I’ve been thinking a lot, lately, about whether or not I’m depressed. I posted yesterday about how someone asked me if I wanted to end it all, and how I said NO, in no uncertain terms.
I’m getting ready to go see my doctor in a little bit, and the first time we met, they thought I might be depressed. They told me so, the second time I went to see them.
Here’s the thing: Going to see a doctor who thinks you’ve got a problem, and who is in a position to “do” something about that supposed problem puts me in a precarious position. I’m not a big fan of pharmacological solutions for emotional issues — some people are chemically and clinically depressed, there’s no disputing that. But if I’m not chemically or clinically depressed, but I’m medicated as someone who is, might that not complicate things even more for me – even more than they already are?
I mean, I have a hard enough time keeping up with my life without my senses being dulled and my processing being interfered with by meds. Plus, some anti-depressants have been shown to produce suicidal behavior in some folks. That’s about the last thing I want.
In my seemingly eternal search for what’s going on with me, what — if anything — I can do about it, and how to best make the most of my amazing life, I have found it quite helpful to first seek to understand the underlying facets and aspects of my situation, before coming up with a solution for what appears to be wrong. I’m an engineer by nature, so in order to move forward with courses of action, I need to understand what all is involved, what the different considerations are, and what my desired outcome is.
Here’s what I think about the “depression” that others seem to think they’ve observed with me:
The first time I went to see my doctor, I was in a pretty wary state. I have not had a lot of luck with physicians over the years, and I have a lot of trouble communicating. I am very aware of doctor-patient power dynamics, and the situation tends to make me nervous. I haven’t the faintest idea, sometimes, how to behave in a way that makes a doctor believe I’m a nice person — I get agitated, and when I do, I can get defensive, combative, argumentative, passive, aggressive, non-verbal… you name it. When I perceive myself to be in danger — and going to the doctor sometimes makes me feel that way — my worst symptoms get triggered and I resort to behavior that is not productive. If I could stop myself or alter that, I would be happy to. But when I perceive my personal safety and self-determination to be fundamentally threatened, well, all bets are off.
Anyway, when I’m in this place, it’s not good. And I’m keenly aware of it. So, when I went to see my current PCP for the first time, I was bound and determined to be on my best behavior. My relationships with my 3-4 prior doctors (I’ve had at least that many, over the past 10 years) ended on sour notes, all across the board, and I didn’t want that to happen again. I HAD to at least try to get off on the right foot with this doctor, who was recommended by someone I really trusted (a rare thing). I did not want to completely screw up my new relationship. I wanted to build a working partnership that could really work.
Needless to say, I was a bit stressed, going into the office. I was on high alert, trying like crazy to make sure I didn’t say or do something that would completely irritate, antagonize, and alienate this individual. It was almost like holding down a wild animal … trying to hold back a large, aggressive dog on a leash… All the past failures with doctors kept running through my head, and all I could think was, “Don’t screw this one up… Don’t screw this one up!”
I thought the conversation I had with the doc went really well. I liked them and they seemed really on the ball. Engaging and compassionate and highly intelligent, not to mention a little intuitive, which can be helpful when I’m at a loss for how to communicate to someone. I wasn’t rude, I didn’t say or do something that was completely inappropriate, I didn’t lash out, I didn’t make a snide comment about something that alarmed me, I didn’t make myself look like a total fool. I was poised — I thought — and polite and coherent. I was really happy.
But when I went back, the second time, the doc said they thought I was depressed.
I suppose on the surface it might look that way — apparently low energy,flattened emotional effect, slow responses… Over at The National Institute of Mental Health, they say:
* Persistent sad, anxious or “empty” feelings
* Feelings of hopelessness and/or pessimism
* Feelings of guilt, worthlessness and/or helplessness
* Irritability, restlessness
* Loss of interest in activities or hobbies once pleasurable, including sex
* Fatigue and decreased energy
* Difficulty concentrating, remembering details and making decisions
* Insomnia, early–morning wakefulness, or excessive sleeping
* Overeating, or appetite loss
* Thoughts of suicide, suicide attempts
* Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment
And on the surface, it looks like a lot of them could have applied to me.
