What if depression comes back

Over the past year, everything happened in Russia but in the field of awareness, definitely, there has been a progress: many have understood that it is necessary to speak about problems out loud and this alone becomes the first step towards their solution. This happens, for example, with the issue of domestic violence. An open conversation about diseases like HIV or oncology, which were previously silently feared, leads to their destigmatization, improvement in the quality of life of patients and a more thoughtful attitude towards prevention. The same applies to depression: a serious illness that affects many more people in the world than statistics knows, until recently they were not taken seriously - and the patients themselves didn’t even think that their suffering could cure their visit to the doctor and were afraid to admit their relatives.

One of the first to talk about his encounter with depression was our columnist Alisa Taiga: the text caused a storm of approval and thanks and, I want to believe, helped many decide on a very important step - to stop being ashamed of their illness and ask for help. However, a single and painful victory over depression does not guarantee a final cure. Having survived a relapse, Alice tells how to cope with depression again and again — and what is really important is taught by this hard and painful experience.

"Oh, it's you the girl who wrote about her depression," - people who know me badly come to me. Since the publication of the text about how I fell ill with depression and gradually, with some losses, I got out of it, several hundred people wrote to me. They listed the symptoms, asked for advice and thanked me for expressing their feelings with the words: many showed my text to my relatives instead of my own confession. Many were determined and very much wanted to recover, someone shared thoughts of suicide.

In the confessions of these people there were the most typical signs: severe sleep and appetite disturbances, inability to crawl out from under the blanket, irritability, suspiciousness, terribly bad memory and inhibited thinking, weakness in the body. "I seem to myself an idiot who cannot even read the page," "I am ashamed in front of my parents: their life was much harder than mine," "It was enough for everything: husband, children, once favorite work." What to do? It seemed to me, having first encountered depression and struggled with it, I recognized the answer once and for all. But when I came from vacation and charged a dozen and a half difficult cases, I overstrained myself, tired and on the third night without sleep, with sharp weight loss and ringing in my ears, I called the psychiatrist. “I had a presentiment,” he said and made an appointment. It would seem - nothing foreshadowed. So why? "People like you are especially hard in the fall and spring, and you may have to support yourself with medicines at this time." This indicated a problem that is not solved quickly or is not solved in principle.

In the past, I wrote that in addition to reactive depression, which is triggered by a strong external circumstance (illness, dismissal, death of a loved one or bankruptcy), there is an endogenous one, such as appearing to nothing. In fact, it is the body’s response to stress and heavy loads, especially those that have accumulated. It is not necessary, coming from vacation, to rush at once to do everything that has accumulated and is desirable - it is worth giving yourself a few days to reorganize the regime. No need to work at night and desperately try to do everything. I made this mistake exactly and cracked - as if history had not taught me anything. You may have to fight, not just once or twice, like me, but you will gradually get the skill to separate bad thoughts from good ones, block some and nudge others, and finally, enjoy life.

From a crisis, whether financial or existential, you should not try to escape - on trips, emigration, alcohol or drugs

If you are very sick at the moment, you are supposedly saddened by reason or even have suicidal thoughts, don't be surprised - people like you are millions now: doctors say they have been treated more often than before. On the one hand, this is a good sign: depression has finally begun to speak out loud, and many have realized that this is a disease and it should be treated. On the other - the pain of life now feels every second, if not the first: a crisis looms overhead, which is unknown when it will end, and every day gives a portion of heavy news.

It was not by chance that the main crisis of the 20th century was called the Great Depression: people were thrown out of the windows, losing their fortune, home, family and health. No matter how much you read that a crisis is a time of opportunity, it doesn’t get any more money in your wallet, you can be asked to work, and sooner or later your enthusiasm runs low. The situation is not helped by the noise of the big city (simple, but life-giving life hacking - quiet evenings with loved ones, a bath after a hard day and a phone off during sleep). Not to mention how difficult it is to protect yourself from negative information.

