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What 'amount' of depression is acceptable?


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Not sure I can articulate this question. lol

Yesterday I was down the rabbit hole, depressed but also sad and very emotional, could not get out of bed. Did manage to play Pokemon Go at night, but that was it.

Today I worked out but came home STILL feeling sad/depressed. Went to therapy, cried the whole time, covered everything however, and afterwards I felt...fine. Stable. Went grocery shopping, cooked a meal, played with the kitties. 

I've been thinking of changing my meds, changing my therapist but....I wonder. All these decades of my functional depressive life, depression has NEVER completely gone away. Not when I was on more meds, not when I was married. Never. Ever. I AM struggling now but that is mostly due to major life changes. Been thinking of getting a CBT therapist, but I usually feel better after therapy despite the lightweight work. I am less depressed than when I was married, despite the lower does of bupropion and lack of lexapro.  And since I quit smoking pot, I am SO much more emotional. Filled to the brim with emotions. But I do not want to medicate/smoke them away. 

If I am focusing on being healthy - physically, spiritually, emotionally - is this level of depression acceptable? Do I really need to change the meds, the therapist? I realize this is a very personal decision, but I was wondering, how much of your depression do you just...accept...blunder thru...deal with....let yourself have those down the rabbit hole days. When do you stop changing up the meds, changing therapists?  

When is the amount of depression 'good enough'?

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Not even on point and perhaps insensitive, but (first of all) have you changed anything in your sig in 5 years?  Trying to remember but I think not?

Sorry, I'm just trying to remember, or test my own memory.  Because that's important to me to know if I can remember those specifics.

Edited by Will
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For me, days here and there don't even warrant mentioning to a Dr. They do get very low.

 

For me, 2 weeks to a month of utter disfunction. Then mention to a doc. 

 

I've learned that when I force myself out of the house in public. The best response to random social workers approaching and asking "Are you homeless?" Is to respond "No. Are you?"

 

But I have no job, few responsibilities. Ymmv

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The depression side of my illness is under control. Currently I can get glum due to situational things, but I wouldn’t say I get days where I can’t get out of bed and I really don’t cry very often. I’m not super happy all the time because I’m not depressed, life just sort of is what it is and I get through my days pretty neutrally.  I think that’s what I see as normal. What you describe sounds abnormal. 

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For me, the point at which depression becomes something I have to try to treat is when I can’t connect to anything or anyone. I’m autistic, so my ability to connect with individual people blows anyway, but if I lose the ability to feel compassion, and instead feel only the beating of the world’s troubles, I know it’s gone too far and I have to try something. To me this is a debilitating blow to my normal, baseline function, and I can’t endure it.

So perhaps the best way to decide if you’re suffering beyond what’s tolerable is to define what your most cherished aspect of yourself is, and say this, and no further, when you become depressed. 

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For me it's a factor of severity x time. When it continues for a long time it becomes harder to bear. Moderate depression (what I have currently) is easily tolerable for a few weeks, acceptable (to me) for several months, but past 2-3 years it isn't. I have to extrapolate for mild depression, but I think that if there was a degree of depression that was so mild I could accept it forever it wouldn't count as clinical depression.

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Thank you SO much everyone. This was wonderful to read this morning as I woke up groggy and unsure about the world to come. 

13 hours ago, Will said:

have you changed anything in your sig in 5 years

I did. I went off my meds. BAD idea. Then went back on Aplenzin only. Still haven't added lexapro back to the cocktail. It was SO hard to get off and I know added to my IBS. So, I am trying my damnedest not to use it again.

 

12 hours ago, DogMan said:

For me, days here and there don't even warrant mentioning to a Dr. They do get very low.

Thank you. Thinking of keeping track on a calendar. Of course my first thought was to write down the depressed days, but an understanding friend suggested I do the opposite, mark the good days. :-}

 

12 hours ago, saintalto said:

The depression side of my illness is under control. Currently I can get glum due to situational things, but I wouldn’t say I get days where I can’t get out of bed and I really don’t cry very often. I’m not super happy all the time because I’m not depressed, life just sort of is what it is and I get through my days pretty neutrally.  I think that’s what I see as normal. What you describe sounds abnormal. 

Situational stuff definitely does me in. I think it was a visit to my girl that triggered the episode on Tuesday.

Also, I think my normal, may be abnormal for other people. lol. I am VERY emotional. Always have been. 

 

 

11 hours ago, Gearhead said:

define what your most cherished aspect of yourself is, and say this, and no further, when you become depressed. 

What a GREAT idea. Love this. Very comforting idea. :-}

Now..I have figure out exactly where my line is, what the most cherished aspects of myself really are. 

I occasionally read thru my high school diary, with a bit of trepidation. Was shocked to discover, at age 15, I wrote,
"I am so confused. I feel both happy and sad at the same time."

 

2 hours ago, Ion said:

For me it's a factor of severity x time

Yes! Me too. How long it lasts, and how far down the rabbit hole I go. :-{

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I think what matters how much is acceptable for you? It sounds like you don't feel this is an acceptable level. I think the severity x time formula is fantastic. Many periods in my life I didn't call myself depressed because I was in absolute agony, but only 2 days a week. I was handling it because the other 5 days were ok, but if that feeling had stretched over the 7 days it would have been more than I could cope with.

