I've felt both a desire to write about it here, but also a hesitancy to talk about it too soon. But I'm gonna talk about it! Two weeks ago, on the eve of my 33rd birthday, after years of talk therapy that helped me but didn't change the clear fact that my biochemical disposition has been towards depression, I had a meeting with a psychiatrist and got prescribed small doses of generic Wellbutrin and Lexapro (Bupropion and Escitalopram — from memory I think that's what they're called anyway), two medicines that affect dopamine and serotonin respectively.
And y'all? The internal weather has been very different from normal. Not in major ways; I'm told the Lexapro won't really kick in until 4–6 weeks have passed, though I think I've dealt with some its side effects already. The Wellbutrin is almost definitely affecting me, in ways I'll elaborate shortly. But the biggest surprise is that I felt different as soon as I took the first dose, and not because the drugs kick in that quickly: I felt relief that I was doing something, that there was a chance things would change, and the thought that I might finally escape the quicksand feelings I've dealt with in some form for over a decade... I felt relief, and something like hope, immediately.
In the couple weeks since then, here's roughly what's happened. I'm gonna go into day-by-day detail and then sum it up at the end. Read it, skim it, or don't!
Sept 9
Surprised by how much I liked the psychiatrist. I was only able to afford counseling by going through Nuçi's Space, a local musician support / suicide prevention institution. You can go there and get hooked up with counseling at a significantly-reduced rate. And I only went back to counseling after a year because of my partner Erin, who was also the one who convinced me to go to counseling in the first place several years ago. I owe her and Nuçi's a great debt of gratitude. And the psychiatrist they connected me with was thoughtful, sweet, and felt trustworthy.
I went back to counseling because I've had such vicious depression in recent months that it was hard for me to work, let alone enjoy myself much at all, and because I had reached a low that had me wondering if it would be easier to die than figure out how to improve. "Easier" is relative, and while giving up is an option, hurting everyone around me and leaving them with the mess of my unwillingness to try everything else wasn't on the table for me. So I started do everything I knew to do to manage my depression, talked with people about it, Erin helped me make a new counseling appointment, and this time I decided I was willing to try medicine if it would help me avoid getting this bad again.
I've had a contentious relationship with drugs my whole life. There's addiction in my family; early contact with alcoholics made me so opposed to drugs that I avoided recreational drugs and alcohol until I was almost 30. Smoking marijuana where it was legal helped me remember what it was like to relax; drinking small amounts of alcohol helped me re-learn to enjoy singing, dancing, and being silly. I had gotten so pent up, anxious, and afraid of myself — fear that I would lose control, that I couldn't trust myself — and carefully engaging with these things helped me in a big way to learn to trust myself better.
That's not everyone's experience, and I certainly don't recommend that broadly. What I really needed was therapeutic medicine, probably, but for some reason that was even harder to let down my guard on. What I think of as American individualist and Christian guilt-driven mentalities made it very difficult for me to accept that I was unwell in a way that needed treatment, rather than simply failing to try in the right way. I made a lot of progress through personal effort and talk therapy, particularly cognitive behavioral strategies around catching and breaking negative thought loops. But if it were possible to simply lift myself out of depression and into better living, I would have. It didn't work that way. So I finally acknowledged that trying medicine was better than being stuck wondering if I should die. I don't want to die! I just wanted to feel different.
So the psychiatrist was good. The medicine was only $18 for a month of generics; obviously we should have a national health service that includes mental health care and we should all be able to get this stuff without paying extra. But here in hellworld USA, that's not bad. I got home, read all the guidelines about the medicine, and took the first dose. Wellbutrin in the morning, Lexapro at night. And the immediate effect, as I said before, was simple relief at doing something new that might help.
Sept 10
I felt buoyed and hopeful by doing something, and may even have felt an immediate spike in energy from the Wellbutrin. Hard to say. But I got more work done than I had been, and had some good hangouts with friends.
Sept 11
My birthday. On Monday the pharmacist asked me if I had any big plans for my birthday; I gestured at the medicine and said, "I'm finally trying to treat my debilitating depression!" She laughed sympathetically, but I wasn't kidding. I didn't do much for the day itself; and by the evening I was feeling kinda weird. Just sat and played Boundless with some friends, doing a little mindless digging as my brain felt kind of hazy and tired in a strange way that wasn't entirely unpleasant.
Sept 12
Hazy day. Didn't get much done. Worked, went to band practice and hung in there but really wasn't feeling like myself. I did go to karaoke, but taking this medicine also means no alcohol for at least a month while I adapt, so that changes the karaoke vibe. But it turned out I was really feeling spacey; I said weird stuff, and had to just tell friends I was adjusting to new medicine and wasn't myself. Again, not terrible, and I was told to expect a few days here and there were I might not be up to normal tasks. Several friends have told me during the first few weeks of new medicine this is normal enough.
