Monday, February 6, 2012

High-Paxil Resolution

It has occurred to me that one of the drugs that I might be taking right now as part of the double blind test, Paroxetine, is beter known as Paxil. 

Some members of my family have been on Paxil at one point or the other. This resulted in very negative effects including one (thankfully unsuccessful) suicide attempt and a month of "missing time."

I have told my wife to watch out for me acting "extra crazy."

Sunday, February 5, 2012

The Depression Obsession Confession

I thought long and hard on whether or not to discus my emotional issues in a public manner such as this, but one of my favorite bloggers, Allie Brosh, talked about her depression in front of the entire Internet. I figured if she could do it then I had little to lose and much to gain by by talking about my own issues here. (Allie's article, by the way, is both a hilarious and highly accurate depiction of clinical depression).

So what is depression? It's more than just feeling sad. Everyone feels sad. It's more than just not being happy all the time. No one is happy all the time. The human body—the brain especially—is a chemical machine. When you have Major Depressive Disorder, your body doesn't make the chemicals that allow you to be happy. There are peaks and valleys, of course, and there are times when you feel better than worse. But for the most part, a person like me with MDD isn't just unhappy, he is incapable of being happy. The world is gray, and you are numb to everything. You lose interest in all the things you used to love—hobbies, friends, family.

It's hard for non-depressed people to understand. Trust me, I didn't understand it in the past, either. With depression, you just can't “get over it” or smile and cheer up. People say this, then you begin to feel bad. You think you should be able to be happy. You think about all the people who have worse lives than you. You know you should feel thankful, content, happy even.

But you can't, and now you have guilt and anxiety on top of the soul-crushing depression. More and more you think about death. You are desperate for anything to stop the psychic hurting. The lure of drugs, alcohol, self-destructive behavior, and suicide grows stronger and stronger.

And you don't want attention, either. You want people to think you're fine and “normal.” The last thing you want is people to know how much you hurt. You begin to isolate yourself from people, especially the people you love. You don't answer your email, you don't return phone calls, you find excuses not to leave the house. Then you realize you haven't talked to your best friend or you parents in months. Now you feel bad. You knowjust know—that they're angry at you and HATE you for not talking to them. So you continue to avoid them and you isolate yourself more and more, even though you feel more alone than you ever have. You ignore responsibilities, and things pile up. It's all too much to think about, so you just don't think. Eventually you can't even get out of bed and you wish you could go to sleep and never wake up.

I've dealt with this, to one degree or another, almost every day for twenty years.

Depression is a genetic curse of my family. Most of my immediate family has suffered with it for years to varying degrees. I never dealt with my own problems. “Other people have their own troubles. I don't need to bother them with mine too,” I said to myself for years and years. I stomped on that shit, bottled it down in the pit of my stomach where it festered and blackened, just waiting to boil over and kill me from the inside out.

It started in high school. I remember sitting in my room crying for no reason, ashamed for feeling so miserable. I was desperate for affirmation but terrified of drawing attention to myself. Things got better after getting out of high school, as they always do. It was another several years of ups and downs until I got into my early-twenties and moved out on my own.

For several years in the late 90s and early 00s, I engaged in a lot of auto-destructive activities. Nothing suicidal, but I drank way too much, experimented with drugs, started chain smoking, fell into emotionally abusive relationships, drove people away, and looked for fights. Thankfully I wasn't really good at any of this, but for much of my 20s I was slowly trying to destroy myself.

In my 30s I went back to college (again) and this time I actually had a pretty good upswing for a few years. I had married my one true love. I was back in school and enjoying the hell out of it. I had also recently started working for Hex Games, helping produce roleplaying games, my favorite things in the world! The good folks at Hex had the ill luck of meeting me during a high period in my life. Between having an unusual amount of free time living for a few years at a freakishly happy emotional state, I set my bar too high. I have never been as productive as I was during the Rocket Jocks, Fort High, Funky Frank era.

But things like that don't last. After finally graduating college, the sky totally failed to crack open, and unicorns didn't fly down from the clouds to anoint me with rainbow kisses. I slid back into that old-time gray malaise. Over the next few years, job woes, money woes, housing woes, and the general state of the world combined with existential dread would sink me deeper into depression than I had ever been.

