Sunday, August 11, 2013

A Look Inside My Skull

I've been wanting to write about the depression and anxiety I experience constantly for a while now, but of course, the anxiety makes that difficult.  But I figure I'll go ahead and put it all down, so hopefully it can help other people experiencing similar things.  In this I'm largely inspired by JT Eberhard, and specifically the talk he gave at Skepticon a couple of years ago. Just today I also saw this piece, which hit a lot of the bullet points I want to mention, especially #4.  But here's how things happen for me, specifically.

Somewhere around 16-17 years old, I was diagnosed with clinical depression.  More recently, the official term I've seen on shrink paperwork is Major Depressive Disorder.  I kinda dig that, it sounds more important.  Anyway, after an initial month on Zoloft which gave me the shakes, I switched to trazadone, and I've been on that since, and I'm 35 now. (Note: My bad experience with Zoloft doesn't make it a worthless drug, different people have different brain reactions.)  The trazadone helps a lot, but not with everything.  I'll break it down.

When I'm not medicated, I have zero control over my emotions.  I can go from laughing to screaming in a matter of seconds.  Mood swings is too mild a word for what happens.  It's not a cyclical thing like manic depression (I guess they call it Bipolar Disorder now?), it's basically an extreme overreaction to emotional stimulus.  Where a neurotypical person might get irritated and mouth off to someone pissing them off, I would get into huge screaming bouts, often flinging things across rooms.  What the trazadone does is give me a thermostat for the emotions, and on it, I react just like a normal person.  I still feel my emotions, but they aren't uncontrollable.  This is a good thing.  Whenever people tell me, "you don't seem depressed," I tell them that's because my meds work.  I know this because there have been times when I've been off them, most notably on a trip out of town for a few days when I left them at home.  What happens then is that on the first day, I'm mostly good, but I'm a bit more anxious than normal, tapping my feet, experiencing body temperature fluctuations, that kind of thing.  Day 2, all of those symptoms are worse, and I start to get extremely irritable, minor things that I would blow off as unimportant seem like major annoyances.  By day 3, I can't really tolerate the presence of other people at all, because everything they do pisses me off.  In such states I get irritated by the way people breathe.  Oddly enough, cats don't bother me at all, and normal annoying cat behavior is less irritating than when I'm in normal mode. (The same effect might hold with other animals, but I don't have close contact with anything other than cats.)

So, trazadone is necessary and good.  All of the weird and possibly scary behavior above just goes away completely.  (This is also why I know that people who like to spout off about how 'the brain is more than just chemistry, man' are complete fucking fools.  It's really, really complex chemistry, but it's chemistry all the same.)  So, on to the stuff trazadone doesn't cover.

I don't hear voices, but I may as well.  I'm going to use the term "voice" as a metaphor in this a lot, because it's just easier to put things into words that way.  There is a constantly running dialogue in my head, and it tells me that I'm a piece of shit.  It tells me that all of my friendships are elaborate hoaxes being perpetrated on me, and that one day they will all reveal the joke and have a huge laugh at my expense (I suspect this is based on my first "girlfriend" in 7th grade, who did just this).  No one in my family gives a shit about me.  I'm adopted, and my parents wish they could get their money back.  I am a fraud, putting on a front, afraid to reveal my true self to the world.  Nothing I have ever achieved has been of any importance whatsoever to anyone, and any sense of accomplishment or good will I've ever received from anyone was wrapped in contempt.  The joke is always on me.  Women find me disgusting.  I am always awkward, and a huge embarassment.  I might as well be dead.

That's a sampling of the kind of shit that runs through my head in the background, pretty much whenever I'm awake.  It's kinda like the news-ticker at the bottom of the screen on some cable news shows.  I'm not an idiot, I know that most of that, if not all, is complete bullshit.  That is the depression fucking with me.  So I've gotten ok at ignoring it for most practical purposes, if you talk to me, you probably can't tell that I'm thinking anything of the sort.  Of course, even now, that ticker is screaming, fuck you, they can tell!  They know it, you stupid fuck!  Everyone knows! Again, I know with most of me that it's bullshit, but when you have those kind of thoughts going constantly, it worms its way in.  I'm constantly second-guessing myself in any interaction whatsoever, no matter how inconsequential, because in my mind, there's always some fraction saying, what if the other voice is right?

