My Depression Story

There's been a request at another blog to learn more about my story, surrounding my depression and suicide attempts. This is a sensitive topic and so be aware that this may not be appropriate for younger audiences. I'm opening up here to the public, which I've not done before, to educate, bring awareness, and fight stigma/shame, and so I only ask for a listening ear and for you to withhold judgement.

Millions of Americans, including an estimated one in five families are affected by mental illness: severe depression, schizophrenia, bipolar disorder, panic and anxiety disorders and other disorders, which disrupts a person’s thinking, feeling, mood, ability to relate to others, and daily functioning. Mental illness is a biologically based brain disease. Just as diabetes or heart disease, mental illness is a medical condition, which can result in a diminished capacity for coping with the ordinary demands of life, without treatment. I am one individual with a mental illness. I have a major depressive disorder. Here is my story.

In the fall of 2002, I began college for the first time. I had a great social life there, but was struggling with academics and having difficulty picking up on life management skills. I had began on my ADD medication in August but saw no improvement, frustrated and discourage, I gave up on it by September. Over Mid-term break in October, I felt even more sad, and very argumentative/irritable. When I arrived back from midterm break, that night I was very depressed and suicidal ideation/thoughts of cutting became overwhelming. I became frightened and sought help and started seeing a counselor. I was diagnosed by the counselor as having a major depressive episode. I dropped out of school and moved back home, which was in my best interests at the time, but I saw it as a failure.

In the fall of 2005, I decided to try college again, this time at a small community college away from home, where I got help with both life skills and my learning disability. I did better in my academics and had ups and downs with depression, but more good days than bad. Even still, I thought it might be a good idea to see a counselor at the student counseling clinic to work on contributing factors and prevent a recurrent episode. My second year I took on too many extra-curricular activities and subsequently began to struggle with my academics and my depression became worse. I immediately made an appointment to start seeing a counselor, but during the time I was seeing her, I didn't improve. Once again, I dropped out of school in January of 2005, but this time with plans to finish my degree at a later time.

In June 2005, I landed my dream job at a library, only to loose it in September and with the realization that it was a hostile work environment and I wasn't suited for the job. Loosing my job on top of my other shortcomings and personal struggles was a big blow to my self esteem and self-confidence. I had already became deeply depressed during my time I was working there (my depressive symptoms were part of the problem) and sought out a counselor (L.C.S.W.) at the local community mental health clinic.

After returning home to live with my parents, I lost my health insurance coverage because I was no longer a college student and was unable to obtain private insurance because of the depressive condition was preexisting. Anti-depressant therapy costs upward of $60-$200 depending on the medications and therapy can cost upwards of $90-150 a session. I gritted my teeth and continued to pay for my medication out of my own pockets, however therapy was out of reach. Fortunately, in the fall of 2005, I discovered our local community mental health clinic. Clinics such as these are a vital part of our community, offering vital mental health services at low-cost and sliding-fee-scale to the homeless, impoverished, uninsured, and under insured of our community. Most people with serious mental illness need medication to help control symptoms, but also rely on supportive counseling, self-help groups, assistance with housing, vocational rehabilitation, income assistance and other community services in order to achieve their highest level of recovery. At the clinic, I was able to see a therapist in addition to a nurse practitioner for medication and my medication was affordable. However, like many community mental health clinics, they are under-staffed and poorly funded, which can result in poor quality of care. In addition, persons with a mental illness are often faced with additional challenges in the workplace, in the home, and in the community due to barriers to obtaining treatment and the stigmas surrounding mental illness.

In November, I landed a new job at a small community library with the help of a family friend. In December, my counselor suggested maybe I would also benefit from medicine to help my depression and I started also seeing a nurse practitioner who prescribed a selective serotonin re-uptake inhibitor or SSRI. (Did you know, there are 40 different types of anti-depressants, every person's brain chemistry is slightly different and individuals respond differently to each medication. Usually the most effective treatment for depression is a combination of medication and therapy, but other effective treatment options include electroconvulsive therapy or ECT, vagus nerve stimulation, eye motion desensitization, and trans-cranial magnetic stimulation.) On the first night of the medication, I felt great, energetic and I even felt normal again. I started the new job at the library in January, but even with this new job going well, I couldn't help but think about my past failures and I self-doubt my abilities. Eventually my doubts began to play like a tape in my head over and over enough to where I started believing myself to be a failure. I had quit taking my anti-depressant after running out (due to side effects) and with the self-doubts and biological influence, I began a downward spiral. (I can honestly say that during this time, I didn't understand my illness very well).

