Thursday, April 11, 2013

Depression - treated "good enough"?

I was just over reading Tina's blog post relating to the seriousness of depression. Fits right in with my current thinking and reading. My current reading is Against Depression by Peter Kramer.

And then my appointment with my psychiatrist. I showed him my pretty graphs of my mood. He noticed how my sleep was pretty steady. I'll agree on that. My sleep has improved to a pretty nice spot and held. Other than that?

Guess what; I'm functional.

Do you know what that means? It means that the doctor can say things like what he said, "Sometimes we use medication to keep you steady so that you can do the work in therapy."

Uh-huh. Since, obviously, my mood is getting better from my therapy while the medication keeps me steadily in the never-never land between health and severe depression. My mood ratings are the same, whether I show the paper to my therapist or my psychiatrist. Face it! My mood has plateaued for the winter (i.e., since December), with ups and downs, and it is a little worse than last summer.

But I should be okay with that. And if I'm not, I should just thank Freud for all his hard work providing a therapy that doctors can send me to when they are done messing with my meds. Because my psychiatrist thinks I'm still dealing with "issues" from my childhood and my family and upbringing.

Uh-huh. So year after year, the story remains the same. "You are growing up. Learning to be your own person. When you get settled, you will get better. Probably eventually wont even need medication."

What a pity that the people who actually talk about mental illness with me happen to be in it long term. (P.S., if you are reading this, and you talk about mental illness, and you're in for the short term, that is fine, too; I'm glad you are here, too.)

So is it that I just want to be in long term care?

Uh-huh. You want to be in long term care. That, Abigail, is why you want to be all the way recovered instead of just "held stable enough." Because you just love this experience.

Well, so I'm kind of angry. I don't necessarily mean that the Dr. should change my medication. Or maybe I do. Now that I'm not in danger of killing myself, the medication is working well enough.

Haven't we gone through this already? "This feeling you have isn't normal; you can feel better."

"You are feeling better. Now we just hold things steady."

Yeah. Steady. So what do you mean? That this is it? This is my mangled piece of pie for my life?

Oh, no. Psychotherapy should help. I mean, forget that its track record isn't so much better than medication (if better at all). Forget that combined therapy and medication have left me on this beautiful plateau. Something will make me better soon. Since obviously, near on three years of weekly therapy isn't enough, but in a few more months, I'll be better.

I guess I'm unfair to my psychiatrist.

I wish I could have an appointment split over two days so that I could think on his words and then come back intelligently with my issues.

Hah! My issues are no longer enough. No longer worthy of the psychiatrist's time (catastrophizing, anybody? Abigail?). Now I'm "healthy" enough. Suck it up, wont you, Abigail? Like really, what were you expecting, joy and happiness and sunny days in your mind every day? Hah, wanting to really live? What a joke. That was a myth. We tell that to people in the hospital. No, wait, we don't tell it then, either. The "suck it up" line works so much better.

Forget the health risk. Forget my increased risk of heart problems. Forget the holes that might be developing in my brain. I'm just too "sensitive," wishing for something that isn't. See? It is a "God-sized hole" after all, and if you'd just love Him enough...

Oh, good, what is this, day three of crying? Keep this up and you might qualify as being a bit depressed, enough that you should go talk to your counselor and get over your childhood and move on with your stupid life.

How is this, nasty commentator, defender of stigma against depression, encourager of doctors leaving depression on hold once it is "stable" enough. My new assumption that I actually wanted to live was based on the fairy tales that things get better, that lots of people actually want to live, that my feelings were depression, that they weren't a character defect. If you want drama, I suppose I could give it... But really? You told me I didn't need drama to qualify for help.

Okay, I'll try to believe you again. I'll call my counselor. The one I didn't get to see yesterday because I canceled because I'm sick with a virus or something.

And, just to be clear, I'm quite safely within the choosing to live range. I'm just annoyed. Well, the stronger version of annoyed.


  1. Abigail, I hear you. I hear the frustration and pain, and I have been in, and still hang out in, the same place sometimes. I wonder what "good enough" is, when is the depression bad enough for further intervention, what is going to help me, when will it be REALLY better, etc. I wonder about the place of therapy in my life. It seems like I've had so much of it, and I still struggle at times. I hope talking with your counselor helps. Maybe talking out these concerns of yours with him or her would be helpful? I'm thinking about you.

    1. Thank you, Tina. I did go ahead and call my counselor, and it did help. And I really am better than I have been. But I'll keep hoping for something better than this.