Sept 13–16
This was a surprisingly-good few days. I found myself waking up early, which is weird: I'm historically a wake up between 10 and noon kind of person, which I've been able to get away with thanks to a freelance work schedule for several years, or by working jobs the in afternoon and evening. However, I've been waking up between 6:30 and 8 for months now, but then rejecting it and making myself go back to bed. So I decided to lean in to that schedule and try to just get up whenever my body wanted to. This got way easier on these days, such that I got up and walked someplace for a small breakfast with coffee and then got to work. I also found myself getting super sleepy around 10pm, rather than being wide awake until I tricked myself into sleeping between 2am and 4am, so I tried to just go to bed.
On Saturday I went to Atlanta with the cover band to play a big house show slash fundraiser for the Piedmont Park conservancy, and felt kind of buoyed throughout. A bunch of stressful stuff happened, outside of my control, and I got kind of stressed but didn't let myself spiral into darkness and anxiety. It was much easier than normal for me to just say, "Hey, you know what? This is what's happening. I'll do my part and let the rest of it go." The show went great, I had fun with it, and we had a nice hangout including my brother and other nice folks. Got super tired around 10 again, but had to walk back and chill in the living room of the house we stayed in with one of the guys' family and friends. It was nice, and when I did go to bed I slept well, and then woke up way early the next morning to get things ready since I knew my bandmates had been drinking and wouldn't get moving quickly. I just got up and accepted that I needed to do these things, rather than engaging in the "uggggh noooooo" kind of feeling I have had so much of the time.
I want to call attention to that: reduced mental friction. One of the biggest ingredients in what I think of as my depression has been friction between thinking of something I need or want to do and then actually doing it. It's just been hard to change course, or to accept that I have to do something difficult or unpleasant or even just mandatory. Again, whether it's the medicine or the renewed sense that I can be helped, I've had a much easier time just doing things that need to happen, from washing dishes to waking up earlier to tackling new problems with work. That's been quietly remarkable, and several people have noticed and commented on it positively. It feels good to just not go through this internal tug of war over whether something is going to happen. It's a battle I've often lost in favor of doing something irresponsible like scroll twitter, play video games, or just fuck around in some other way that diverts away from the feeling there's something I should be doing that I'm not.
Another possible effect: focus. I'm told Wellbutrin can also be prescribed for ADHD, and for the last year or so I've really been thinking about how many ADHD-type symptoms I've been displaying. It sucks to pathologize yourself in certain ways, but it's been helpful to try and identify these things. I still don't know how to assess the effect this might have had on my earlier life, but in the last few years it's gotten harder and harder for me to stay focused on tasks that require me to sit still and focus, which is terrible for doing computer-based work of any kind, especially programming. But this last week or so it's been a lot easier for me to lean in and just commit to doing something without questioning or distracting. I've also been working on this in other ways, including reducing distractions by force if necessary, including bringing fewer options with me, putting myself in places where I don't have access to too many possibilities, trying to just do whatever seems most interesting rather than fretting and getting stuck on not choosing anything, and very importantly using software to restrict my access to Twitter, which has been very painful to recognize as an ingrained habit, but deeply helpful to reduce. So there are a lot of factors I can't simply attribute to the medicine, but I'm doing everything I can do try and improve my relationship to myself and my obligations.
So after waking up early, getting stuff ready, and riding back to Athens on Sunday, I got home and rather than go back to sleep or kick it on the couch, I cleaned up the house, took out the trash, and decided to go to work. I didn't wind up doing much web work, but I did read the first few chapters of The Artist's Way, skim some of the later chapters, and made a commitment to try the Morning Pages. I've had a contentious relationship with this in the past, particularly because of the tension between thinking of myself as a "good writer" who has found it painful to write at length in conflict with the pain of not having done more with that skill and associated dreams. But at one point she points out this exercise is especially difficult for writers, because they tend to try to write them well, which isn't the point. Just write three pages as quickly as possible, let it be messy and tedious and simple, and that's all fine. That was helpful, and I've kept that in mind this week as I actually did the Morning Pages more days than not.
On Monday I had a good work day, a nice dinner with Austin, and then went to Flicker to see my friends play music, including bandmate Jack Cherry's last show here before moving to Austin for work. It got started late, and I was tired around 10pm again, but I stuck it out and just kinda chilled until after midnight without getting upset about it. I slept in a little more the next morning, but still didn't feel like sleeping all morning.
I also want to record that on Monday morning I had an unusually-vivid dream that included a lot of things that would normally make me anxious, which I also acknowledged in the dream, but which the dream seemed to ask, "Okay, but what would these things feel like if they worked out well?" I was going to college despite my difficulties with that, I was worried about getting older but people said it was okay, I danced and fell in love and talked with people I haven't seen in a long time, and all of it had elements of worry that were met with relief and gentleness. It was a remarkable dream and waking from it left me feeling warmer and more optimistic than I have in a long time. Usually my dreams leave me murkier or worried or, when they're nice in some way, disappointed that they aren't real. This was a very different way to wake up and its images have stuck with me and made me question my waking assumptions about what is possible! Weird, huh?!
On Monday night I also upped the dosage of Lexapro, as the doctor had told me, from a half-tablet to a full tablet.
