Thursday, January 28, 2010

Diagnosis: Major Depressive Disorder, part 3

Woke at 10:00 today. That would make for 12 hours of sleep. Still feel tired. Lots of headrushes when I stand up. Still a little shaky. Very irritable. I have popped Guy in front of a movie for the second time today because he wants desperately to go play outside (yes, the pendulum has swung) and the prospect seems overwhelming to me. I feel like Horrible Mommy.

I have accomplished several projects, cleaning and some organizing. But now I feel too annoyed to clean and organize anymore. This house is much smaller than Ed and I are used to, so when it gets messy it looks like a bomb exploded.

Appointment number two with psychiatrist is later today. Will post about that later. Maybe.

So I was going to talk about the beginning of this major depressive episode. About a month after Jemma died they finally finished the autopsy so we could bury her. It was probably only two or three days after we placed her in the ground that the symptoms started setting in.

The first and most prominent symptom is irritability. Actually, it is a combination of sensory overload and irritability. I'm struggling to find the words to describe it. I don't like talking when I am this way. I don't like people talking to me when I am this way. I don't know why, but it drives me crazy. When the phone rings I want to tell it to shut the fuck up. Excuse the language but I want to convey the intensity. I feel like I cannot handle the  normal amount of activity going on around me. If I am trying to concentrate on something and someone interrupts me I find it to be the most irritating thing in the world.

I don't feel that I can adequately explain this symptom. I am frustrated with myself for not being able to find the words.

The only thing I know to do when I am this way is to completely absorb myself in something. I used to read a lot of novels. Sometimes I will completely absorb myself in movies. Or paint the house. Or perfect some cooking technique. Or clean. Or work in the yard. But at some point I will get overwhelmed and pissed off with whatever I am doing and I stop. Lately I have been feeling that way a  lot, and so I will only accomplish a little of each project at a time. I will paint a little here, clean a little there, write a little on the blog. As I get overwhelmed with each project I switch to something else.

I don't want to talk to anybody when I am this way. I feel too weird It's like my brain's neurons are only able to fire for a couple seconds, and then I am not able to process information. And so in a conversation with my husband, I am able to listen to him for a couple seconds, but then I realize that I have completely zoned out and am not processing the conversation. Then I feel frustrated that I cannot concentrate on what he is saying and then feel annoyed with him for talking so much. All I can say to him is that I am not really here right now.

I am able to push these feelings aside somewhat to interact with Guy.

The next symptom is fatigue. Various degrees of fatigue, with no rhyme or reason to how I feel. I could have slept for 12 hours, like I did today, and still feel tired. There are times when my body is so heavy that I can hardly stand up without getting a headrush. It is hard for me not to fall asleep with Guy during his nap. I try very hard not to because I feel like a lazy failure when I do. And sometimes it will interfere with my ability to fall asleep at night, and so double the exhaustion the following day. And I know that no matter how much I sleep the fatigue will not go away, possibly feeling worse if I do sleep.

When I am feeling overly fatigued is usually when I eat a lot. Not that I am grossly overweight, but I am about 20-30 pounds outside of the healthy weight range. I crave very high energy foods when I am tired... ice cream, chocolate, pasta, nut butters... etc. And, if I am tired, I will typically reach for whatever is easy which typically means something high cal.

Next come various somatic complaints. Achiness all over my body. My knees hurt more and my back hurts. I feel ill. Nauseous. It was this feeling of being sick that prevented me from seeing whatever is wrong with me as depression. I had an aha moment when I read wikipedia's article on sickness behavior. I realized that I had been denying what the doctors had been telling me all along--that these various somatic complaints that had no explanation were the body's way of dealing with "depression." Evidently the body has an adaptational response to abnormal neurotransmitter levels. And so the immune system kicks in, as if there is a pathogen, trying to fight the invader off.

The most intriguing article I read regarding sickness behavior is: The malaise theory of depression: Major depressive disorder is sickness behavior and antidepressants are analgesic. The author(s) of the article are attempting to redefine major depressive disorder as sickness behavior and that the emotional aspects are secondary to the physical symptoms. As in: "I feel like shit all the time and that's why I am so emotional."