On January 23rd, 2006 I made my first suicide attempt, while my parents were out of town. My boyfriend found me and his parents took me to the hospital, where I received intensive medical treatment. I was held over night in the ICU and saw a psychologist from the hospital in the morning, who evaluated me and said it was ok to send me home.

After that experience, my parents took precautions such as checking with me every day for the first couple of weeks and ensuring my safety. At the time, I was in counseling and had been for 4 months. For personal reasons, I did decided to stop seeing the counselor, but continued to see the CNP. She not only administers medication, but can also help me track my depressive symptoms and progress. She seems to better understand what I'm going through and be in tune with me.

I was still able to continue to work afterwords and my supervisor has been wonderfully understanding that I was in the hospital and even allowed me to even make up the hours. In February, my nurse practitioner emphasized the need for me to continue therapy and I found a new counselor at a student practicum clinic, through the local teaching college. And for a while, with my CNP's ok, I tried St. John's Wort, an herbal supplement for treating mild to moderate depression as well as more frequently exercise and light therapy. But I didn't take the St. John's Wort consistently enough for it to have a strong-enough effect, so my CNP and I decided to try prescription anti-depressants again, this time another SSRI. I was still having major depressive episodes and more frequently, now at least once a month, sometimes with suicidal ideation.

My new therapist did some diagnostic testing (MMPI-2) and I was diagnosed as having major depressive episodes. This was a huge relief for me, because now I had an official name to what I was experiencing and it was more concrete to me. I started out on the lowest dose possible of the SSRI, but it wasn't reliving any of the symptoms and at the therapeutic level, made me feel heavily sedated. I became physically and mentally tired of constantly fighting depression, frustrated and discouraged. In hopelessness and despair, and impulsiveness, I made my second suicide attempt in May 2006, just over two months after my last.

Early Wednesday afternoon (May 10th), I attempted to reach my CNP to schedule an appointment to discuss increasing the dose of my med because I wasn't seeing any changes and I was concerned about how bad I was feeling. Instead I was given to her nurse aide and told her that I was feeling suicidal, but they weren't able to get me in sooner (because of our conflicting schedules), so she asked me to come in during their walk-in hours, which would be in 2 days. Well, in retrospective, I don't think the nurse aide understood the severity of the situation and because I was having suicidal thoughts, I should of called their hotline instead. I got worse over the next 24 hours. I left work early that afternoon, telling a co-worker I was feeling ill. I went to my boyfriend's apartment, knowing that he's out of town and in desperation and hopelessness, overdosed again, this time on any medication I could find. I then laid down on the couch and while waiting for the end, asked God for forgiveness (I think divine intervention is what kept me alive). My mom called my cell phone around 4 hours later, worried that I hadn't returned home. After talking to me on the phone, she could tell something was wrong and immediately came over. Seeing the condition I was in, took me to the hospital. I was held overnight in the ICU at the hospital for observation and my boyfriend stayed with me. The next day, I was medically healthy enough to be released home. A hospital psychologist came in to speak with me and I was glad to see it was the kind psychologist who'd seen me before in ICU. Following the evaluation, when it came to time for him to ask me what I wanted to do, I was willing to be committed to the psychiatric medical center in the same hospital, which was operated by the community mental health clinic. My commitment was voluntary and would last 72 hrs, then we'd decide where to go from there. It was a very safe and non-threatening environment. I was on an adult acute treatment unit, where the majority of the patients had mood disorders. Also, it was nothing like what is portrayed in the movie "One Flew Over The Cuckoo's Nest," but rather it looked like a floor of a college dormitory, complete with single and double occupancy dorm rooms, a nurse's station, a small laundry room, and a lounge where we could watch TV, do activities, and have our meals. Going to the psychiatric medical center helped and it was a chance to get my medication dosage just right. I had an awesome psychiatrist there who used analogies and spoke at our level. He was really kind. Also I saw a clinical social worker, who I knew from karate class and she's really nice and got me taken care of.

