family or anyone else.
ramblin_phyl
Jul. 1st, 2015 03:45 pm (UTC)
Thank you for being open about this. I'm 30+ years out of therapy and medication and still need to count my spoons. Hubby helps. He knows the signs to watch for and will surgically remove me from the computer and take me away from the house for a day trip, or remind me of good times with old photos, or just sit and hold my hand. He's a treasure and may be the only thing that truly got me through some totally awful years.

Keep at it. One step at a time.
klwilliams
Jul. 1st, 2015 04:08 pm (UTC)
*hugs* I know that journey. One thing I've found that is necessary for managing my depression is SEEP: get some Sleep, Eat some (healthy) food, get some Exercise, hang out with People. (The list is mine; my friends gave me the acronym.) Since I've been married I've been so happy that this is far less of a problem, but it still rears its ugly head.

My mother pointed out that even good stress is stress, and I've also learned (the hard way) that "just stress" isn't. Any stress can damage you. Due to my other disability (though I really don't think of myself as disabled, I just can't walk that far anymore) I've learned I can do only one "thing" per weekend. I need the other day to recover.

I'm sorry your life's adventure has these dragons in it.
la_marquise_de_
Jul. 1st, 2015 04:52 pm (UTC)
The thing I found with depression is that it's tidal: it ebbs and flows and changes and it can take much longer than we expect to die away. But it does go.
deborahjross
Jul. 2nd, 2015 06:14 pm (UTC)
I'm delighted to hear that your life is better. May it continue so!

I'm now watching my husband's journey through diagnosis and finding the right combo of meds for his bipolar. He'd been improperly diagnosed with depression, so of course the SSRIs didn't work.

Misdiagnosis seems to be common. I too was told I had depression when it was PTSD. Fired that psychiatrist, found one who would listen to me, found meds and therapy that actually helped.

What la_marquise_de said about the rhythm of depression is true in my experience for PTSD also. For the first decade, it was highly seasonally triggered: I would have more spoons in the spring than in the fall and negative spoons near the anniversary date. Now I am mostly on a predictable and fairly generous number of spoons, except that I know all that can change in a heartbeat, given the right trigger. Or in a year, as the next parole hearing approaches.

I cherish the spoons of the day, many or few.

Edited at 2015-07-02 06:15 pm (UTC)
agirlinamerica
Jul. 2nd, 2015 08:24 pm (UTC)
I know what it feels like to have a constant battle in your life. I've dealt with many struggles since I can remember and I'm only 19 years old.
I am glad you are improving, and I hope that you continue to do so! It warms my heart to see people like you overcoming life's obstacles. Sure, I know it isn't always easy and sometimes you can't get through it alone. But all that matters is that you get there, it doesn't matter how. At least, that is how I see it.
So keep counting spoons and doing what you need to do in order to live a fulfilled life, and continue to inspire others just as you have inspired me
elialshadowpine
Jul. 5th, 2015 01:55 pm (UTC)
Argh. I thought I'd posted this, but apparently I left the tab open...

Oh man. I hear you. I have both physical and mental health issues. On the physical side: Fibromyalgia, rheumatoid arthritis, PCOS, PMDD, hypermobility syndrome (this means that my ligaments are missing sulfur bonds that hold them together and in place, so it causes my joints to partially dislocate; dealing with that at the moment, actually, because I slept on my side wroongg *grr*), scoliosis, lordosis (yes I got both), and I'm sure there's something I'm forgetting. On the mental health side: PTSD, bipolar type 2, ADD, generalized/social anxiety disorder, autism.

I was first diagnosed with fibro when I was 19. It took me YEARS to figure out how to manage spoons. When my mental health started to deteriorate also, it took me years to figure out how to manage spoons for that, too. And when I'm dealing with extreme pain *and* a bipolar or PMDD episode, spoons just go out the window.

I know you don't want advice, so I won't give it, but I hope this will help. Managing spoons and predicting their vacillation becomes easier over time; to be this much better in three years is actually really good! :)
( 27 comments — Leave a comment )

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