I need reassurance (re: Severe Major Depressive Episode)

I’ve suffered from clinical depression on and off since I was ~10. There’s a high incidence of depression on Dad’s side of the family, and of suicide on Mom’s. I would classify my previous episodes as moderate.

Last May, I graduated from law school and moved to a city where I don’t know anyone. I began a demanding job at a corporate law firm last September.

Around Thanksgiving, I stopped taking pleasure in any of my usual hobbies. I began to suffer from a lack of motivation. I could not make myself do the things I need to do to take care of myself: take out the garbage, change lightbulbs, do laundry, etc. I began to come home from work every day and sit in front of the television in a stupor. I did just enough to make sure that no one from the outside world could tell something was wrong.

Right after Christmas, I was MIA from work for several days. I called in with the stomach flu, but in truth, the problem was that I could not get out of bed.

A week later, I had a severe cold sore outbreak (sores inside my mouth and all over my lips) that was probably caused by extreme stress.

My memories of events since then are a little fuzzy. I know I had a big blow-up with a longtime friend that I discussed on these boards. It was serious, but my emotional reaction to it was extreme. I remember crying uncontrollably in my car, convinced that I was going to die alone, unloved and friendless. I felt cut off and disconnected from other people.

Two weeks ago, my stress level at work increased. I was given a number of assignments by difficult-to-work-with lawyers; all of them required me to learn new skills ASAP. I began to have panic attacks in my office and in the car on the way to work in the morning. I began to suffer an almost complete inability to concentrate; sometimes, I literally could not read. I had to work 14 hour days to rack up 8 billable hours; the other 6 hours were spent in a useless stupor in my office.

I began to feel like a zombie in my own body, like there was a blanket between me and the rest of the world. Talking to people and making myself coherent was so difficult and painful that I would grit my teeth.

I was convinced I was going to be fired because of my incompetence. Yet no one noticed. In fact, my work was praised, and my semi-annual review was completely positive. When they told me this, instead of feeling good, I thought I would be sick to my stomach. I felt like I was invisible.

Then I started having uncontrollable thoughts about suicide. When I’d go into the garage in the morning, I would think about closing the door, turning on the car, and exiting peacefully. I wondered who would find me, and how long it would take. I found myself sitting in lunch meetings at work, eating pizza and making a mental list of all the ways to kill myself that I could implement with things in my very own apartment. Meanwhile, my colleagues learned about cost-effective legal research. While sitting in my office during my “spells”, I imagined throwing myself out my office window (I work 30+ stories up).

Fortunately, I have a good therapist who got me in to see a psychiatrist ASAP. I started taking 300 mg of Wellbutrin a week and a half ago. I am no longer having the uncontrollable suicide fantasies, and I don’t feel so incredibly unhappy, but I’m still having problems with concentration and lack of energy. Work still takes so much effort. At the end of one very stressful day, I realized I was actually panting as I struggled to finish drafting a simple affidavit.

I told my supervisor in confidence and am taking some time off of work. The bigwigs have been very good to me–they told me to get well and not worry about anything else (i.e., I still have my job and I’m still being paid). My best friend, who lives in California, is flying out to see me at the end of this week at her own expense to help me clean my apartment, which looks like a trash dump. I finally told my parents, and my mother has told me that all I have to do is ask, and she will come stay with me–she has lots of vacation and comp time saved up. Even my dad, whom I have hitherto considered a complete emotional retard, surprised me with his attempts to reach out and comfort me.

But I still don’t feel like myself, and I am starting to be afraid that I will never, ever feel normal again. I have always had incredible self-control, and now I feel like my whole life is out of control, and that I’m teetering on the brink of disaster (financial and emotional).

I’ve been doing a lot of reading about clinical depression and anti-depressants lately. And a lot of what I read is disheartening. Medications don’t always resolve all the symptoms. Prolonged use can lead to tolerance, which results in a need for increased doses, and sometimes the drug simply stops working for you. Many of the medications cause drowsiness, and a sleepy lawyer is not a good thing. I read “Prozac Backlash” and now live in fear of brain damage and long-term side-effects like tardive dyskinesia. I’m 25. I picture myself taking drug after drug, each one working for a time and then failing on me, and ending up at age 40 in the same place I am now. SSRIs can cause weight gain and loss of orgasm; I’ve gained 40 pounds during this depression, and damnit, orgasm is sometimes the only pleasurable thing I’ve got left.