For me, I know that the frustration/irritation that I feel is directly related to the way that I am feeling. And the word "depression" to define my condition is vey misleading. The word "depression" conjures up an image of a person who is sad all the time. Except that I am not sad all the time. Yes, I am sad that Jemma died and there is a lot of guilt associated with her death. And there are days, especially premenstrually, where I am definetely overly emotional and quick to cry. But sadness is not my dominant symptom. I have many things to be happy about. To me, Guy is the most marvelous spirit on earth. I love every second I spend with him. I love my new property, my little piece of the enchanted forest with all of my wonderful animals. It's beautiful.

I think that what's happened to me is that I had so many extroardinarily stressful events happen all at the same time, creating the fight or flight respnse (AKA "stress response") and creating a wacked-out brain chemistry.

But I will say now that it is not quite that simple. I am very prone to depression. I will talk about that in a later post.

So, back to the original topic. Just after Jemma died, all of these symptoms started kicking in. And it was bad. Really really bad. Even though I've felt some of this before, there were two times when I was scared that I was seriously losing my mind.

The first was a day that Ed and I had some company over. I was trying so hard to just be normal, even though I felt so bad. The strangest thing that happened that day was that I couldn't get words out off my mouth correctly. Like my brain wasn't able to spit out the words that I wanted to say. I kept stuttering, which I have never been able to do. I would say something, then stop mid-sentence completely forgetting what I was talking about. It was so awkward. And I couldn't figure out how to form the sentences that I wanted to say.

The second incidence I recorded in a journal. It took me forever to record it but I was so scared by it that I wanted to have a record of what happened. It happened when I was trying so hard to accomplish unloading the dishwasher, but my brain had an extremely hard time recalling what every item was, what I was doing, and where everything went. It took me like an hour, maybe longer, to unload the dishwasher.

Journal entry: November 11th.
Feeling a little better today. Couldn't sleep last night but Guy and I slept in until 10 am today.
2:30. Here I go again. I felt ok until about 12. I cannot even seem to engage my son, I just plop him in front of the TV. He is desperately vying for my attention when it is off.
I am so spacey. My hand feels weak and I have to really concentrate on my thoughts--my stream-of-consciousness is all over the place and it is hard to finish sentences. And I find myself just staring off into space. I just got up to put the dishes away and looking through the rack of dishes feels overwhelming. I felt like a child, having to take things one at a time. First I have to make sense of it: pick up an object. What is it? It's a bowl. A bowl. A bowl. Where does a bowl go? The cabinet. What am I doing? Oh... yeah, putting away dishes. 'But there is garbage on the floor. Dirty laundry too. And beans that taste bad I should go give them to the chickens. I wonder if the ducks would eat it? Are the goats ok? What is Guy doing? Why am I standing here staring off into space and what is this thing in my hand? Right. I am trying to put dishes away. The bowl. It goes in the upper right cabinet. My eyeballs hurt. God, what a freak I am. This place is a fucking mess. I don't even have to work and this pace is a mess. Cry. Right. The bowl. Just put the dishes away. Don't worry about anything else. For now. Baby steps. Cry. I don't want to feel this way. Terrible guilt. Inadequate mom. wife, homemaker, caretaker. Please tell me I will be myself againry soon. Cry. The bowl goes on the shelf.


That's all for this post.


Anonymous said...

Oh Amy Dear~~ Your words have done a great job of conveying what you're going through. I'm curious to see what the doctor says. It sounds like major postpartum depression to me. I was confused by "depression" too but, you're right. It is much more complex than merely "feeling sad."

One thing I must say is that you shouldn't be hard on yourself. I know and you know that the healthy-you would have the house in order. In ten years, housework won't be that significant. It's all just stuff.

Love you, Grace

Laura said...

I send you much love.

You are good at describing things. You've always been a great writer.

I am so sorry for all this and the guilt. I would like to tell you "no reason to feel guilty" so I will and hope that a smidgen of it goes away.

Yes, I feel very guilty for not living closer so I could help with Guy, etc.

I hope you're feeling better when you read now.

Much love,

Madeline said...

I'm sending you lots of prayers and hugs. I went through a very long period of severe depression about 10 years ago. It was after my grandfather died. I can't imagine how I would deal with a miscarriage. I know your heart must be so broken right now. I hope you find peace and healing soon.

Madeline said...

Sorry, that was me up there. My gmail and my blogger account are separate and I always forget when I'm signed in on the wrong one. :)