Tuesday, December 17, 2013

How I Deal With A Depressive Episode (Written While In A Depressive Episode)

As I write this I am in the middle of a minor depressive episode. I say minor because its effects seem relatively weak, especially in comparison with more intense episodes I have felt in the past. Throughout the past few days I've felt increasing lack of satisfaction from entertainment and hobbies, had difficulty sleeping, and felt a sense of aimlessness and ennui I struggled to remove. I am currently writing this at midnight, after laying in bed for twenty minutes unable to sleep.

Interestingly, the onset of this depressive episode coincided with the end of my Fall semester. I can think of a few reasons for this, among being the sudden lack of work and pressure on me. On the one hand, work can be a very fulfilling and I would argue even necessary part of life, and a life full of productive work can provide great satisfaction. However, at the same time work is a hell of a drug. There is a reason such a thing as a "workaholic" exists. With constant focus on work, it becomes very easy to put aside ill thoughts and focus solely on whatever task is at hand, and when the tasks cease, I have greater difficulty distracting myself from the ill thoughts.

Another component I feel is the absence of social interactions. At school, while I was by no means a social butterfly, I had access to constant social interaction through my classes and my work which took me outside of my room. Now at home and separated from many of my college friends, and lacking the same convenience of socializing as I did at school, I have a tendency to stay too far within myself, and as a result can become depressed.

It may also be the result of a certain degree of existential angst, which seems to come in waves and is something I'm sure most people my age are familiar to. Various questions of existence, such as "what is my purpose in life", "do my actions matter", "is there a God", etc. are an excellent source of constant stress, as they lack easily accessed answers. Such angst appears and disappears rather randomly, and it may have simply come at a time where these other issues were also prevalent and thereby intensified the stress felt. This is lessened by the fact that I have certain responses to these questions which I tend to fall back on, and so their impact is not as significant as the others. I raise the questions to myself, give myself the answers I have given before, found myself satisfied by those answers, and move on.

However, the focus of this post is not meant to be why I have a depressive episode, but what I do to manage it.

Years ago, I was jogging through a forest near my house. I was not the most in-shape at the time, and it was at times painful to run. As I was rounding a bend, I began to think about the pain I was experiencing, to intellectualize it. I began to separate the thoughts of my mind from the sensations of my body, and for a very brief period of time I viewed the pain as an observer would, and thus its effects were numbed on me.

This technique proves very difficult to do reliably in terms of physical pain, but I've found that intellectualizing emotional and psychological pain helps considerably to reduce the intensity of the harm. Hence, in part, why this blog exists. When going through a depressive episode, I must bear in mind that the pain I feel right now is solely within the intersection of my brain and mind, and that the world outside of my head is not affected one iota by what goes on in it. My therapist has emphasized to me identifying "false beliefs"--unhelpful thoughts within my head that are not substantiated by reality (such as me being a bad person, or that I fail at all tasks I try). The depressive episode is nothing more than a series of numerous false beliefs in rapid sequence. Their relationship with the actual world is tenuous at best, and if there are any links at all, they are greatly exaggerated, and things are not as nearly as bad as my depressed mind makes them out to be.

I remind myself that in addition to my depressive episodes sometimes having concrete causes, they also are caused by chemical imbalances in the brain, which occur outside of my immediate control. They can be allayed with medication and proper nutrition, but the primary cause of the depression is not my fault. I am not to blame for feeling as I do.

Thus, because I am not to blame for these feelings, the focus should not be in how to make myself stop feeling this pain, but rather on what treatments I have done before. Even if I do not feel that the treatments will be effective in the middle of the depressive episode, the mere habits I develop dealing with them give me something to fall back on to allay my feelings. For myself, when I have a depressive episode, I have learned to combat it through numerous means, among them:

  • Taking my prescription Xanax
  • Taking a nap to offset any existing sleep deprivation, as well as to mentally refresh myself
  • Feeding myself properly, as malnutrition can often intensify if not outright cause a depressive episode (normally this involves eating fruit. For whatever reason I don't seem to eat enough fruit).
  • Calling my therapist to talk about the issues on my mind at the time, if they feel too overpowering for me to handle on my own
  • Finding something enjoyable that I can do while I ride out the episode

As I write this, I find the fog of depression lifting somewhat, though whether this is temporary as a result of distraction or longer-lasting through the writing of this post I'm sure I will find out soon enough. Regardless, this episode will pass, as all of the ones have before it. And that is the most important thing to remember. This depression will end.  While in the middle of the depressive episode, it can be very easy to feel as though one has reached a point of no return, a state of misery which at the time feels inescapable. The best way to combat this feeling is through reminding oneself that you have had such experiences in the past, and that they too ceased. The feeling of endlessness which the depression provides is an illusion easily refuted by evidence from memory. I have felt this before. It has ended before, and it will end again.

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