[Edited 3/28/22 to add: I pulled this up to link back to it recently and I realized it has the order of events reversed. I’m not sure how I made this error, but I seem to say below that I started the Prozac after the auditory hallucinations, and I know that’s incorrect. I started the Prozac in late November 1991 and the hallucinations started shortly after that. They were at their worst in mid-January 1992, and then they receded. At the time I wrote this in 2012, I didn’t know that hallucinations are a possible side effect of Prozac; I believe I’ve only learned that in the past decade. In 1992, when these events happened, none of the psychiatrists or psychologists I saw mentioned it to me either. I usually correct small errors here without a comment, but this would require such an overhaul of the post that I’m placing this introductory note instead. Is this mistaken remembrance down to brain fog in 2012? I really don’t know.]
The middle of winter marks a mixed bag of anniversaries for me. I’ve always been a bit – well, nostalgic isn’t the right word here. I’ve always marked anniversaries, as a way, I guess, to measure where I’ve been and where I am. So at this point I’ve been bedridden for four years (okay, I’m ready to graduate already) and a vegetarian for 21 (V8 and vodka all around!).
And today marks the 20th anniversary of an important event in one of the darkest periods of my life.
Twenty years ago today I was hospitalized for depression.
I think some people might not want to talk about something like this. However, it was impressed upon me from an early age that it was perfectly normal to seek mental health care – getting help for those sorts of problems had no more stigma in my family than getting it for physical ones. So admitting that I’ve been a psychiatric inpatient has never bothered me.
In January 1992, I was in 11th grade. The school system I grew up in is a large and well-regarded one, and there was a lot of pressure to do well. For my all-important junior year (if you don’t do well junior year, you won’t get into a good college, and if you don’t get into a good college, you fail at life), I’d ratcheted up my schedule a notch so that all my academics were honors or AP classes. And by the end of the fall, I was totally overwhelmed – and totally depressed.
(There was a guy involved in this, too, but we’ll leave him out of it for his privacy’s sake. And, well, okay, for my privacy’s sake too. I know, I’m usually totally willing to tell the whole internet my business, but I’m leaving that part out. Honestly, that’s the only part of this that’s embarrassing. To be diagnosed with major depression? Fine. To be depressed (partially) over a guy? Mortifying.)
Anyway, I’ve forgotten a lot of things about high school, fortunately or unfortunately, but let me tell you, I remember exactly what it was like to be that depressed. It was, as you’d expect, complete misery.
To be that depressed – the way I described it, at the time, was that it was like having emotional mono.
I’d had friends with mono by that point, and that really was what it reminded me of most, because the depression left me overwhelmingly exhausted much of the time. Before that winter, I’d had no idea that mental illness could be so physical. Everything was a titanic effort. Trying to ford the constant tide of sadness to get done the things I was supposed to be doing was almost impossible, and the less I accomplished, the more hopeless I felt.
There were many days when I woke up and couldn’t force myself out of bed. My limbs wouldn’t obey me, and I would lie there watching the sun and shadows slide across the room until dinnertime. I didn’t much care what happened in the world outside, anyway – I was trying so hard to merely keep afloat that I didn’t have any energy left to do so.
In addition to the tiredness, I felt like my skin had been peeled off and I was walking around as one big raw mass of exposed nerves. Emotionally, everything hurt, all the time. Going out into the world was one unbearable wound after another, and I would just try to endure it until I could go home and fall apart again.
But even retreating from the world wasn’t enough sometimes, because the littlest thing would throw me into floods of tears. I remember one particular afternoon I was cleaning my room and tripped over the phone cord. The sudden startle of it set me crying – and I slumped down on my bed and cried for the rest of the afternoon.
The depression was so bad that I started to have auditory hallucinations, first when going to sleep at night, and then increasingly during the day. On Monday morning, January 13th, 1992, at the beginning of drama class, I stopped being able to keep the voices at bay, and I collapsed into a breakdown. And that was the point at which my really good shrink decided that it was time for me to be hospitalized for a bit.
Thank heavens for a really good shrink, and for prescription antidepressants.
I went on Prozac, which was the miracle drug of the era. If you’ve never been on an antidepressant, being on one doesn’t make you suddenly happy. What it does do is take away that terrible raw feeling, and it replaces it with numbness. I’ve always described it as like living in one of those balls you put hamsters in to let them get some exercise outside their cage. You put them in it, and they go roll roll roll bonk into one wall, and then roll roll roll roll roll roll roll roll bonk into another wall. You’re at a bit of remove from the world, and you don’t really feel much of anything, but when you’re really depressed, that’s better that feeling everything, too much, all the time.
Thankfully, a few weeks in the hospital and getting established on Prozac gave me enough improvement that the hallucinations receded and I started managing a little better. I dropped a couple classes I didn’t need the credits in and converted that time into a personal study hall, trying to catch up on all the work I’d fallen behind on. At the end of the school year I passed all but one of my classes. (Algebra II Honors. Why on earth did I take honors math? I should have known myself better than that.)
I stayed on Prozac for a couple years, but that year proved to be the worst of the depression. I wasn’t really sure whether I was going to need Prozac permanently or not. I think I dropped it my sophomore year of college, and I’ve never felt a need for it since.
I actually have rambled on and on here telling this story for a reason.
When I first fell ill with ME/CFS, the first internist that I saw – who came well-recommended – listened to my litany of sudden, out-of-the-blue health weirdness, and when I finished, offered me a prescription for an antidepressant. I remember bristling at the suggestion.
“How is that supposed to help?” I said. “I’m not depressed. I’ve been depressed. I know what it’s like to be depressed enough to need medication. This is not depression.”
She looked at me blankly. She didn’t answer. She had no other treatment ideas. I never went back to her.
I try to give that doctor the benefit of the doubt. Faced with a young woman with a (long-ago) history of depression marked down on her chart, who’s tired all the time and is having trouble doing the things she needs to do, I can forgive her assumption. She did brush off my long list of bizarre physical symptoms, but it’s not the worst that a doctor’s treated me in the years I’ve had this disease.
The difference, though, the big difference, the gulf of difference between tiredness from depression and tiredness from a physical illness, any physical illness, which is pretty easy to discern, is the presence or absence of anhedonia – lack of pleasure from activities usually found enjoyable. This is what every person who’s experienced both depression and ME/CFS, and every doctor who knows anything about both will tell you.
When I was depressed, I didn’t want to do anything. Nothing sounded appealing. Nothing was fun. I mostly just wanted to be left alone with my (depressing, hopeless) thoughts. But if you asked me, presently, what I’d like to do if I woke up one morning and was miraculously feeling better – well, I’d run out of energy to talk before I would run out of things that I’d like to do. (I actually answered this question on my pre-No Poster Girl formspring account.)
Is it depressing to be sick all the time? Sure it is. But just because I’m sick all the time doesn’t mean I’m depressed all the time, or even often. While of course I’d rather be well, I’ve gotten about as used to being this sick as one can, and I do my best to enjoy myself within my abilities.
But maybe that’s all the sedating antidepressants I take to help me sleep talking.