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Author Topic: The horrible cycle of depression
Telperion the Silver
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What do you guys do when depression hits and you still have over a week to the next therapy session and you have no family and are afraid of driving your friends away with your issues?
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Elmer's Glue
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Eat some ice cream?
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MightyCow
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Try to have fun with your friends without making it into a therapy session.
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Telperion the Silver
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What do you do if you've eaten all the icecream, and you've already driven your friends away with the therapy sessions?
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Wendybird
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Take some vitamin B, get as much sunshine as you can, put on uplifting happy music, pray (if you are the praying sort), Eat lots of fresh fruits and vegetables....

I actually went back on Prozac about 4 months ago because the depression got so bad and I wasn't able to shake it. Life has gotten a whole lot harder since then so I'm glad I did or in my depression I would have shut down.

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Shigosei
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I guess that depends on what you want to do. Take your mind off things until you can see your therapist? Try to work through it by yourself?

If you think distracting yourself might be helpful, you could read a funny or upbeat book, or watch that sort of movie. What do you enjoy doing?

If you want to work through things, perhaps you can write down what you're feeling. Or start inviting people to Hatrack chat so you have people to talk to.

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DDDaysh
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Read, sleep, go out to a store or a bookshop or somewhere just to get out of the house, play random mind numbing computer games, take benadryl and go to bed....
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rivka
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My suggestion would be to call your therapist.
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rollainm
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If you're on medication now, be sure to continue taking it as prescribed until your therapist tells you otherwise - whether you think it's working or not.

As for right now, if you're still awake, I suggest going to sleep. Try to relax. Chances are you'll feel at least a little better in the morning. If you don't, then definitely call your therapist.

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Lyrhawn
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quote:
Originally posted by Telperion the Silver:
What do you do if you've eaten all the icecream, and you've already driven your friends away with the therapy sessions?

Two things I'd do in that situation (and that I've done in situations analogous to my own life):

Go to the gym. Burn it off, work it off, exhaust it off, distract yourself. It might do nothing but burn come calories, but you might find it cathartic.

The other thing is write. I don't know if you write or not anyway, but write. Sometimes I write the equivilant of an OpEd about whatever thing in the world is bothering me, sometimes I write a fiction piece or continue work on one I've already got going. Once in awhile I'll write a journal type entry to lay it all out on paper. And once in a great while I'll create a fictional story that's 99% autobiographical but just different enough that I can look at my own life from the outside. I don't do that very often because it feels childish, but it's relaxing.

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ketchupqueen
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I like to go out for a long walk, preferably someplace with, you know, real nature.

What rivka said, too.

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ketchupqueen
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And also, if you have an urge to harm or kill yourself, please go to the ER or call 911.
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Telperion the Silver
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Yeah, but I'd lose alot of my rights as a citizen if I did that...want to keep away from the hospital as much as I can.

Thanks guys for all the advice. I wish there was a shot to cure depression once and for all.

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ketchupqueen
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quote:
Yeah, but I'd lose alot of my rights as a citizen if I did that...want to keep away from the hospital as much as I can.

If you voluntarily check yourself in you do not lose any rights. If you ever think you're really going to do it please go to the ER instead.

But yeah, I know it's much better to avoid it if you can. So do try calling your therapist.

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Telperion the Silver
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Has anyone been to the hospital for depression?
Or know anyone who's gone there?
If I did go what can I expect?

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ketchupqueen
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I'm gonna e-mail you. OK? [Smile]
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Telperion the Silver
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ok
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ketchupqueen
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sent
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Telperion the Silver
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Thanks
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ketchupqueen
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No problem. [Smile]
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katharina
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Get some exercise. The endorphins will help, and being busy will prevent you from doing other things (like overeating) that will make the depression worse.
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pooka
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While the diagnosis for seasonal affective disorder excludes being depressed at any other time, it seems to me most people with chronic depression become more depressed in the fall. I seem to recall you were a night security guard for a while, don't know if you are still doing that, but it would complicate matters a lot for you. Sleeping when it is dark and being up and about when it is light is important to staying balanced. In the fall, the darkness gets to be more of the day, but people tend to keep the same hours. And ditto the suggestion on exercise, preferably when you first get up or more than three hours before bedtime. (((Telp)))

One thing that happens if you check into a hospital is that you will generally have to stay for a minimum time period, such as 48 hours.