Our generation is the first one that is bombarded with bad news all day long. A fallen plane or a flood, gang rape on the camera, and planted activists — no one before us had such an avalanche of frightening and oppressive events. I will not say always look on the bright side of life, because for millions of people every day it hurts and it is terrible, but everything in the world is monstrously unfair. Think of how you can help - it is known that people involved in charity live happier and longer. Even a small translation will support not only the needy, but also you.

But this is only part of the solution to the problem, which must be approached thoughtfully, systematically, and given patience for weeks and months ahead. The main thing at this moment is to go to a doctor and at the same time weed out the excess, not to commit rash actions and start building life around processes that are enjoyable. Where to begin?

Do not rush to assess the reality

From a crisis, be it financial or existential, you should not try to escape - it does not matter to another country, to emigration, short trips, alcohol and drugs. This is the simplest, but the most wrong decision. A depressed person should not hide from himself, but take up treatment and, most importantly, not make any impulsive, fateful decisions during his illness. Weddings and parting, investing money and finding out the relationship, the risks and dangers, the dismissal and the thought that it is time to have a child or a cat - all this is better to be postponed until the moment you get better and you are confident in your own actions. For now, you may just suffer from misinterpretations and your own illusions.

For the same reasons, you need as soon as possible to quit scoring in the game "What did I achieve in my ... years?". It can be a great motivating game for a healthy person, but you can't play it with depression patients: you can’t give any adequate marks to yourself and others. The month before your birthday is especially dangerous - many have difficult times in this particular period, when the inner voice with a lot of question marks starts to sound especially loud. It is important to remember how the symbolism inherent in this date puts pressure on us, and to be calmer and more rational - with a knowledge of what is happening, you can prevent a nervous breakdown.

Do not measure yourself as someone else's success, expressed in beautiful instagrams and funny tweets: often with pain, confusion and despair. It's just that it is not customary to speak out loud as much more: bad habits, betrayals, and hysterics. I remember the days when I wanted to fall through the earth and become lighted before everyone’s eyes, while my acquaintances used to say with admiration to me at a noisy party: “Alice, I am amazed at your self-confidence.” After the publication of that first article about depression, volitional and talented guys wrote to me with the same confessions. I never would have guessed that they are tormented by the same thing as me. You would not have guessed either.

Filter the social circle

First, the environment plays a huge role in recovery. During this period, it is worth pausing to communicate with people who hurt you. You cannot be cured of depression in a couple or a family where you are suppressed. It is impossible to plunge into work where you do not get along with colleagues. You can not share an apartment with those who annoy you and whom you annoy. Never - and in such moments especially - you need not endure meanness, cruelty, tactlessness and, through force, try to be nice in return or respond to evil with evil. To cope with depression, you should let only allies close - those who love you in any condition, those who care about what you feel, who will not refer to employment and their problems. Depression perfectly marks the people who want to help you, and everyone else.

Now you are not the most interesting person to talk to, because you are walking in a circle of your pens, but you don’t have to talk at all - hold hands, watch the Animal Planet channel or listen to your favorite general album. These actions treat pain and help both parties feel needed and useful - no matter who is next to you: a friend, partner or parents. So this is a win-win.

When I was bad, many friends asked me: "Alice, maybe come?" - and I answered: "Don't, I'm out of shape now." My doctor advised me to always take help from loved ones, if they themselves offer it. “I feel bad, but come and see what a stupid film is,” so to speak, for example. Silently go for a walk in the park, read books on the adjacent armchairs, yelp in the shoulder, call your parents or write a letter to an old friend who once understood you so well. These things, unlike isolation and self-flagellation, really work. Yes, in depression I don’t want to see anyone and even get out from under the blanket (I swear, once I didn’t leave the bedroom for several days), but setting yourself to hate yourself alone only keeps you from recovery.

Because of the specifics of the Soviet and Russian upbringing, the family for many of us is often not a fortress. But if you know that papa and mama will understand, if they are still alive, depression is a good signal to see them and talk about everything. I was put on my feet a frank conversation with my dad and a week at my mom's place - I, for the first time in many years, I felt absolute maternal love, like in childhood, when you come to mom with a bruise and scratch at five, place, strokes him and says that everything will pass.