Initially after I got out of the hospital, I struggled with depressive symptoms. I did attend the follow up appointments scheduled for me in the hospital as well as went to an appointment with my counselor at the University. During that time, I made some breakthroughs in a couple of issues in therapy. Also, 3 weeks later I had another appointment with my nurse practitioner and we made some adjustments and tried different medication combinations over the next several weeks. My boyfriend and a couple of close friends who know had been really supportive and encouraging. As for my parents, well there were supportive, but were having a hard time trusting me, understandably.

I stayed on an SSRI for about 5 weeks consistently, but didn't see any improvements and at my last couple of appointments with my CNP, my depressive symptoms were marked as worse. In addition to depressive symptoms, I was having difficulty with my ADD as well and my work performance was suffering. Also, in early July, I'd been depressed and one morning felt especially depressed, sleeping most of the day. But, went from depressed to hypo-manic that day, where I impulsively chopped my hair and my thoughts and speech were racing. I had a therapy appointment that day, where I was very antsy and couldn't sit still. The hypo-mania resolved itself back into depression the next day, but I was still experiencing what I can only describe was rapid cycling up to a couple of times a day.

My primary care doctor had taken the time to come to see me that last time I was in the hospital and seemed to have both compassion and a knowledge Eastern and Western medicine. So I went to see my primary care doctor for a second opinion on the best medication for me and diagnosis. I didn't feel like my needs were being met by my CNP, we'd run out of options and she was about to put me on lithium. After the initial consultation and reviewing the notes from the psychiatrist at the hospital, he gave me a diagnosis of major depression 1) with a genetic disposition (it runs on my dad's side of the family) and 2)aggravated by premenstrual syndrome. Based on my past history with medications interactions and depression/ADD, he recommended a new atypical anti-depressant which was supposed to work on a few different neurotransmitters (the chemicals in our brain which regulate our mood, appetite, behavior, etc). After the medication change, my moods were a lot more stable and I hadn't had any pronounced side effects, that is until I had a manic episode.

My younger sister was home and I was quite irritable that day and got into an argument with her. That evening,I went over to a friends house for dinner. At one point, after putting my friend's toddler to bed, I thought I'd heard her crying, but when I went in to check on her, she was just fine and quietly laying in bed. My friend asked me then if I was hearing things and manic and I told her that I didn't think so. But I was becoming more and more hyper and antsy as the night went on. Also, my friend, who was had anxiety disorder was hyper that evening as well, which didn't help. After I left my friend's house, impulsively I decided to drive an hour to go see my boyfriend as soon as he got off work, now this is 10:30 at night. I didn't care about the consequences, I didn't care if my parents were worried, it's like I'd made up my mind and got stuck in one gear. My boyfriend was pleasantly surprised, but wasn't too worried. I stayed the night there and drove back early the next morning for work. The mania resolved itself to hypomania the next day, then a stable mood the day after that. I discussed it with my mom and she recommended getting enough sleep and taking the medicine in the morning instead of evening to see if that helps and rule out minor problems before assuming its bi-polar. I was afraid it was, but the weird thing is that while major depression runs in my family, bi-polar depression does not. But for the mean time, my doctor put my on a mood stabilizer, which helped, but made me feel sedated and "out of it."