Sept 17
Good work day, did morning pages, good dinner with my friend Ashley, which included a moment I also want to comment on. I'd been noticing that I was feeling things differently, or more than usual. There was warmth and silliness available to me that I've had a hard time accessing; and things were reaching me rather than hitting a cold, dry, unfeeling wall of, "So what?" And for dessert we had this chocolate tres leches cake that, when I bit into it, I felt in a way I haven't felt food in a long way. It was vivid, rich, and honestly verging on erotic in a way I don't know I've ever felt. It was wild. Maybe this was Magic Cake — and Ashley described it similarly, so it wasn't just me — but I think the changing parameters of my emotional availability definitely had something to do with my ability to enjoy it!
MISTAKE! I had one margarita with dinner because it was offered and I wanted to find out what would happen. It didn't seem to have much negative effect the next day, but then I goofed it!
Sep 18
Had an appointment with my counselor (not psychiatrist, that's tomorrow) where I was able to recount a lot of this. She was surprised, and asked me whether I thought all these changes and efforts — exercise, morning pages, drinking less coffee, changed sleep schedule, etc — are sustainable. I told her I have no idea, and I'm not attached to keeping things this way or afraid of having off days, but I'm leaning in as much as I can when I feel like it. She said that sounded good and to keep track of it.
Good work day, good hangout with friends that evening. But then MISTAKE 2: hanging with my friend Gemma at a bar, I decided to have TWO drinks over several hours, and I tell you what I think that was not a good idea!
Sep 19
Between upping the Lexapro on Monday, which I assume has been the culprit in making me sleepy/hazy sometimes, and having alcohol which I know is prone to bad interactions with these drugs, Thursday was not a good day! I felt okay, but definitely not as good as I had been, and couldn't find as much focus or energy. Still managed to go try out singing with a new band, had a good time but couldn't bring a lot of energy to it. I also had some throat tightness and sneezing so this might also have been related to weather shifting colder, or construction in the vicinity of the practice space. Who knows! But I'm gonna totally refrain from alcohol for several more weeks, following this ill-advised experiment.
Sep 20–22
Also dragging a bit, on Friday I was able to still get some things done, including a bunch of housework before having a guest for the weekend. So even while down, I still got more stuff done. On Saturday I deliberately rested, played a bunch of Hollow Knight (which I love so far), and also leaned in to just wanting to play a bunch of that game. Played Overwatch with Austin, Peter, and Patrick, and found myself feeling about it more, possibly in an annoying way, as when I got frustrated I think I was more vocal about it than normal. Even though I can be a complainy son of a lich about competitive games even on a good day (I hate being killed by a Reaper, Mei, Bastion, or Doomfist, all of whom are super annoying and hard for me to counter, and I am not above calling them unbalanced rather than accepting responsibility for my own poor aim and awareness 😎). Sunday I spent time with Erin, watched a bunch of Deadwood for the first time (also enjoying it much more than I thought I would) and was still able to do household chores and basic responsibilities with less internal friction than before. I skipped the morning pages and slept in later these days, partly because my sleep schedule was interrupted by our house guest getting in late both nights, but I didn't mind!
And that brings us to today, when I got up early again, did the morning pages, had my morning call with Ryan (that's something I've omitted from most of these days, but Ryan and I are having weekday morning calls to check in on what we're working on and make those things feel more concrete, which is so helpful for me as a base level of accountability), had breakfast and then got set up to work. And now, as a break while I marinated on how to approach my next programming tasks, I wanted to write this up and let y'all know how things were going.
Overall
Week one was a couple decent-feeling days, followed by a couple of hazy days, followed by about 4 days of some of the best mental space I've had in a long time. Then, whether from upping my dosage or having alcohol, I had a couple more hazy unproductive days, which are now trending back upward toward productive and possible-feeling.
I wanted to write this down for you who have been subjected to my less-filtered difficulties in recent months and years. Things are changing; and this hopeful start may or may not lead to lasting improvement, but I'm willing to adjust medicine and try new things and engage whatever strategies I can to be less of a burden on myself and others, and that feels really good to be able to say. Medicine isn't magic, but I do need treatment of some kind and am not afraid to admit that anymore. I spent years struggling against myself and my environment, and if medicine can help reduce that struggle, I want it. I want to feel okay. The biggest thing for me hasn't even that I've felt more positive; I still feel and think about the negativity and difficulty of so many things. Rather, what's changed most is that instead things feel possible. It feels possible to handle those difficulties, to work when it's hard, and to feel good when there are things to appreciate. So that basically kicks ass!
I also wanted to write about this in case any of you think medicine could help you but have been afraid. There are a lot of different drugs and different outcomes, so who the heck knows, but I've gotten a lot of positive support from friends and acquaintances who have taken medicine, and I honestly wish I had seen a psychiatrist when I was 23 instead of waiting until 33. But it's okay; getting there eventually is better than giving up or beating myself up about past events. Maybe it'll still wind up sucking, but I'm glad I'm trying it and will try whatever else I can to keep moving toward being healthier!
I don't know if I'll do another public day-by-day account like this, but I felt like documenting so I could talk about it more in the future. I'll let y'all know how things develop, and also share more stuff that's been going on. I felt a little blocked on making Posts before talking about this in some way, but now that's out of the way!
Thanks for reading.