When I told my therapist I went to Harvard Law School, she congratulated me. And I burst into tears. I don’t see a bright future for me anymore. I see a mountain of student and consumer debt and the cold, hard fact that I may be unable to practice law–that I may have to choose financial ruin just to save my sanity.

I really want to get married and have kids someday. But now I wonder–who would want to marry someone who’s seriously mentally ill? Probably no one I’d want to marry! And it would probably be selfish and irresponsible to pass on this misery to my children.

My point: I really need to hear from people out there who have had it this bad and gotten better. I need to hear that what I’m doing–the therapy, the medication–will eventually work. Especially if there are lawyers out there who have coped with this, because of the intense intellectual demands and high-stress nature of this profession. I need to hear that I can be cured, or at least send this sickness into remission.

'Cause if I don’t get back to feeling normal, I don’t see the point of going on. The glimmer of hope is really the only thing that’s keeping me going.

Sorry this was so long. Thanks in advance for any responses.

Why did your psychiatrist prescribe Wellbutrin? Were others like Zoloft considered?

I’m extremely hesitant to claim I’ve ever had it nearly as bad, but hopefully that doesn’t take away whatever smidgeon of value this may have. I slid into what, in retrospect, was very much clinical depression approximately ten years ago; I didn’t have career stress at the time (it was “just” college). I could rarely stir myself to do necessary laundry, I spent weeks not talking to anyone in person; there were several semesters where I would start with a full-time courseload and simply drop all but one or two classes by the end due to not bothering to get up and go to class.

I never sought counseling, which, is probably one of the stupidest things I’ve ever done by inaction. So you’re already way ahead of where I was in smart actions. Still, I managed (luck of fools) to pull out of it.

Practical suggestions that helped me:
1: meditation. You don’t need to ascribe to any particular spiritual or religious baggage attached (although if a particular religious formulation resonates for you, by all means explore it). I mean, simply take some time, each day, to sit comfortably, breathe, and follow your breath. Don’t make an effort to think or not think of anything, don’t try to breathe in a particular way, just let yourself breathe and keep returning your attention to your breaths.

Short term, this can be maddening; the intensity of feelings that surface by simply sitting and breathing mindfully for twenty minutes can shock–and also shock in just how quickly they dissolve again. But long-term, it helps, very much so.

2: The worst part of suffering, I’ve felt, isn’t the pain itself–as hellishly bad as that is. The worst part is the damning feeling of isolation; and how the cycles of suffering reinforce it. Hard as it is at first, do things to defy that tendency. Do you have good friends you haven’t talked to in awhile, out-of-state? Call them up, find out how they’re doing. Bring up old memories with them. Laugh together–a minute of genuine laughter with a friend can shatter the weight of days of bleakness.

Above and beyond that, one of those things that’s damnably easier to say than to do (the truth’s irritating like that): rise above the fear to trust and reach out to other people. People are better than it’s easy to judge them to be.

It’s a pithy little statement, but I’m inordinately fond of it: “accept the diagnosis; defy the prognosis.”

May this cloud lift quickly.

  1. Why Wellbutrin? I asked for it, and my psychiatrist agreed that it was probably a good idea. A common side effect of SSRIs is sleepiness. I’m already out of it much of the time. Wellbutrin is considered more “energizing.” Also, SSRIs are good for people who have a lot of anger/irritability symptoms. That is the one symptom of depression I have had very little of. Also, I did not want to gain any more weight or lose the ability to have an orgasm.

I realize this is an incomplete and rather generalized discussion; let’s just say that my doc and I weighed the factors, and decided together that Wellbutrin would be a great fit, if it works for me.

We’ll see how it works out. I’m open to the idea that this may not be the right drug for me, but I’m hoping it is.

  1. My friends and family keep me going. I’m home with my parents right now, actually. And you’re right–it helps. Not enough, but it helps.