'Damn, that's crazy, how do you put up with that?'

As opposed to what?  It's there, I've had to come to terms with it, and even now, there are days where I believe it more than others.  It's affected my personality in a number of ways.  One of the most irritating is that I have absolutely no reliable sense of whether someone is or isn't interested in me romantically.  There are lots of women I'm attracted to, but I have no way to gauge whether it's reciprocal, because that little voice completely fucks up my judgment on such matters.  Most of the relationships I have had have been the result of a woman approaching me and declaring their interest.  At least then it's easy to ignore the voice.  It's not that good, though, because I still end up with trouble interpreting signals.  When I was married, if my wife said something was fine, I went with it, because I can't trust my own analysis due to the voice filling my head with paranoid scenarios.  When it comes to actually asking someone out, I can barely manage.  Simple rejection, that I could handle.  What makes it difficult is the voice yelling all of my flaws at me, making me self-conscious as hell, terrified if I'm going to be seen as a creep, etc.  I'm already worried about how I go about such a process for rational reasons, not wanting to be some kind of douchebag making assumptions that may or may not be sexist because I'm blind to my own privilege, I don't need this additional shit as well.

It extends to non-romantic social interactions as well.  When I'm pretty sure I've upset someone, I often go overboard with asking them to tell me what's wrong, or I end up apologizing for things that my mind has blown up into major offenses, and the person I'm apologizing to has no idea what the hell it is that I'm supposed to have done to offend them.  When I'm having conversations online and I don't have body language to observe, I often tend to end up interpreting what other people say in the most hostile possible manner because that's what my mind is telling me.  Even with people I know and trust, I still have to deal with it, see the paragraph up above talking about the big joke.  Basically, I'm always multitasking whatever I'm doing, because part of me has to be countering all the self-accusation.

So far, I've only found one thing that shuts up that fucking voice, and that's alcohol.  When I drink, once I start feeling the effects, the voice goes away, and I can actually relax and enjoy myself and the company of others.  I am well aware of how dangerous this is, it's a pretty sure path to alcoholism.  When I don't drink, I don't have any particular craving for booze, but I always want to shut up the goddamn voice, trying to sabotage me at every turn.  I am actively trying out things to help with this, however.  I've recently added Wellbutrin to my medication regimen, and it seems to be helping a little bit, but not enough.  I'll continue to seek alternatives until I find something that does work as well as intoxication.  I'm probably going to send this very piece to my shrink as a diagnostic aid, hopefully that works.  I will post follow-ups to this if/when I notice changes in symptoms, so that perhaps if/when it gets better, I can have a further example to show people how getting help actually, y'know, helps.

I know that this whole piece is a huge pile of too much information for most people.  I'm going ahead and putting it up on my blog anyway, because I know that there have to be others out there dealing with their own mental illnesses, and they need to know that they're not alone, there are people who understand what they're going through.


  1. "When I'm having conversations online and I don't have body language to observe, I often tend to end up interpreting what other people say in the most hostile possible manner because that's what my mind is telling me."

    Wow, that is a really profound insight into your behavior. I bet I do that also.. I bet everyone does that, actually.

    Thanks for writing this. My experience is different, but I have also noticed that alcohol helps which is frustrating. You might ask your doctor about benzodiazepines, which have very similar chemical action to alcohol, but they are far from harmless. They have similar addictive potential as alcohol and narcotics, but it does work well for some people too.

  2. I'm seeing my doc tomorrow, I'll mention them. Thanks.

  3. Also, since it's come up in conversation at least once, I'm not actually adopted. I just gave that as one of the examples of the way my anxiety lies to me, to fuck with me.