I don't know if it's too late with your friends, but if you can keep in mind that depression is a disease, which is why you take it to a therapist. If you had an illness in any other part of your body, you wouldn't ask your friends for suggestions. I know it's hard to remember, since it affects your social emotional system directly. But detaching from the disease, not so you can hate that part of yourself, but so you can give it proper care, would be huge. If your arm is broken, you don't think it's stupid and useless. You get a cast on it so it can mend and give it a rest. Anyway, I know it's not easy, but it's another stab at explaining how it happened in "A Beautiful Mind."

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Eaquae Legit
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I put on a movie or show that makes me laugh and smile, or read a book that does the same thing. I keep a bunch on hand for just that reason. ("Galaxy Quest" and the new BBC series "Beautiful People" are my current go-tos.)

Meanwhile, I'm not a doc and everyone else has listed better suggestions. So I'll just say I hope you feel better soon, Telp.

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scholarette
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One suggestion from a therapist to someone I know who was a bit suicidal. Before checking yourself into the hospital, check yourself into a nice hotel (like not Motel 8). The hospital stay will almost always end up costing a whole lot more then the hotel room and the hotel room is a lot pleasanter. It helps get you away from the negative stuff and you can get really pampered. Spend some time in the exercise room, the spa, eat a nice dinner out, etc. And if you ever start worrying about the cost, just remind yourself that you are saving hundreds of dollars in hospital bills. Also, set up an appt with therapist as soon as possible. So, you spend the weekend in a nice hotel and then Monday go to therapy. Of course, if at the hotel, you realize that you are still feeling an overwhelmig urge to kill yourself,then you should go to the ER.
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Brinestone
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quote:
Originally posted by scholarette:
One suggestion from a therapist to someone I know who was a bit suicidal. Before checking yourself into the hospital, check yourself into a nice hotel (like not Motel 8). The hospital stay will almost always end up costing a whole lot more then the hotel room and the hotel room is a lot pleasanter. It helps get you away from the negative stuff and you can get really pampered. Spend some time in the exercise room, the spa, eat a nice dinner out, etc. And if you ever start worrying about the cost, just remind yourself that you are saving hundreds of dollars in hospital bills. Also, set up an appt with therapist as soon as possible. So, you spend the weekend in a nice hotel and then Monday go to therapy. Of course, if at the hotel, you realize that you are still feeling an overwhelmig urge to kill yourself,then you should go to the ER.

I like this suggestion. I also liked the suggestion of going to the gym and really pushing yourself physically.
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Belle
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Call your therapist. Seriously. The ability to call them when you are really struggling is one of the things you pay him/her for. They know clients sometimes need to call on weekends or after hours - it goes with the job. And every therapist I've ever known would rather a client call them and bug them at home than suffer needlessly because they didn't want to "bother" their therapist.

Call.

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scifibum
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"And every therapist I've ever known would rather a client call them and bug them at home than suffer needlessly because they didn't want to "bother" their therapist."

I was about to quibble but I see you included the qualifier "needlessly." Depression therapy would probably not be where this happens, but sometimes therapy is about helping a person learn to have a stable relationship with appropriate boundaries, and in those cases, a therapist might insist on sticking to scheduled sessions. But, in those cases, any suffering this entails is not needless. [Smile]

Telperion: my quibble doesn't apply to your situation. You probably should call your therapist (or another qualified professional).

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T:man
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I send all my karma points to you, so life is easier for a while.
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dabbler
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I suggest increasing the visit frequency to your therapist. Weekly or even more frequently during periods of crisis can be helpful.