My legs were weakened from lack of sleep, but I drove my grandmother to Traviata in the conservatory and was happy to watch her eat napoleon in the pastry shop. Yes, I literally could not add up 4 and 2 when I lived with my mother and spent the days in a trance in front of the canal about traveling, but I was pleased to take her hand, whisper and walk in the wind with her and the dog. Yes, mom, like me, is not sure about tomorrow, but she listens to lyrical songs, practices yoga and watches great films - and the knowledge that a man for fifty loves life a lot, is not afraid of problems and is ready to embrace you, he is very warm need to neglect them.

Do not be afraid of antidepressants

The fear of pills is, it seems, in every person with depression. But what does it mean if you are prescribed pills? That the problem is sometimes not solved by gestalt therapy or psychoanalysis. That this disease requires medical treatment, like pneumonia or diabetes. Do not think that depression should pass, as the temperature.

The first thing to do is to determine if you have suicidal thoughts. They should immediately contact a psychiatrist. With serious disorders of sleep and appetite - also to him or a neurologist. Public clinics (with terrible color walls and patients in serious condition) are no worse than private ones (with doctors of dubious education and huge prices for everything). Ask for contact with friends. Choose a doctor who will be constantly in touch with you. You may be prescribed pills, and the sooner you take them, the sooner you will feel the effect and understand your dosage.

Knowing that Russia is a country of sofa experts, I strongly advise anyone and never try to treat yourself with antidepressants. And forget about the forums and forum users. Dosage and medication are prescribed only by the attending physician, you will never understand what is happening to you with the adequacy of depression. I am writing about this separately, because the forums are filled with recipes for cocktail mixes of antidepressants and antipsychotics in different proportions.

Antidepressants strongly affect the body - many want to sleep and the head does not work, but they are very helpful, it is just difficult to assess it in this state. Drink them if they are assigned to you, and keep a mood journal — note your well-being during the day, appetite, sleep breaks. You will visually see your emotional ups and downs, and after a while follow the pattern that will help you get through them, and your doctor will choose the drug and dosage.

While you are taking pills, try to take up as little as possible new things and heavy loads, do not be fooled by the deceptive feeling of relief, do not confuse the primary biochemical euphoria with the radical changes inside you. Most often it takes several months for the mood to even out and physical health to accumulate. You need a lot of rest and just sleep, lead a healthy lifestyle and listen to intuition. If you do not believe yourself, ask advice from those who love you and have known for a long time. Are you unusually cheerful and cheerful? Takes on a few unfamiliar cases? Spend in two weeks what saved up half a year? Let there be a person next to you who will track your mode and your behavior. The opinion from the side is very important in order not to overestimate your strength and not to fall into another breakdown.

Watch the mode

It also helps to normalize the day routine complex - so I call the mandatory work that is done automatically and without reflection. For example, I get up, take vitamins, do exercises, go to the shower, crash, go for a walk with the dog, have breakfast. I don’t think I should brush my teeth and wash my face. I just do what is necessary and what I have in the plans. Antidepressants quickly help to establish this rhythm and are indispensable in the event that the inner voice from morning to evening tells you all sorts of nastiness. It helps me. Everyday.

During depressive episodes, it is better to work as little as possible or, in a serious condition, not to work at all and take a vacation at your own expense. It often happens that unrealized plans and not done things on time, inattention to oneself cause depression. Perhaps you have long been trying to do well to others, completely forgetting about yourself. Say "yes" and only then think whether you need it. Take over fifty cases, and you want and can at best half.

Depression teaches you to say no and be more attentive to your interests. A sudden, relatively free two weeks will help you review your daily routine, call and see those who have not been seen for a long time. General cleaning or a trip out of town, a book in which you can drown, or your favorite movies that you did not watch from the first year, allow yourself to spend some time on it. Three days with zebras in the savannah on the huge TV screen saved my life, even though it sounds very silly.

