I Think I Have Depression. Now What?

Miscellaneous and Personal Stuff I Must Share
1

First, a language question. “Have depression,” “suffer from…,” “am afflicted with…,” “am depressed?” What’s the common or preferred usage?

If my self-diagnosis is correct, it’s not severe or crippling. No suicidal ideation. No thoughts of self-harm at all, nor harm to others. It seems to mostly be manifesting as lethargy and more-frequent irritability. Someone recently described their own depression as like a big, heavy blanket over them all the time, and that’s a pretty good description of how I’ve been feeling - like there’s a constant weight or pressure all over. I’m not getting things done in our business nearly as efficiently or as well as I know I’m capable. Ditto with projects around the house. It’s been quite some time (maybe a couple of years?) since I have woken up in the morning looking forward to the day (granted, I’m not exactly a morning person). It takes more effort than seems appropriate to get out of bed and get the day started.

I think this has been going on for a couple of years now. I haven’t been working out, not even something as simple to squeeze into the day as a couple-mile run. I’ve gained 20-odd pounds over the last 3-4 years. I drink a little more than I should. I have to put forth a significant effort of will to get out and do things I actually do enjoy. I am, by nature, pretty low key and more than a bit prone to laziness, but this feels different.

So - next steps?

First, I need to talk to my wife. I predict it will be a difficult conversation, not because she won’t care or be supportive, but because I suspect it will bring up memories and negative feelings about her own struggles with anxiety and depression. I don’t want to bring those to the fore, but we’re a team and it’s time I brought her in on this. I think she’s starting to feel that something’s off anyway.

Second, I need to get myself physically healthier. I don’t have a life-long history of athleticism, but I started getting into shape when I turned 40, and by 43-44 I was feeling pretty good, and quite literally in the best shape of my life. The guy who was my personal trainer (who was outstanding) does training via Skype (we’re on opposite coasts now), and we’ve got a pretty kick-ass home gym. If I start making training appointments, I’m pretty sure I’ll keep to them - accountability usually works with me, particularly with people I respect and whose opinions I value.

Third, I need to enlist professional help, and that’s where I don’t really know how to get started. We don’t know many people in our area, especially anybody I’d be comfortable opening up to and asking for a recommendation. I can start with in-network providers on our insurance plan, but how do I then vet the provider? I dread the thought of having to visit multiple therapists, giving them my backstory each time, and then finding it’s not a great fit.

So - advice, suggestions, stories to share? I would particularly like to hear any tips for finding a good match with a mental health professional. I don’t promise I’ll take all of the advice provided, but I promise I’ll read it and consider it.
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2

Consult your PCP; he may prescribe something (e.g. Sertraline) that helps just enough to avoid the next step. Knock off/dial back the booze–alcohol is a depressant.

3

Coming out and admitting you have an issue is always a great first step, and you’re definitely on track with getting exercise and fixing your diet–we have a support thread here for a bunch of us doing low carb/keto right now and do feel free to drop in for support and encouragement.

As for finding pro help, concentrate on in-network providers who have websites. My best friend is a therapist who recently went into private practice and her website has a very good section on what kind of a therapist she is, what issues she specializes in and her site itself makes her personality very clear. You can help the process along by identifying what kind of a person can motivate you best–do you need your ass kicked? Do you need someone very supportive and warm? Someone with an evil sense of humor so you can make awful jokes without catching that big side eye? Knowing what kind of person makes you comfortable will help a lot when you’re looking for a therapist because if you go to one that isn’t a good fit, well, they know others in the business who might suit you better and will belong to a listserv for referrals. For instance, my BFF does not do couples therapy or work with paranoid schizophrenics but she can find you someone who does.

My own personal recommendation is that you put psych meds at the bottom of the list of approaches. It’s too often Job #1 and I think that’s lazy and not very helpful for the person with depression. You can’t just throw pills at it and expect great results. Although I do have to admit that since starting to take beta-blockers for high blood pressure it’s helped tremendously with the heart palpitations that accompany my panic attacks, and that does take the urgency out of the attack since I’m no longer convinced I’m gonna die when they happen.

Best of luck to you–as a fellow sufferer with depression, anxiety and PTSD I can assure you there’s a whole crapload of control you can get over your state of mind if you throw yourself into it and work on taking care of yourself.

4

“I am depressed works”, I think. It does sound like you are depressed. One of the things that snuck up on me was that I stopped reading books. I had read several books a week for most of my life and I just stopped, and didn’t really care.

One suggestion for finding help is to start with your primary care provider. They may be able to recommend a good counselor or center in the area. They may also be able to start you on medication (if you are interested) while you look for someone to work with. If your medical care is through a health network (on the west coast we have Good Samaritan and Sutter Health, for example), you can look on their website for providers that might work for you.

As far as knowing whether things are a good fit, there are a few things to think about. One is how you connect personally with the individual. Do you trust them? Do you think you can confide in them? I had one counseling session where I walked out and never went back, and others where I felt at ease instantly. Hopefully you’ll find someone that you can connect with and work with.

Another thing to consider is the type of therapy that is practiced, and that you are interested in trying. Cognitive Behavioral Therapy (CBT) is one type that is positively regarded. I would recommend that you do some research on that. Other posters may have some recommendations for you as well. Therapists will talk to you during the session, and will also have some “homework” for you as well. This can be charts for you to track things like sleep or anxiety (raises hand), it might be a thought exercise for you to share in the next session, or it might be some reading. Therapy will be about more than the time you spend sitting in session, in other words. There is work for you to do on your own.

Your wife might be more supportive than you think. It may bring up memories but she may also be able to offer you helpful advice on moving forward as you tackle this.