After the previously mentioned manic episode I had or whatever it was, I continued to feel worse and I talked to my counselor about my how I've been doing depression wise and we looked over my mood chart. Also, he asked questions and used reflective listening to help us understand what I was feeling. I wasn't feeling suicidal at the time, but did let him know about recent depressive/manic episodes I've had. He seemed almost skeptical that I was having manic episodes, I don't quite fit all the criteria. He advised that I review my medication with my doctor, we needed to make sure this is the right medication for me and I'm on the right dose. I went into work as normal, but continued to feel more and depressed (slowed thinking/movement, feelings of hopelessness) and by early afternoon was having suicidal thoughts. By mid afternoon, I just felt like I couldn't go on and planned on committing suicide after I got off work. But at the same time, there were times were I was better, so part of me knew I still had hope, so I went back to the break room to call my counselor. The counseling clinic was already closed for the day so I called the community mental health clinic hotline and talked to a counselor. After talking to the counselor, I called my best friend, who's been my rock and support through my depression, and asked her to come pick me up from work. I sat with my supervisor, who knows about my depression issues and understands, until S got there. My friend drove me to the hospital and stayed with me until a little while after my mom got there. My mom reassured me that I was doing the right thing. Basically, in my ER room, they took my vitals and I talked to a doctor. I was mentally out of it, groggy and slightly confused. I slept until the actual evaluation itself, which was done by a L.C.S.W. from the community mental health clinic. I groggily woke up to the sound of voices, confused and dazed. The L.C.S.W. talked with my mom and I about what was going on, medication, and my support system. She decided that I didn't need to be held overnight and we created a plan for safety, which included involving my mom more in my mental health care. Also she gave me their after-hours emergency hotline (which I of course already have) and my nurse said to come back in if anything changed or things became worse. The next day, I still felt a little depressed, but was defiantly more clear minded and more functional. I'm glad I called the hotline and went to the hospital.

Fast forward 7 months to April 2007. Once I got past the intial months of first being on the atypical anti-depressant, the hypomanic episodes decreased and eventually ceased and I eventually was taken off the mood stabilizer since I wasn't have the hypomanic episodes and the side effects outweighed the benefits. Also, I hadn't had a major depressive episode in a few months (and virtually no hypomania in around 10 months) and with my doctor's ok, I was off all meds, although continuing therapy. I was stable for the first time in over a year, engaged to be married, and had received a job promotion at the library. Life was good.

However, in May, my paternal grandmother lost her battle with a cancerous brain tumor and I began to grieve. Also, the stress of planning my wedding caught up with me. I had gone back on two atypical anti-depressants, but I've got to admit that I wasn't exactly compliant either due to side effects. I got fed up with the side constantly feeling hungry and the weight gain. I had expressed concerns about this with my general practitioner at one of my three month check-ups and pretty much felt like I wasn't taken seriously and told just to deal with it. I finally reached a point where I was fed up and frustrated and dropped the medication completely against medical advice, while still continuing the other anti-depressant in my regimen.

Then in about mid July, my mood took a downward turn very quickly and I didn't see it coming. On the day for my regular counseling appointment, I really didn't want to go, but know I needed to. My counselor immediately sensed something was up. When I told my counselor what was going on he became concerned and asked me to sign a no-self harm contract (which has been effective in the past). Well, I was set into the suicidal mindset and refused to sign a no-self-harm contract. He told me he was concerned about my safety and wouldn't let me leave until he felt I was safe. He asked if I wanted to go to the hospital and I blandly told him, "Do what ever you feel you need to do." He thought about it for a few minutes and then asked if he could speak discuss my case with his supervisor and I nodded my head yes. He told me he'd be gone for a few minutes, leaving me in the counseling room alone. About 15 minutes later he returned and told me that they would like to send me to the hospital for an evaluation. At the hospital, I was put into the same examining room I was in for my first suicide attempt, which brought back bad memories. The attending physician decided it would be best if I was hospitalized for 72 hrs observation. While I was in the hospital, they change my medication to my current medication which has worked better and I've been stable over the last 5 years.

Today, I look back at how far I've come: I've learned and improved in my coping skills, learned to be aware of how I'm feeling, learned the warning signs of when my depression is worsening, reached out for support and found some great resources as well as strength in my friends and family which I didn't know I had. The outlook for individuals with depression, who seek treatment is very promising. By working with a qualified and experienced mental health care professional, you can regain control of your life, as I have.