The second part of this advice is to do what you want and what is good. I want to make a gift, call an old friend, draw a stupid picture - you need to take on everything that gives pleasure from the process, not from the result. Do not evaluate the poems that you write only for yourself, your appearance and relationships with other people. Just try the pleasant and watch the mood change. Yes, maybe you will not have a Nobel Prize and your poems are lousy, but as long as you like to rhyme "love" and "blood", you have to do it here and now. I am helped by singing and Spanish, film festivals and notes on everyday. You and what you do are not obliged to please everyone, but you must definitely like you.

Do not give in to quick euphoria

I would like to say separately about one very important feature of my illness, which taught me how important it is to count strength. In my case, these are dramatic mood swings and alternation of a prolonged depressive and short manic or hypomanic phase. Yesterday you barely ate yogurt for the whole day, today you knead the cake with spoons (I'm not joking, it was with me!). Yesterday there were five successful meetings, today the head does not cook at all. A very important part of my treatment was the realization of the fact that positive events require energy no less than negative ones. Depression is much exhausting, but mania is exhausting no less. A big party, a warm dinner in the company, the launch of a complex project, a difficult creative task - all this requires strength, even if you love it with all your heart.

Our body and our nervous system are still useful for real feats and big things - when it will be resources. In the meantime, do not fight with the mills and do not seek to understand all the difficulties in a short time. There is a banal saying that life is what happens while we make plans. Депрессия часто вызвана тем, что мы недооцениваем реальность и настоящий момент и расстройство психики - самый простой и явный сигнал того, что прошлое и будущее в вашей жизни должно уступить настоящему.

Позвольте себе кайфовать прямо сейчас. От любимой песни вместо будильника на телефоне. От любимой шоколадки на завтрак. От непривычного секса перед работой. От путешествия с людьми, которые вам по-настоящему интересны. От книг, которые вы откладывали на потом. От утренней пробежки, на которую не могли решиться годами. Или от прогулки, если пробежка вам не нравится. Спите, ешьте досыта, говорите о любви с теми, кого вы любите, - это постепенно вытащит вас со дна. Not immediately, but pull out.

Use the experience of the disease for the benefit of

Suicidal thoughts and self-loathing is an unnatural process that refutes the forces of nature and the innate attitudes of a person for happiness, joy, and strong social ties. I understand perfectly well that my problem can never leave me alone - patients with manic-depressive psychosis have lived with him all their lives. The disease is changing and taking on new forms, life is building new obstacles, and things that are so clear yesterday, seem to be misconceptions and mistakes. This fall, a second series of depression happened to me, which I, of course, did not expect, and it hurt and hurt me. I just learned to live in peace with myself, I have been gathering strength for so long, I tried and changed so much. And what? All for nothing?

If you believe my doctor, I held up pretty well this time and learned a lot in a year. I understand the signs of my illness and the reasons for my anxiety, I calmly take failures and learn not to undertake things I don’t need or that I don’t have time for. I am not afraid to talk about my condition with family and friends, and they understand me better than before. Sad thoughts, difficult partings, the financial crisis and personal disappointments covered half of my acquaintances - joyful, active and fearless. No one is alien to death, illness, poverty. Right now, everyone is in roughly the same confusion: the financial crisis, the terrible political background and the new risks. But depression teaches the most important thing - to accept that life is cyclical and everything is not forever. After winter there will be spring, after a fall - take off.

This is trivial, but it is precisely the moment when you feel the effect of global laws on yourself, brings recovery and a feeling of belonging to other people. Depression is a difficult affliction, but in addition to it, an individual is often given exceptional empathy, attention to detail and an intuitive understanding of people and moments. Every time you feel that something is missing, think about what you already have.

In the great tale "The Wizard of the Emerald City," Lev, the Scarecrow, and the Tin Woodman were expensive to get courage, mind, and heart from the Wizard, but the trick was that they already had it. The most important things: love, friendship, dedication, parents and children - are given to each person completely free of charge. There is something that we can influence, and conditions to which you just need to get used to it. Depression gradually teaches me to distinguish one from the other. I did not choose this ailment, but I stopped turning away from it. I do not know when and with what account this game will end, but I will not give up. And you do not give up.

Photo: 1 via Shutterstock

Watch the video: Depression: A Student's Perspective (April 2024).