24 little hours.......

It's amazing the difference a day can make. Yesterday, and for the preceding few days, I was pretty much in the horrors. Today when I woke up, it could have gone either way. Thankfully, it went the right way. Turns out (and this really, REALLY shouldn't be news to me at this stage) that missing even one dose, as well as making me high as a kite, also has a significant impact on my mood. My question is this - is this sudden and dramatic drop in mood a rapid return of depressive symptoms, or is it simply withdrawal?

I know there's massive variation between different medications, and I'm sure everyone reacts in different ways to them. I already know I have a propensity to be really sensitive to them, and am very prone to side effects, so maybe I experience more rapid and severe withdrawal as well. I spoke to my pharmacist yesterday and he confirmed that yes, the longer you're on them, the more dramatic the impact if you suddenly stop taking them suddenly. There's also  the question of different classes of anti depressant. The last time I saw my psychiatrist, we discussed the possibility of my having to change medication. This would pose some problems, because as she explained it to me, there are 4 levels of drugs typically used in treating depression, starting from the most basic at level 1, moving through to the most complex at level 4. Needless to say I'm at level 4, as levels 1 to 3 proved ineffective, and the dreaded words 'treatment resistant' were being bandied about for a while. So I guess the level 4 drugs are going to cause far more problems when trying to stop them.

Which leads me to another problem. I've made no secret of the fact that I would rather not be taking anything at all, but to date, stopping isn't a topic the hospital are prepared to discuss. My difficulty is that if the withdrawal from these things is so severe, and causes the apparent onset of symptoms again really quickly, how am I ever supposed to get off them? Not a question for now, I know, but I'm curious about how this will be managed in the future, because I certainly wouldn't like to think I have to be on these for life. If nothing else it'll bankrupt me!!

I've been thinking a lot the last few days about how this blog is going. I wonder do people want to hear positivity and hope, and assurances that depression once gone, is gone forever? While I have plenty of good days, I also still, unfortunately, have quite a few bad, and I can't give that assurance. By reading even semi-regularly, it must be clear that there are peaks and troughs in life with depression, and that it's a work in progress. Meds work to a point, but sometimes circumstances mean meds alone aren't enough. The occasional missed dose plays havoc with recovery. Psychotherapy is incredibly helpful, but also brings it's own set of issues and you have to be willing to engage.

Mostly I write for me, particularly on the bad days, because it helps to get me through, and I know I tend to post more frequently when I'm low because that's when I really need to write. But I am also aware that there are at least 2 people out there reading as well, and I wonder how it makes you feel to see the reality of life with depression. Is it reassuring? Does it help you to realise that there will be bad times, but they always pass and the good times come again? Or does it in fact bring you down, and leave you with a bad taste in your mouth? I don't want to sugar coat it, depression is tough, there's no doubt about it, and I'm a particularly tough case. For some people it is a once off. But for others it's not. At the end of the day, this is just how it is for me. I hope it's of some use to you, and that maybe you can pick up on some of the mistakes I'm making and not repeat them (case in point - medication!!). But likewise, sometimes, just sometimes, I get it right, and I'm able to not only manage, but enjoy life. That gives me hope. Maybe it does you too?

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