I wanted to give people a glimpse of an inpatient psychiatric unit. I've worked as a training psychiatrist on one for 5+ months. Heck, my overnight call responsibilities include managing any overnight issues on the psych floor as well. This is going to be from the perspective of this particular hospital, YMMV especially with regard to state laws.

On this psychiatric unit, there are about 30 patients, split on three teams. A patient has a particular nurse per shift assigned to them (who cares for about 4 patients), a social worker (10 patients), a training psychiatrist(5 patients), and an attending psychiatrist (10 patients).

Admission: "Conditional Voluntary" is a specific form of admission used for psych units. Basically, if you wish to leave Against Medical Advice, you must sign paperwork indicating such, and the treating team does not have to discharge you for three business days (weekends and holidays don't count). They can discharge you sooner, if they feel you're safe to go. You can rescind the 3 day notice if you change your mind. If they do not discharge you by the third day (due to concerns of Suicide, Homicide, or unable to care for yourself, to summarize) they must submit court paperwork to request "Commitment." Commitment for psychiatric reasons can last for a maximum of six months or until the Suicide/Homicide/unable resolves. Filing and receiving commitment is rare as far as your run of the mill psychiatric patient goes. This more often applies to people who are actively psychotic such as hearing voices to kill themselves, refusing to take their medications, etc.

An "Involuntary Admission" basically throws you into 3 day status immediately. Legally, the team has three business days to evaluate you and determine if you fall under one of the three criteria for commitment. Then they file, discharge, or convince you to sign a conditional voluntary. Rarely, the commitment leads to a psychiatric document that allows psychiatric medications to be given against your will. The reasoning behind this is that you would have wanted those meds if you were mentally sound. Another legal quirk of psychiatric hospitals is that psychiatric medications such as antipsychotics can be given against your will in "emergency" situations of high agitation, violence to the staff, uncontrolled behavior. It does happen, but usually only with patients with psychotic illnesses (bipolar d/o, schizophrenia, for example). Restraints are also a rare occurrence but still happen in psychiatric facilities. They're four point restraints and almost never last over an hour.

So what's your day like? Some mornings you may have bloodwork drawn (like a regular hospital!) for routine labwork, or checking on a medication level. Breakfast is usually in a communal space. There are two one hour groups held before lunch and two after lunch. These are sometimes centered on a particular topic (Loneliness, Anger, etc) or are more for relaxation. They're not mandatory but they're strongly recommended. At some point during the day, your social worker, psychiatrist, or even medical student will come and talk with you. The purpose is to see how you're feeling, discuss any medication changes or decisions, and future plans such as outpatient treatment. For some people this will be a short visit (15 minutes) and for others it will include some therapy (30-45 mins). The social worker helps people with places to stay, outpatient appointments, and information about resources like AA or therapy groups. Lastly, if you're at high risk to yourself or others, a staff will stay with you 24/7 to help keep you safe.

The average length of stay at my psych hospital is about 4-5 days. About ten years ago, I think it was more like 3 weeks, and about 20 years ago, probably a couple months. Insurance has played a large role in this. The focus of inpatient treatment is Risk Risk Risk. We're supposed to stabilize and send home. It's really a shame, because medications can't take full effect in that time. But as pointed out, it can be very expensive to be at hospital level of care.

I'm sorry if any of this frightens people (especially involuntary medications and restraints). Ask any specific questions if you'd like. I'm at the hospital all night...

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dabbler
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Oh I didn't add that my unit is a locked unit, as are most psychiatric hospitals. I know that Dartmouth's psych floor is unlocked which is unusual.

Austen Riggs is a fascinating place where I spent a month training. They're an unlocked facility, more of a college campus in feel. Patients undergo intensive psychodynamic therapy (four one hour sessions a week) and "examined community living" which means that almost any action or statement by yourself in the community of staff and patients is relevant to your treatment. Their average length of stay is 6-9 months (!).