Let's jump ahead to a few months ago. Barely working, I'm just hardly making any money to scrape by. Toledo itself is kind of a depressing place--essentially a wannabe Detroit. I felt the worse I have ever felt in my life. I spent several hours at work dwelling on how much I hate my life and everything in it. I even developed petty and unjustified anger at my wife. My thoughts grew increasingly morbid. I was never quite suicidal, but I often thought “if I were to die right now, I don't think I'd really care that much.” Things came to a boiling head right around Halloween. The seasonal question of “What would you do in a zombie apocalypse?” prompted me to answer  that I'd “put a hose from the exhaust pipe into the car and say good night to the world.” 

It's a joke originally, but the fact that I had figured out how to kill myself was startling and frightening. Things went downhill from there. With “Someone to Pull the Trigger”* on constant repeat, it eventually came to a point where I don't get out of bed for an entire day. My wife, concerned, asks me what's wrong, and I can only answer that I am “just to scared” to get out of bed. I'm falling into Brian Wilson territory (except for, you know, the genius talent).

Then... a twist...

While searching Craigslist yet again for a new job, I came across an ad from the Ohio Center for Neurology and Neuroscience. They were looking for test subjects--people suffering from long-term depression--to test a new drug. They offered free psychological evaluations, and if accepted into the study, I'd get free medication plus several months of free follow-up care.  They'd also pay me for my time. I figured I had nothing to lose by signing up.

After a few weeks and a couple of evaluations by both physicians and  psychologists, I was accepted into the study. I had never been on medication before, so they put me on Celexa (which also happens to be the same medication some of my family is on, to great effect). My doctors and nurse were (and still are) very friendly and supportive. I come into the office about once a week for evaluation.

In a couple of weeks, the medications made a notable difference. Morbid thoughts are gone, as is much of my anxiety. I don't get senselessly angry any more either. Celexa really is a "mood-leveler." My performance at work makes an immediate improvement, too.

There were a couple of drawbacks. For one, I grew incredibly tired. If left to my own devices, I'd often sleep 10 hours a night, plus extra naps in the day. More distressingly, while medication means I no longer dwell on all the bad things (real or imagined) in my life, I also don't care about the good things either--all the things I used to enjoy. Between fatigue and a medically-dulled sense of interest, it is so very, very hard to motivate myself. The drugs have made me just not care (and I don't like feeling that way).

Case in point... I haven't picked up a drawing pencil in, like, three months.

It's a trade off I've heard of a lot with depression. You no longer want to die, but you don't want to do anything else, either.

So let's take one more jump to the present. The doctor in charge of the medical study (who I refer to as my “brain-care specialist”) isn't satisfied with the Celexa's performance. “If I were you, and this was as good as I was going to get, I wouldn't be happy with it, would you?” I agree.

Since the Celexa is performing at less than 50%, we have moved me into the actual medical study, testing a new drug called EB-1010. My doctor has great hopes for this new medication, as it apparently treats three neurotransmitters at once. There were a lot of big words, and I'm an artist, not a chemist.

EB-1010 is not approved by the FDA yet, which is what this part of the study is about. We get to document its effectiveness and any side effects. I visit the office every week, and I have my nurse's 24-hour phone number, so I am confident that they have my best interests at heart. I have always been trusting of doctors and scientists.

It's a double-blind study, so the pills I'm taking now are unlabelled. There's even odds that I could be taking EB-1010, Paroxetine (a common and effective anti-depressant), or a placebo. I've only just started the new mystery pills this week, so it's too early to see how effective they will be.

Worst case scenario, I crash hard and wind up worse than I was a few months ago.

Best case scenario, I develop amazing superpowers from the experimental drug.

I'm hoping for somewhere in the middle.

So there it is. It took me many years, and I had to become a human lab rat, but I am finally getting help. So far, things have been improving, but I still have a ways to go. After the test is over and I am off the study medications, I will get six months of free psychological therapy. The Neurology Center will also help me get a therapist for continuing care. I am on the long road to healing.

I am so thankful for the caring people In my life. My family has been very supportive, and we spent a good chunk of the holiday season bonding over therapist and medication stories. Thank you to my friends, both local and world-wide. I especially want to thank the wonderful people at Hex Games for continuing to be my friends, even after I have let all of my responsibilities slide.

I hope this new blog will help me in the healing process. If nothing else, I hope it helps explain my behavior over the past couple of years.

Thank you, everyone, for being my friends.

*Don't blame Matthew Sweet, that's actually a great song.