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Difficulty judging the degree of my illness.


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So I've been put on 20mg citalopram a day by my doc for anxiety and depression. This is my first time using medication and the first time I've ever really been considered "clinically depressed".

I find it hard, probably in part due to my anxiety, to guage how ill I am. I deliberate over filling out those "how depressed are you" forms because I don't want to give the wrong impression.. but neither do I want to underestimate how I'm feeling. I think about suicide.... but not as a solution... it is more of something that I'm forced to think about by my situation. When suicide is talked about in all depression articles and videos that I look at I can't help but think about it. I consider what it is... whether it is a valuable thought... and whether I would do such a thing. I don't think about it BECAUSE i am thinking of doing it... but I think about it purely because there is nothing in life that I don't think about. So then my anxiety kicks in.... and I think, "oh god, is this suicidal ideation? am I going to lose control and have an unbearable urge to end it all?! should this be adressed? or maybe this problem is just anxiety...". So is that suicidal ideation? I mean I'm depressed.. ofcourse I'm going to think dark thoughts... but is it suicidal ideation if I'm not seeing it as an option that I want to take?

I want to know if I'm dangerously close to a line that once crossed will be impossible to climb out of... or if I'm just mildly depressed. The nature of my obsessive and intrusive thoughts/anxiety means that I really have no solid idea. Sometimes I feel like I'm on the brink of insanity and sometimes I feel like I might not even be depressed.

I've been on and off depressed for the last 4 years. Triggered by the death of my gran and perpetuated by lack of achievement due to social anxiety. Winter is always far worse.... to the point where, in the summer, I kind of forget that I can get depressed because I'm so content. I spend days in the house without leaving. Ocassionaly I medicate with copious amounts of alcohol (but none since new years eve) and have the odd outing with a friend or two. I can go for 2 weeks without showering... days without doing my teeth. I research existential and nihilistic philosophy.... and although I'm trying to overcome these and have a more optomistic outlook on life they are always playing at the back of my mind, undermining my relations and achievements. I'm self destructive in other words. A massive over-thinker. My mind is my worst enemy. Everything culminated on new years eve when I ingested, for the first time, a large amount of ecstasy. I'd never felt love like it... and peace and harmony. I told my friends all the most cringy gooey stuff and hugged them all all night. The comedown triggered my pre-existing anxiety and I was seriously fucked up and disociated for 10 days. Then I cleared up and felt manic for a week... then back down.. then up then down... and then I stayed down and here I am. The product of mild depressive episodes over 4 years culminating in a constant state of some kind of depression and a panic attack every 3-4 days. I suppose it all hapened slowly... and it was never so bad that I felt compelled to really sort my life out.. until it was too late. I realise that it's kind of hard to assess my depression from all this though.. hmmmm

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Everything culminated on new years eve when I ingested, for the first time, a large amount of ecstasy. I'd never felt love like it... and peace and harmony. I told my friends all the most cringy gooey stuff and hugged them all all night. The comedown triggered my pre-existing anxiety and I was seriously fucked up and disociated for 10 days. Then I cleared up and felt manic for a week... then back down.. then up then down... and then I stayed down and here I am. The product of mild depressive episodes over 4 years culminating in a constant state of some kind of depression and a panic attack every 3-4 days. I suppose it all hapened slowly... and it was never so bad that I felt compelled to really sort my life out.. until it was too late. I realise that it's kind of hard to assess my depression from all this though.. hmmmm

Yes, it is difficult to judge your own state when you're in it. I always have trouble filling out those forms too.

Are you seeing a general practice doctor or a psychiatrist? Keep track of anything that might be a symptom, and keep in touch with your doctor. If you haven't already told your doctor about details such as the use of ecstasy, the dissociation, and the "manic" feelings, tell him/her next time. Also let your doctor know if you have any surprising effects from the new medication.

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Everything culminated on new years eve when I ingested, for the first time, a large amount of ecstasy. I'd never felt love like it... and peace and harmony. I told my friends all the most cringy gooey stuff and hugged them all all night. The comedown triggered my pre-existing anxiety and I was seriously fucked up and disociated for 10 days. Then I cleared up and felt manic for a week... then back down.. then up then down... and then I stayed down and here I am. The product of mild depressive episodes over 4 years culminating in a constant state of some kind of depression and a panic attack every 3-4 days. I suppose it all hapened slowly... and it was never so bad that I felt compelled to really sort my life out.. until it was too late. I realise that it's kind of hard to assess my depression from all this though.. hmmmm

Yes, it is difficult to judge your own state when you're in it. Did you tell your doctor about the ecstasy, the dissociation, and the "manic" feelings too? Are you seeing a general practice doctor or a psychiatrist?

When I use the word dissociation I mean like depersonalization, that is right yeh? Anyway it was a 24/7 feeling of anxiety, drowsiness, dettachment and blurryness. By manic.. i guess i don't mean it in the bi-polar sense exactly but I just felt very energetic and positive and a tad dizzy with it... partly because of the triumph over the long depersonalization.

I went to see her (GP) because of the anxiety/depersonalization and told her all about the ecstasy. I'd say that when the anxiety really hit during that week I was almost psychotic. I have gotten over that "eiposde" though... but it probably helped to seal the deal with my pre existing anxiety/depression.

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Soundclash...reading this was a bit eerie for me. Apart from the ecstasy experiment, you could be describing the way I've felt for the last twelve years, from the depersonalization to the constant, intrusive anxiety and self-doubt. Even when I felt really bad, I would ask myself if I was sure I hadn't just talked myself into these feelings, like a hypochondriac. It's been strange for me to finally seek outside help, because absolutely no professional I've talked to has had the least doubt I am, indeed, depressed, and depersonalizing to cope with both it and the anxiety it engenders. I am coming to think that perhaps part of the point of professional help is precisely that objectivity. Having someone to see what's going on and recognize it when I can't.

I've been on Celexa for a couple of weeks now, and so far I've noticed only mild side effects. It does give me vertigo, but according to the doc that's an uncommon one. I haven't begun to feel any "better" yet either, though.

As far as suicide, I think docs tend to take even idle thoughts seriously, because after awhile those thoughts can start to become true for the person thinking them. Even if you aren't considering suicide, or have dismissed it as an option, I would still tell your doc. Have you got access to therapy? That might also be of benefit; I'm no expert, but I think the treatments for depersonalization are mostly behavioral.

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Guest Vapourware

To be honest, does it matter to gauge how "depressed" you're feeling? If you are depressed, then you are depressed. The lines that mark the level of depression that you're in when you do those tests are more to gauge how to treat you then to put you into a box saying that you belong to this or that level of depression.

That being said, it's good that you're seeing a GP and told them about your experiences. You might also benefit from seeing a therapist.

I would imagine the anti-depressant that you are on is intended to lift your baseline mood to something less depressed. If you notice a sharp increase in mood, then tell your GP.

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It sounds like when you are depressed, it's not mild at all. The severity of a depressive episode is gauged more on the whole spectrum of symptoms and their effect on your ability to function and quality, rather than just suicidal ideation. Also, thoughts about death and morbid thoughts check the box on that particular. Suicidal plans/ intentions mean that symptom is severe but not having plans/intent doesn't necessary mean youre less depressed. Different people experience the symptoms of depression in a different balance. Yes the severity of each symptom is relevant but it's the severity of the symptoms as a whole that gauge the severity of illness. Also, on those depression questionnaires the best way to answer honest is just go through it quickly and choose the answer without thinking to much about it. Don't second guess yourself.

I hope this has made sense. Just a disclaimer: I'm not a healthcare professional. I'm just a high school dropout who remembers some stuff his doctors have said ;)

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