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Tatiana
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Telperion, I want to reinforce the advice people have given you. You know that depression and suicidal feelings are a vicious cycle. Set about to generate an opposite cycle to combat them. If you still work that night job, call in sick and do whatever you can to find a day job as soon as you feel well enough. Night jobs are death to those of us with this temperment. Remember that fall is the absolute worst time of year. Remember that if you can wait it out, it DOES get better, contrary to how you're probably feeling right now. It really does get better.

Reach out to anyone who will listen. It's quite common for depressed people to lose all their friends. It's not a reflection on you. It's this disease you have. The disease is extremely treatable.

Exercise makes it much better. Run hard intervals until you drop, or swim laps to exhaustion. Aerobic seems to work best for some reason, but lifting weights, doing pushups, chin ups, yoga, anything that gives you a total workout and leaves you exhausted will help.

Sunshine works a whole lot. Go outside for at least an hour a day during daylight hours, even if it's a cloudy day, even if it's early morning or late afternoon. Our eyes adjust so we don't really realize how very much more light there is outside than in. It's huge. The corollary to this is let it be very dark at night. If there are lights outside your window when you're trying to sleep, block them out. If there are lots of LEDs in your room at night, block them off in some way. I look around the room and there are three devices here that have lights burning. In my living room there are probably a dozen, including various power strips and things. Cover them all up in the room where you're trying to sleep. Even a small amount of light can mess up your circadian rhythms and that can cause depression.

Realize that you ARE strong enough to get through this, and it's going to be an experience that you'll be glad you've had someday. You'll be able to do something you wouldn't have been able to do otherwise, because you've lived through this. You'll be able to help someone you might not have been able to help, or understand something you might not have been able to understand. It's not meaningless suffering, even though it can and should be alleviated as soon as possible.

In the end, and if there's nothing else you can do, just breathe in and out. That's all that's required of you right now. Just keep breathing. You can do that. You can continue to breathe. We care about you. You will get through this. You are a worthy, good person. You are loved.

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BannaOj
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*hugs telp*
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Christine
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I wish I had the words to snap you out of this, but from personal experience I know better. Also from personal experience, I know things can get better. The fact that you are seeking professional help is a very positive first step. Of course, therapy is usually about an hour a week (you should be going at least once a week, from the sounds of it) and there are 167 other hours in the week to get through, so next time you go to therapy, talk about strategies for getting through the other hours. There are a lot of good suggestions here, but everybody's triggers are a bit different. This takes time to work. You can't break this vicious cycle tomorrow. But maybe tomorrow you can make yourself laugh once, and that can be progress.

Anyway, you're not alone. [Smile]

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Goody Scrivener
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I'm glad I stuck my nose into this thread. I'm going through a down spot myself, mostly situational after having been terminated from a job I held for 7 years. I'm going to try out some of these ideas!!
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The Rabbit
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Tatiana gives excellent advice. Our bodies are designed for certain patterns that include physical exercise, being outside during daylight hours and sleeping when its dark. I think one of the reasons depression has become so rampant in our modern society is that we too frequently depart from these patterns which throws our natural biochemistry out of balance.

The only thing I would add to what she said is to pay careful attention to nutrition. Eat regular meals and eat lots of fresh fruits, vegetables and whole grains. When you are depressed, you may not feel like eating or cooking so skip meals and then snack on junk food.

One of the ironic things about depression is that it makes you want to do all the wrong things. You're depressed so you don't get out ant do things. You're depressed so you can't sleep well at night and then end up lying in bed during daylight hours. You're depressed so you don't feel like socializing, when you do interact with people you drive them away with your negativity and hostility. You're depressed so you stop eating right, stop doing all the things you enjoy, stop being productive, stop everything that would help you get through the depression. That's at least part of what makes depression such a vicious cycle. To break that cycle, you have to consciously recognize this and fight it. You have to force yourself to do the right things even when every fiber of your being is resisting.

