The most frustrating thing about having depression is that you can never get a straight answer to any question. Even the simple questions like, "Am I actually depressed?" or "How long have you been depressed?" can take entire therapy sessions to answer. The hard questions, ones like, "What are we going to do to treat this illness" take years.
This dearth of straight answers regarding mood disorders and mental illness exists for several reasons: psychology and psychiatry are sort-of soft sciences and therefore are constantly evolving, thanks to new technology our understanding of the brain is increasing and changing methodology, people are being more honest and that changes things too. The biggest reason, though, in my mind, is a hard truth: the answers are never straightforward because, well, there are no answers.
When it comes to the hard questions--the one that has been plaguing me most recently is "how am I supposed to deal with this for the rest of my life?"--there are no answers. At least not any that anyone knows. Not your therapist, not your doctor, not even you.
Case in point: this last weekend.
I took the last pill in my cymbalta bottle early Saturday morning. I was on my way to the temple--we always try to go in the morning so that we can get into a session without having to wait--and had to drop my kids off at the sitter so I didn't even notice it was my last. The next day was Sunday and it was then that I realized I needed a refill. I figured I was doing well enough that missing one day wouldn't hurt. Then came Monday morning with all its usual busy-ness and some lovely warm weather. I was completely energized by the sunshine and set about deep cleaning my kitchen. I cleaned all morning, skipped my nap and got some work done, and played with the kids the rest of the afternoon. I didn't realize I'd missed another pill until after Family Night. Tuesday morning (yesterday morning) I called the pharmacy first thing and picked up my refill as I left for storytime with my kids. I swallowed the cymbalta as I drove and prided myself on managing my life so well.
That good feeling disappeared about thirty minutes after I took my pill. As I loaded my kiddos back into the car after storytime I found myself swooning. While driving I felt like my eyes were disconnected from my hands and I wondered if it was actually me controlling the car. The disconnected feeling deepened as I picked up my oldest from school and got us all home. I tried to feed the kids lunch but I couldn't focus. My mind felt like a scratched DVD, skipping from scene to scene. I was sweating furiously and nauseous. I ate a third of a container of ice cream and felt a little better. I could focus enough to get everyone fed and settled down for quiet time. Then I crashed.
My oldest woke me up when her movie was done. My brain felt more stable and smooth but my limbs felt too heavy to lift. There was a lot of housework to be done but all I could manage was sitting outside while my kids played. After an hour or so I got up and made a little dinner. Then I mustered my energy and headed off to Enrichment.
After Enrichment I crashed again, but this time it wasn't my body it was my mood. I was so depressed. I felt awful. Every time my husband tried to talk to me it took a lot of effort to avoid crying or yelling. Finally I just went to bed cursing the medicine and cursing the mood disorder that makes the medicine necessary.
This morning I took my pill and my body feels fine but my mood is still struggling. It's like PMS except I'm not on that part of my cycle. My house is a wreck because I just don't feel up to tackling it.The little work I've done on the dishes and taking out the trash pretty much wiped me out. It's not that my body can't handle it. It's my heart and my mind. It's too much to wrap my brain around.
I was blaming the medicine until I realized that the last week has been textbook cyclothymic disorder. What if it isn't the medicine? What if it's me? What if I hadn't missed those two days of pills, would I have been more even-keeled these last few days? Or what if this is like my lexapro last summer and my body is suddenly interacting wrong with the cymbalta? What is really going on with me?
Unfortunately, those are the hard questions--the ones I'll probably never get answers to.