Tuesday, January 17, 2012


Now that I’ve broken the seal, the depression words are spilling out.

There’s, like, a stigma?

Even amongst people who acknowledge that depression is A Real Thing (as opposed to something you need to just get over), there’s an uneasiness around treating it with medication. People who have never been depressed believe that the first line of treatment should be enhanced diet and exercise, then changes to routine and sleep schedule, then self-help books, then talking therapy, then voodoo, then antidepressants.

Now, I’m not saying that lifestyle changes don’t help. But they didn’t get me close to functional – and I had professionals keeping me on track for 6 months. Without support, and without fairly immediate results, it’s not really feasible for someone who’s severely depressed to take on these kinds of changes. When you’re barely coping with life as it is, how do you fit in 5 hours a week of cardio?

Part of the problem is a misconception that antidepressants are “happy pills” which replace all genuine emotion with unspecified elation, and so taking them really just avoids the problem. This couldn’t be more wrong. If people want to feel good regardless of what’s happening in their lives, they have options – we go to doctors to feel normal again. Antidepressants don’t replace real feelings – they enable them in a person who would otherwise just see grey.

There’s also concerns about the effectiveness of some antidepressants (most notably the SSRIs, which have never worked for me but do for some other people) as well as generic fears of Big Pharma. No fears of Big Diet and Big Exercise, I would note.

Me and my meds

It wasn’t easy to find meds that work for me. I am currently on a cocktail of 3 different drugs (an antidepressant, a stimulant, and an anticonvulsant, for some reason) which get me out of bed in the morning and let me taste food. It took YEARS to find this combination, and it’s changed my life.

For a long time, each new treatment I tried worked for a while and then stopped. For medication, the pattern usually went something like this:

  • One month to build up to a therapeutic dose.
  • Two months of things working out pretty well.
  • One month where it starts dropping off. I understand that people have good times and bad times, and put it down to bad times, and give things a chance to clear up on their own.
  • One month where I stop being able to function. I miss work, can’t socialize, and otherwise exhibit full-on depression.
  • One month to taper off the drug; and the cycle starts with the next one.

Throughout this I’d have ups and downs at work and in my personal life, making commitments when things were going well that I’d break when they weren’t.

The current regime has been working for about 9 months now. Let’s hope there isn’t a next one.


  1. "Let them eat cake!" That's what I think when ppl say depressed ppl should eat/sleep/excercise better. I think people forget that the brain exists and only consider 'the mind'. If your body produced too much or not enough of something in any other organ, you would get medical assistance for that. But in the most complex and sensitive organ in your body? Just will it away. There is a stigma, and it's silly.

    1. Well, there are diabetics who can control their diabetes by avoiding sugar, and diabetics who need to take insulin. We just don't assume that severe diabetes is a sign of weak character.

  2. "... let me taste food ..."

    Was this a pretty way of making a general point about being able to do normal things, or does your depression actually interfere with your ability to taste? I have another friend who currently has no leads on her sudden inability to taste. My lack of a medical degree says it could be stress or hormones or both -- and an anecdotal link between depression and taste would be interesting for me to share with her.

    And yes, depression is hard to explain and admit to. But you know me, I tend to share too much information about my health publicly. So I've kinda told a lot of people about what I go through.

  3. My sense of taste was definitely dulled - I could distinguish different flavours but there was no spark to anything I ate.

  4. AE, I think depression could definitely contribute to loss of taste. There was a study a couple of years ago that found people with untreated depression did not register color as brightly as healthy people (not self-reported, they were measuring retinal response). That said, it could also be a whole bunch of other things - gum disease is apparently a common cause, along with various neurological stuff (and yes, hormones or stress) - so I would highly recommend that she at least call her doctor if it doesn't resolve soon.

    (Oh, and also, she might want to confirm that she doesn't have a loss of smell too. The two interact a lot, and her doctor will need to know if there's problems with both.)

  5. Thank you for sharing all this. While I haven't had serious battles with my own depression for a long time, it had a huge effect on me for nearly 10 years, and throughout puberty. (Which was part of why it took me many years to identify my problem as depression - it was way easier to assume it was just teenage angst and normal hormone fluctuations.)

    Pharmaceuticals were a necessary part of my treatment, too. Extreme cardio and a good diet probably helped, but there's no question that I needed prescription to get "over the hump" to a place where willpower was actually effective - or where I actually had any relevant willpower.