I had originally planned to write about self defense and how it is taught at Valkyrie, as something of a follow-up post from last week's. It seems that will have to wait for another week though, as I can't really focus on it at the moment. Instead, I want to talk more about depression and medication.
I'm on a new medication again, the 4th or 5th in the past year. I can't remember anymore how many I've been on since I was first prescribed an anti-depressant when I was 15. I've been on medication more than I've been off them since then, and there have still been times when I should have been taking something and wasn't. Some haven't worked at all, some have worked for a year or two before losing effectiveness. I don't think they have ever had me feeling good in a stable way by themselves, but they have still helped a lot - when working. Each time they stop working is even more frustrating than the last.
Unless you've taken them yourself or are close to someone who has, you probably don't know that most anti-depressants take 6 weeks to fully come into effect. That means that when trying to find a new one, you have to wait at least that long before you can be sure it isn't working and try something else. Often you have to wean off your previous medication over 2 to 4 weeks before starting a new one. That means that you can spend at least 2 months feeling depressed, have the doctor reach the decision that the new medication isn't working, and start the whole process over again. If the medication is helping but not enough, then the dose might be increased - with another 6 weeks waiting for full effects before possibly another dose increase. There is also the option of supplementing one anti-depressant with another, or with another kind of drug - this is where I'm at now. I've been on the same anti-depressant for at least 6 months now, and am now trying a second supplement - the first one was technically an anti-psychotic and the new one is usually used to prevent seizures, but both have been found to help with depression as well. Now I'm back in the waiting game, waiting to see if this new thing will reverse my current downward spiral, or if I'll be starting something new in the next month or so.
I'm lucky in one way - I don't tend to get much in the way of side-effects. That said, last supplement almost sent me into a manic state - I went from an ok mood with low energy to a great mood with incredible energy within about a week, almost uncontrollable. Fortunately, the amount of energy slowly decreased to a reasonable level. Unfortunately, the decrease in energy continued, bringing my mood with it - hence now trying something new. The other time I've responded badly to a medication was much worse, and due to increasing the dose too quickly. That time (several years ago), my energy increased dramatically while my mood stayed low. To me, this is the most dangerous combination - highly depressed and highly agitated. It was made worse by the fact that it happened to coincide with my doctor going on paternity leave and my psychiatrist going on vacation, leaving only a nurse practitioner who was unwilling to make changes to my medication, so I had to spend an additional 2 weeks in that stated. If it weren't for the incredible support of my partner and friends, I probably wouldn't have survived.
The lack of resources for mental health issues in our health care systems makes all of this more difficult. Many family doctors don't have a very good grasp on psychiatric care. This is made even more difficult if, like me, you don't have a family doctor and instead rely on drop-in clinics. While I always go to the same clinic so they have a record of all my history, the levels of comfort in treating depression vary greatly. It is also extremely difficult to get an appointment to see a psychiatrist. I first requested a referral to see one when things were going downhill fast last March, and was told to expect a wait of 3 or 4 months. The referral was renewed in June, and made again in October. It wasn't until December than I got in to see a psychiatrist for a one-off appointment, after which he sent some recommendations to the clinic that I go to and having been told that I could get an appointment to see him again within 6 months if things were still going badly. After some confusion involving making several phone calls, appointments made, then cancelled and then made again, I saw him again yesterday. To my great relief, he seems to have decided to see me more consistently now until we find some combination of medication that works - I have another appointment for a few weeks from now.
Needless to say, my relationship with anti-depressant medication is complex. As I said, each time one stops working is more frustrating than the last, and the process of finding a new one is long and complicated. When they do work however, medications make my life much better. Even if they don't get me all the way to happy, they get me better enough to do the things that get me the rest of the way, like making art and going to classes at Valkyrie. Medication, when it's working, gets me from unable to do much of anything to at least functional.
I want to leave this on a positive note, but I'm not quite sure how. I'm still in the downward spiral, hoping like hell that the steps I've been able to take will turn it around. I guess the positive for today is that I was able to leave the house, sit in a coffee shop, and write this. It's more than I could have done yesterday. Here's hoping those tiny steps forward keep going.