CBT doesn't tend to be long term, so you could ask current tdoc what s/he thinks about you taking a break, going to CBT for half a year or so, and then going back? The decision to do that is yours of course, but it would be good to know whether or not you could go back to the same tdoc after the CBT, if this is someone you can work with.

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Yeah, water, I think I remember Lexapro as being part of your regimen now that you mention it.   I clearly remember the fine print.  Honestly, I have even googled "that's as maybe" to try and figure that out but I can't.  Seems to be a literary or rhetorical device?  Not to pry, just to show interest.

Anyway, I'm glad the responses helped.

I told my therapist today that this board is sorta a virtual hospital ward, without the amount of sensory deprivation and lack of freedom which goes with that.  And, I have made the choice during this episode (which I am coming out of now) not to be hospitalized so the board has come in handy again.  Although I am sad to see many of the "old" timers (like myself) seem to have moved on. 

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This is a question I sometimes ponder, unfortunately. I've had severe TRD for decades now so I know I'm in for more of the same. I'm constantly depressed, it's just a question of how bad. 

Anyway, to your point, I keep a mood spreadsheet with columns like OCD, depression, cognition, IBS-C (I also suffer) and a notes column for any interesting findings. The columns are rated out of 10, with 1 being the worst. I add 1 row for each day and each month is in a different spreadsheet tab. I colour code the ratings, 1 is red and 8 is green etc.

Then this gives me a good visual idea of how I'm doing and I can easily see if a dosage change or new med is working out or not over the weeks and months. I also type in my regimen each day as it changes so much. Then I know how long I've been on every med. 

So I didn't answer you actually. Sorry, went off on a tangent there. But this is how I know how bad I am. 

FTR I also take a depression test once a month and enter the score in a different spreadsheet. Not sure why as I'm always in the "SEEK PROFESSIONAL HELP NOW!" bucket ¯\_(ツ)_/¯

Pete

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22 hours ago, Antecedent said:

CBT doesn't tend to be long term, so you could ask current tdoc what s/he thinks about you taking a break, going to CBT for half a year or so, and then going back?

That's a great idea. I am very bad at change but....I have been struggling with this therapist for a while. It's just too...little. He won't really even discuss my dreams which are so influential on my days.

 

19 hours ago, notloki said:

No level of depression is acceptable to me. 

And are you able to achieve that? No level of depression? I wish I could. But I understand what you are saying. I wonder if my reluctance to switch up the meds and the therapist is just plain old fear. 

 

18 hours ago, sming said:

Anyway, to your point, I keep a mood spreadsheet with columns like OCD, depression, cognition, IBS-C (I also suffer) and a notes column for any interesting findings.

Love this! I wonder if I can break down my moods.  My depression is complicated. Sometimes it's melancholy, sometimes deep sadness, sometimes plain old stark depression... and then there are those days I wake up..fine? lol.  It's sounds strange perhaps, but so much does depend on the dream I had the night before. They are so vivid, so real, so all encompassing, they seep throughout my days.

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1 hour ago, water said:

Love this! I wonder if I can break down my moods.  My depression is complicated. Sometimes it's melancholy, sometimes deep sadness, sometimes plain old stark depression... and then there are those days I wake up..fine? lol.  It's sounds strange perhaps, but so much does depend on the dream I had the night before. They are so vivid, so real, so all encompassing, they seep throughout my days.

Yes, different meds give me very different intensities and levels of realism in my dreams, with different content. I'm on an AD + sleep aid cocktail right now so God only knows what's causing what...

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For me, pure depression-wise, when I don't feel any “fun” feeling no matter what I do, or when I lose any feeling at all then it is unacceptable.

Usually though depression comes with the OCD intrusive thoughts, which are far more noticeable than depression which sometimes can come gradually and slowly until it is clearly there.

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On 10/11/2019 at 11:15 AM, CrazyRedhead said:

I've been living so very long with severe depression, that I can't even imagine myself getting happier.

But at least I'm still alive...I guess that's something....**SIGH**

I'm sorry. :-{

And YES!!! It is something. Getting up in the morning, putting two feet on the floor is something. This is a disease. A shitty snarky black oily infested illness that saps strength and hope and desire. So whatever we do, however little, is progress. 

 

 

On 10/12/2019 at 9:37 AM, HydroCat said:

Usually though depression comes with the OCD intrusive thoughts, which are far more noticeable than depression which sometimes can come gradually and slowly until it is clearly there.

Those intrusive thoughts are deadly. One reason I want to try CBT therapy again. I want to have tools, weapons, to combat these thoughts. They do me in all the time. Pierce whatever level of whatever I am in at the moment. Bam! A disgusting thought comes flying in my brain and all goes to shit.

 

 

7 hours ago, argh said:

A significant increase in medication or very intensive IOP and therapy is not worth a marginal decrease in symptoms.

This is what I wonder about. Those "marginal decreases". My atypical depression has flows and ebbs. I am now keeping track.  Using a lovely bristol board drawing pad and my colored pencils, drawing smiley, unsmiley, etc faces with a few words. Mostly my mood at waking up. 

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Good points, water.  Therapy helps, meds just seem to prolong the agony.  Or is it that I'm not getting the right meds in the right amounts?  Rhetoric at this point

Bear it, wait it out, endure it, swallow it all down.  Do it again next year

 

Edited by Will
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