But check it out — I didn’t have low energy. I had extremely HIGH energy. And I was just trying to keep it reasonably bottled, reasonably civil, reasonably managed. I was irritable and restless, yes, but hell, I was trying to establish a new relationship with a person who ultimately has a fair amount of sway over my life — and in ways I’m not always comfortable with. Plus, the difficulties concentrating, remembering details, and feelings… hello, can we say TBI symptoms? I mean, come on… not every mental challenge is psychological. Sometimes there are logistical and physiological reasons for what goes on with me.
Now, the thought occurs to me that the fact that I’m a long-term multiple tbi survivor could make my anaylsis suspect in the eyes of the experts. After all, I supposedly am brain-damaged or something like that… (to which I reply, “Who isn’t?”)
But if there’s one thing I know, it’s my experience, and as much as the established experts may disagree with my habit of self-assessment and analysis, and they may say I have no standing to diagnose my own condition, the fact remains that there’s a whole lot in my experience that I cannot now — and perhaps never will be able to — express verbally. There is a lot inside me that may never get out. And the people who have the power to medicate me, commit me, lock me up, or tie me down, can never know the full spectrum of feelings and thoughts and experiences inside this singular head of mine.
Anyway, I’m getting all agitated, and I want to chill out before I go see my doc again.
So, I’ll quickly talk about my therapist, who the other day asked if I wanted to end it all.
NO, I didn’t want to end it all. I was tired, I was taxed, I was coming off a neuropsychological testing session that brought me nose-to-nose with some of my most persistent issues and made me feel like crap. Plus, I was having major sensory issues — with my hearing and my vision being so sensitive, they were driving me nuts. And my familiy situation has been tense, off and on, with money being something of an issue, and my job situation being under the gun. I was trying to sort things out in my head, trying to keep my balance, trying to just get clear on some things, and I was feeling physically low. I was also concerned about my safety, since I was driving home later at night, and I’ve been having some problems dealing with the headlights of oncoming cars.
My mind, quite frankly, was really over-taxed with trying to figure so many things out and trying to come to terms with a lot of stuff in my experience that hasn’t been pleasant, but has been… there. If anything, I wasn’t depressed — I was over-stimulated, and I was trying to sort things out. I was trying to just stay chilled and not freak out over all the unknowns in my life. I wasn’t depressed — I was busy thinking things through and trying to keep my balance. Trying to keep civil. Trying to be productive and pro-active. And I was tired.
I think the big reason I get freaked out over the idea of anti-depressant medications, is because the last thing I want/need when I’m in a place like that, is to have my brain slowed down and interfered with. I need ALL my faculties to figure out my life, sometimes, and if I introduce medication that mucks with my mind — even if it makes me feel a little better — then my most important coping tool is compromised. The very thought of slowing down my thinking or interrupting the natural flow of my brain — even if that natural flow is uncomfortable or “depressing” at times — really concerns me, and I feel like my very survival is being threatened.
I can’t just jump on the pharmacological bandwagon, in hopes of patching up little bumps in the road. I need all my faculties, even if they are impaired in some ways at some times, to get by in the world. And if I spend my energy — or divert it — to smooth over the little issues, then the bigger core issues may be overlooked and never constructively addressed.
For those who are in need of anti-depressant medication to get through life… who are otherwise incapacitated by depression and are in danger without intervention, I say “Mazal tov and good fortune to you.”
But when I just seem a little “down”, I’m not necessarily depressed. Could be, I’m just working really hard to keep my head clear and function in a productive, polite, pro-active manner that doesn’t pose a risk to myself and others, because my brain sometimes misfires when it’s under pressure.
long-term+tbi+survival+ Mild+Traumatic+Brain+Injury+ mtbi+ self-assessment+ tbi+ tbi+survivor+ TBI+Symptoms+ depression+ mental+health+ doctor+visit+ primary+care+physician medication anti-depressants