As for the meditation–I’ve tried, and it’s hard. Right now, when I try to stop and just breathe, I usually start to worry, and then I have a panic attack. I can do it in my therapist’s office, after a long session of pouring out my fears. In the middle of a stressful day at the office, it’s not working so well.

I just got to the end ~ I’m sorry this is so long. I have trouble concentrating when I’m really depressed…(and other times since I’ve been sick) so you might have trouble getting through this. If that’s the case, then read it in little pieces.

Goodness. I’m not sure how this will come out. I’ve been a support for people in person, but I’ve never put it in writing before, at least not that I remember, and I’m guessing this will be harder but I have been where you are and I’d like to do whatever I can to reassure you.

The first time I attempted suicide I was 6 years old. My parents were alcoholics and my mom’s side of the family were abusive. I started sneeking wine when I was 7 and pretty much drank until about 8 years ago. (I’m 45 now… Denial. It took me a long time to figure out I’m an alcoholic too.)

I had a lot of problems for years. I can’t even begin to count how many time’s I’ve thought of suicide or attempted it. I’ve been in the hospital a few times…once in the ICU where I remember watching the nurses working on me while I hovered in the corner of the room.

I tried to get counseling but the counselors I went to told me I was being to hard on myself and would cut me loose within a few weeks so I started thinking my life was the way it was supposed to be and that I didn’t need help.

Then in 1984 the agoraphobia started. I was a legal secretary and still trying to get through school. I started college 5 days after high school but it took me 12 years to finish that 4 year degree. So I was taking classes and working for a firm downtown. I had to be able to leave my apartment and that wasn’t happening so I called the student counselling center and got an appointment. That was the beginning of the help I needed. I did fight the counselor when she said I needed antidepressants. I didn’t want to be dependant on any drugs… Remember here I still am in denial and don’t know I’m an alcoholic. She finally got me to agree to see the doc and get something that would help me sleep. I wasn’t at all familiar with psycotropic medicine at that time so didn’t know what he was prescribing was an antidepressant.

It was a long process. I was in counseling for about 15 years. I have gone through the pain of having to increase the antidepresants because the one I’ve been taking I’ve developed a tolerance to it eventually reaching the maximum dose and it doesn’t work any longer so the guinea pig thing starts again trying to find one that will work.

I also have an anxiety disorder so trying to keep the major depression and anxiety under control can be challenging. At times I’m just sure it’s not worth it or that it’s never going to get better or whatever irrational thoughts I am having at the time but seem to be rational.

I never thought I’d find a good man and get married. For that matter, I didn’t want to get married and had no intentions of it, but then a guy I had dated in high school came hunting for me. Out of the guys I had dated he was the only one I had the best memories of. We’ve been married for almost 17 months now. He’s seen me go through my antidepressant stop working without notice and the guinea pig stuff start. You know, he’s a prince. He loves me so much he gets frustrated with the illness and that he can’t do anything to make it better, but he’s never gotten mad at me or anything like that. There were times he had to remind me that it was a chemical imbalance so to stop stressing over it.

Succeeding in your field. I remember times when I was sure I was a waste of space on the face of the earth and that I’d never be able to work at all much less in my field. I’m not an attorney, but I figured the best way I could turn my experiences into something positive was to get into social work. I didn’t get into grad school but I did finish my BS and I worked in psych hospitals and an adolescent residential facility. I’ve seen attorneys who arrived in bad shape but left fully ready to return to their job.

Given your genetics, I’d guess you will have this illness all your life like I will, but it’s not a death sentence even though there are times it seems like it. As for children, I can’t say. I remember not wanting to pass it on but when I had to have a historectomy at 34, well, that was hard. But speaking as a child of parents with mental illnesses, I’d hate it if they had decided not to have me. Even counting the times I’ve wished I’d never been born. Those times pass and the time I’m happy to be alive far outweigh.

I prefer SSRIs and have been on most of them. You mention not liking some of the side effects. There’s no getting around side effects, but it comes down to weighing the benefits vs the side effects for me. And there are a lot of times I don’t get the usual side effects so I’ve learned to give them a try. The good thing is they are always perfecting new drugs so when one stops working, another one is there to take it’s place. It’s hell on earth waiting for them to start working and for them to reach the therapeutic level…sometimes to find out that that one isn’t for you and you need to switch, but it does work out in the long run.

