Fuck my brain. I know it’s a weird thought, but there’s a very specific reason I’m saying it. For as much good as my brain does me, it seems to be stuck on these little things called anxiety and depression. Instead of making the right chemicals, apparently my brain would rather me be anxious and tired at all possible times.
With this being my first dive into the mental health arena here, I want to stress that I’m not a professional. I’m not a psychiatrist, a licensed therapist, or anything else that requires schooling and certification. I’m just a dude who lives with depression and anxiety that tries to understand it. Between reading about, attempting to comprehend, and living with these issues, I can draw my own conclusions about what helps me and how I struggle. If that helps you, I’m all for it.
More than anything, this is an outlet for me to work through my own mental health struggles and try to make sense of things by writing them down. It might turn into something else, but that’s where things stand for now.
My Dichotomy of Awareness
Awareness is something I’ve always found comfort and strength in, but it also drives a lot of my own struggles. I distinctly remember the first few times I really came to terms with my own mental health struggles. After what was probably years of ignoring the issues I didn’t want to confront, I took a page out of a stand-up comedian’s book. In one of John Mulaney’s comedy specials, he talks about an attempt to get a Xanax prescription. If you want to enjoy the bit in its entirety, have at it.
If you didn’t give it a listen, I’ll sum things up. Essentially, Mulaney talks about an attempt to get a Xanax prescription from his doctor. His plan is essentially to make an appointment about something simple, but to mention that he gets nervous on airplanes at the end of the appointment to get a Xanax prescription. Of course, the plan goes awry in the most hilarious way, but it was this “make an appointment for a different reason” ploy that I grabbed onto.
Having never really faced the concept of having depression, I wasn’t really sure how to approach the subject with my doctor. So I made an appointment for a general checkup, then near the end decided to bring up that I thought I was struggling with depression and wanted to try medication. Of course my doctor didn’t freak out or make some big fuss about it. He responded plainly as I’m sure he does to any other medical issue, and suggested we try “his favorite antidepressant.” I understood what he meant, but it still cracked me up to hear it phrased like that.
My doctor’s “favorite antidepressant” was Zoloft, which has the generic name of sertraline. According to him, it was one of the most commonly used antidepressants to start with, and often worked with about 60% of the patients who tried it. It sounded good enough to me, so I dived right in and he wrote the prescription. After getting my first ever bottle of antidepressants filled at Walgreens, I quickly delved into research mode once I was home.
Between scouring the Wikipedia page on sertraline to understand the nature of the medicine, what an SSRI is, how it worked, and googling about the experiences others had with Zoloft, I felt I’d gained a decent enough understanding to feel comfortable with this new start. It takes a few weeks for Zoloft to really enter your system and show lasting benefits, but I was open to letting it work. My medication journey had begun.
One of the first times I decided to talk to anyone about this new journey and decision was at Texas Roadhouse with a longtime friend. Over bread rolls and cinnamon butter, I brought up that I’d recently gone to the doctor. I mentioned that, after thinking about it, I’d come to the conclusion that I’d struggled for a long time with depression, anxiety, and being overly self-aware. Without missing a beat, he said “yeah” as if it wasn’t a revelation to him at all. It was as if I’d dropped what I believed to be a deep dark secret on the table only for him pull a street magic trick and toss a business card at me with that same secret I’d just “revealed” already written down. How could he have known?!
Some people might be thrown by this reaction depending on who you’re talking to, but for us it was just the kind of interaction I should have expected. It was also comforting to know that something I was barely strong enough to acknowledge at the time was no big deal to someone I trusted. If he already figured it out, and isn’t freaking out like it’s some terrible thing, maybe it’s not some terrible thing. I don’t know that I really expected anything different out of him in hindsight, but it was still a key moment in my own mental health journey.
As I’d mentioned to him, my own sense of self-awareness played a role in my issues as well. Awareness and comprehension have always felt a bit second nature to me. Trying to understand my surroundings, the way things are, acknowledge and process things happening within and around me, and answering that forever lingering “why” have always driven me. This can be a great strength as it helps me connect with others, process external factors in situations and try to think rationally about the best course of action, and simply notice things others may not.
The double-edged sword of this is that my own awareness can spiral out of my own control if I’m not careful. That awareness can morph into an irrational focus on “what might go wrong” and trigger my anxiety. I can be extremely extroverted when around close friends and those I’m most comfortable with, but an unfamiliar situation causes me to become increasingly aware of bad outcomes, embarrassing scenarios, and the dread ‘what if’s of life. This lends itself to social anxiety, and ultimately drives me to go out less and instead shut myself off to the world.
What’s the status quo?
I’m being overly general, but these are the kind of things I struggle with. My psychiatrist has said that she thinks my depression is largely byproduct of my anxiety, and that getting my anxiety under control may help pull me out of my depression. Whether it works or not, I’m certainly not opposed to the idea that learning to cope with and lessen my anxiety (with the helping hand of medication) will help everything else fall in line.
My current medication regimen seems to be working to level things out finally, and having an actual psychiatrist rather than just going on my primary care physicians guesses made a big difference. For those who are interested, I take three medications as of now: Wellbutrin 100mg/day (bupropion), Buspar 7.5mg/twice per day (buspirone), and Zoloft 75mg/day (sertraline). The Wellbutrin and Zoloft are primarily a combo for depression, where the Buspar is primarily for anxiety, but they’ve worked together for me. One of the biggest things I’ve learned about medication is that everyone’s brain chemistry is different and everyone’s brain responds differently. What works for me might not work for someone else, so it’s important to have a good psychiatrist and check in often to try something new if the current set of medications aren’t helping.
Now that I’m on a cocktail that seems to work for me, I have to stress that it hasn’t “cured” me. That’s not how depression or anxiety even work. It’s not like a cold where you take your cough medicine and some antibiotics and it disappears. It’s taken me time to come to terms with it, but this is a struggle that’s not going away. The medicine I take isn’t to make the problems go away, but to help keep them manageable. It takes my status quo, my default position, and moves it back into a normal range. Instead of starting low and having to claw my way to feeling okay, medication helps me start closer to okay and not have to expend as much energy to stay there.
Of course, there are still shitty days. There are still shitty moments. Just recently, on Mother’s Day, a small thing sent me into a spiral. Most of my friends know, but my mom passed away in 2009. That makes Mother’s Day difficult, and that’s not changing any time soon (if ever). Most of the day was okay, I did my best not to dwell on it being another Mother’s Day without my mom. I couldn’t really muster the energy for a phone call, so I texted the appropriate friends and family “Happy Mother’s Day”. Then, out of nowhere, it hit me like a freight train.
I completely fell apart, and it sucked. There I was, 7 PM, crying my eyes out on my couch despite the fact that it’s been nearly 9 years since my mother died. I felt my depression bubbling to the surface, and for the next 36 hours or so (since I didn’t have to be at work) I just burrowed into a hole on my couch. I used some good coping skills (watching comedic or fun television and movies) and some bad ones (good ol’ Depression Domino’s pizza), but I made it through that particular low point. I pulled myself back out of the fog, and I feel confident that it would have been much harder without my medicine.
So, what’s the point?
If you’ve made it this far, you’re either a good friend or really curious about my mental health ramblings. Either way, I understand this initial chunk is disorganized, and I intend to find more focus in time. I really only have two goals here. The first goal is to get my thoughts down and work my own issues. The second is to provide a glimpse into my own reality when it comes to mental health. If no one reads this, at least I accomplished the first goal. If even one person checks this out and takes something away from it, that’s icing on the cake. So, until next time…fuck my brain.