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Xaposert
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Go help somebody... volunteer an hour of your time to do something you think is important... go donate money to something important... do something you consider productive, even if it is a small thing.
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Paul Goldner
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Things that help me deal with my depression:
Exercise. Even in small doses. Where I am in northern massachusetts, we're deep into fall. But this weekend every day I went for an hour long walk around my neighborhood. I got the exercise, sunshine, some exposure to natural beauty. All of these are very helpful in combatting my depression. If I get outdoors for an hour a day 4 times a week, I feel a LOT better about myself.

I cook. Usually something new. Doesn't have to be exciting, but new. Cooking a full meal takes 30 minutes to an hour. And if its a new meal, that I had to go hunting to figure out how to make, at the end I feel productive, and then I get a well balanced meal. This provides productivity, healtful eating, and an outlet for my creativity, as well as being something I enjoy.

Cleaing, or other minor household chores. If I put in 20-30 minutes of making my house look better, its a big deal. My depression is fed by feeling unproductive. When I look into the kitchen, and see a big stack of dirty dishes, or my table has a pile of papers and magazines and envelopes, or my bedroom has a pile of dirty clothes, FIXING that makes me feel productive, and happier in my space.

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The Pixiest
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quote:

So what's your day like? Some mornings you may have bloodwork drawn (like a regular hospital!) for routine labwork, or checking on a medication level. Breakfast is usually in a communal space. There are two one hour groups held before lunch and two after lunch.

Communal living, huh? If I wasn't suicidal before I would certainly be suicidal afterwards.

quote:

The social worker helps people with places to stay, outpatient appointments, and information about resources like AA or therapy groups.

Social Workers, huh? There's not enough torment in hell for what those people deserve. I could start another thread if anyone wants to discuss why, but it would probably violate the terms of service.


Telp: Sleep always helps me when things are at their darkest. Life is almost always brighter in the morning.

What do you do to pass the time?

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Epictetus
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I feel for you. When I get depressed, I usually have a few things that I do:

1. Do something I've been putting off for a while, like doing the dishes or drawing a picture.

2. I write a line of conciousness. Write whatever is going through your head as fast as you can, don't worry about punctuation, handwriting, or spelling. I usually try to write at least two pages, then I close my notebook and never read it (at least for six months or so.)

3. Write what I call a thought correction page (I read it in a self help book at one point and I can't remember what it's called right now) Basically, I divide a piece of paper into two columns, then in the first column, I write down any thoughts that come into my head. In the other column I respond to them with either a logical statement or a positive affirmation. For example, I might write "My work performance is slipping, I'm a horrible person," in the second column I'd write "Nobody's perfect at their job all the time. I've got a lot going on in my life right now, so what if my work is taking a backseat for a little while? Making priorities doesn't make me a horrible person."


Things I try to avoid while I'm depressed include:

1. Playing xbox all day.

2. Sitting at home doing nothing.

3. Avoiding work or my friends.

4. Eating a lot of fast food.

These usually provide a temporary distraction for me, but they never solve the problem.

Good luck dude, I'm pulling for you.

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TomDavidson
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quote:
Social Workers, huh? There's not enough torment in hell for what those people deserve.
You might not want to generalize this. My sister-in-law's a social worker. She puts in 10 hours a day, and volunteers another eight hours a week.
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The Pixiest
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Tom: Yes, I've met one good one out of probably 25? 30? I kinda lost count. So yeah, I'll stick with the generalization. I'm sure your S-I-L is part of the good 3% though.
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pooka
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I've got "Officer Krupke" stuck in my head now. [Wink]
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anti_maven
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Hi Telp - I can't offer much more than to repeat the wiser words of those above.

Personally, I was having a bad time at work a few months ago and going to the gym really helped me get some distance between myself and my problems. I would recommend joining a class of some kind, especially one with a ruthless teacher who will push you. I found that if I was focussing on where the next breath was coming from, I couldn't be worrying about anything else.

I appreciate that work problems don't equal depression, by any stretch of the imagination, and professional help is there for a reason.

I'll be thinking of you, and I hope your load gets easier to bear.

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