The Prozac and Paxil problems that have been documented weren’t a problem for me. I’ve never experienced tardive dyskinesia but I’ve seen patients with it. I’ve decided that I will avoid any meds that have that side effect as long as there are others to try. I’ve made the same decision about MAOIs since I can’t imagine living without pizza… LOL But like I said, as long as there are other things to try, I will. If I run out of them, then I’ll try whatever I have to. My will to survive is very strong and I know that even if I had to go on one I didn’t like, it wouldn’t be forever since they will develop another SSRI or even another class of drugs.

It’s hard to think of the good things in your life when you are feeling like you sound like you are. It’s much easier for me to make a list of things I enjoy in life that I would miss if I died. I’ve had many counselors tell me to make a list at the time it was virtually impossible so I finally made a list when I was feeling good and would pull it out and read it when I felt like life wasn’t worth living.

I’ll share some of the things on my list so you can share them if any of them ring true for you.

[ul]
[li]my husband[/li][li]the way I feel in my husband’s arms[/li][li]the feel of cat’s fur[/li][li]a cat’s purr[/li][li]a hot shower pounding on my back/shoulders[/li][li]the sound of the ocean[/li][li]the smell of the ocean[/li][li]birds chirping[/li][li]snow[/li][li]the smell of rain[/li][li]flowers[/li][li]learning new things[/li][li]people I love and what it would do to them if I weren’t here any more[/li][/ul]

I hope one thing I’ve said will be supportive. Since it’s so hard for you to see the future right now, I share my strength with you. Please hang on to it until you don’t need to any more.

Hang in there

It’ll get better…I promise!!!

Therapy isn’t easy but it’s worth it. That’s a promise too… And I don’t make promises lightly.

I have had bad experience with Wullbatrin. I couldn’t sleep plus it didn’t help me with my panic attacks. I then got prescribed Paxil which has been pretty good for panic attacks and depression. However, I don’t have a long history of depression and it’s pretty much over for me so I can say that my condition definitely not as severe as what yours sound.

Good luck.

Q.N.Jones about ten years ago I was hospitalized for the third time in six months for severe clinical depression. I spent Valentine’s Day in the hospital that year. I was also unemployed, and struggling like mad to get back on my feet. I did. It took time and hard work and it cost me a couple of friends, but I did it. If Wellbutrin isn’t working, try something else. I had good results with Paxil ten years ago and awful results with Wellbutrin and Zoloft a few months ago.

When I was first admitted to the hospital, I thought my life was over. I though no one would hire, let alone love an ex-mental patient, a loony. I still don’t tell potential employers about the hospitalization, although a couple do know I run an on-line support group for depressives,Cecil’s Place. I was wrong. I’ve had wonderful, challenging jobs since then, and, while I’m still not married, it’s as much my choice as anything. I don’t think I’ve met anyone who was repulsed by my depression. A friend of mine did decide to leave her husband, but it wasn’t because he was depressed, it was because he refused to do anything about his depression, even when she told him that if he didn’t, she would leave. That doesn’t sound like your problem.

It gets better, I promise. E-mail me if you need to, and keep slogging forward. You’ll run and even dance again.

Take care,
CJ

I’ve had problems with depression on and of for years as well, which have heightened to dangerous levels since I’ve been living here, and particularly in the last few months. I can certainly understand how moving to a new place brought it on worse for you…large changes in life where you are seperated from familiar things, people, or situations is never easy. Although I’ve never seen anybody or taken medicine to help (I’ve been afraid to), I know people who have and know they’ve had improvement.

Does talking about how you feel help you at all? That’s been my main source of therapy for years, just trying to communicate how I feel with others. I definitely understand the losing your motivation, helplessness, suicidalness I’ve gone through all of that. All I can say really is if you can use the comfort that your friend, your father, and others are giving you, it can help to keep your hopes alive.

Plenty of people understand depression. I’m sure it will not prevent you from finding someone to love and marry.