5

Yup, IMHO, the seeing a doctor should be step 1, not step 3. Yes, talk to your wife, but see a doctor. Like burpo said, even your PCP may be able to get you started on something and after a month or two the two of you can decide if it’s working, if they are comfortable maintaining you and/or if you should see a specialist (because they’re not comfortable treating depression cases and/or your specific case warrants it).

At least call and make an appointment (you may even be able to do it online). IIRC SSRI (and probably others) take about a month to get up to the right levels in your body before you start seeing results. There’s no point in waiting a month to decide to see a doctor, then waiting a month to get in, then waiting a month for the drugs to start working.
Make the appointment now, talk to your wife, push yourself to workout, do whatever else you need to do between now and then.
If by the time the appointment rolls around you’re feeling better, you can always cancel it.

6

But don’t. :wink:
This may sound like a nitpick, but it isn’t meant to be: It’s always best to say, “I might be suffering from depression,” or something similar. The reason–everybody gets “depressed,” using “depression,” makes it a medical affliction and not “a case of the blues.” A slight difference, to be sure, but cuts down on confusion re diagnosis.

7

Have you had a physical lately? This “getting old” shit sux; you could be suffering from things other than depression. Are you on any meds? One of my blood pressure meds was causing me symptoms similar to the OP’s. You can probably see where this is going. It’s no comfort that lots of things change–example: my wife has been taking a certain cholesterol drug for many years, last week it just stopped doing its thing. Doctors just shrug and try a different one until it clicks.

Good luck.

8

What you described sounded a lot like someone without purpose in life, or a sense of purpose. Are there any things you have done in the past that you felt very passionate about but for one reason or another had to abandon them? Do you feel you have ample free time to explore aspects of your own life? Marriage can be demanding. I have what I often think of as underlying depression, I can over ride it with positive things in my life but it is never far from the surface. Find out realistically how much time you can devote to something each week and enjoy the hell out of whatever time you can a lot to it. This will at least give you something you can look forward to.

9

As someone who’s suffered from depression most of my life, please seek professional ASAP. Medication helps, but more than that just talking to someone who’s able to talk and diagnose you objectively is the best thing you can do. Don’t mean to sound negative, but thinking you can do it yourself (including only talking to your wife) only adds to the delusion that everything will be okay without professional help.

You’ve taken the first step forward by acknowledging you may be depressed. Exercising helps both physically and mentally. If you’re religious, speak to your clergy. If you belong to a club or associate with a group, bring it up subtly in a conversation. You’ll be surprised how many others have the same issues and feelings, it’s nothing to be ashamed of.

Many employers offer a confidential hotline or mental health service, usually low cost or free. Again, don’t be scared or ashamed to open up to someone about what you’re feeling.

10

Doctor first: people get depressed and lethargic, or lethargic and depressed, because of health problems – if that works, it’s a magic bullet.

Second, the exercise – that’s known to be as generally as effective as drugs.

2.5: Team sports: Ballroom dancing, Tango. known to be more effective because just exercising can be pretty mindless, which leaves room for rumination.

Third, you’ve noted you don’t know many people around in your area. this is a big one to work on. Maybe Masons, Rotary, Lions, Men’s Shed, Scouts, Coaching, church, politics, gardening club ?

Counseling. I wish I could say something encouraging. I don’t know how to select good counseling. I’d avoid psychiatrists: their skill set leans towards psychotic crazy people. some people with mild depression benefit from lithium, but I’m not aware that it’s a standard treatment.

Then drugs. Hey, you might be lucky: drugs work for some people.

11

Symptoms such as fatigue and general blah-ness* can also be linked to issues such as a lack of certain vitamins. Your GP can check those as well as direct you to appropriate services in your area.

  • Totally a technical term.
12

At least seriously consider the possibility that what you are experiencing is a transient mood, rather than a clinical pathology requiring expensive/extensive treatment. Not meant as a slam on ALL who are depressed, but at least some portion of such people appreciate the diagnosis as an “excuse.” *“Whatever unpleasantness I am experiencing isn’t my fault, and I can’t do anything about it.” * That may be a tiny minority of folk reporting mental health problems, but make sure you do not become one of them.

I was at the doctor’s for a check-up the other day, and saw a posting on the wall saying *“Exercise is a first-line treatment for depression.” *Also said something along the lines of he can only do so much for folk who don’t stop drinking and don’t eat well. Confirmed my belief that I was seeing the right doctor for me.

Heck, if a low dose of fluoxetine takes the edge off, go for it. The brain is chemistry and electricity. Might as well tweak that in your favor. But as others have said, laying off the booze and getting exercise are a good start.

Get busy with something, and force yourself to keep it up. Don’t give yourself a choice whether to exercise - just make it part of your regular schedule. Maybe get a workout buddy to make you feel further obligated. Or set a goal - like a 5-10k. Keep track of the days you exercised/ran - just a list of how often per week, and maybe miles run and times. For me, keeping track CAN serve as an additional incentive. If you are active and adhering to a schedule, you’ll have less time to worry about whether you are depressed and whether you should be doing more.

Minor point - I don’t get the whole “having hard time getting out of bed.” Hell, just about every morning, I think I’d rather stay in bed. But when the alarm sounds I hop out of bed and into the shower. NEVER have hit a snooze button. I don’t give myself the CHOICE of giving into depressive thoughts/tendencies.

Finally - there is plenty around to be depressed about. IMO, if someone reads a paper or watches the news, or even just thinks about what is going on and ISN’T depressed about some things, THAT’S the person with a pathology needing treatment! :wink:

The world can be a hard, sucky place. It can take a lot of hard work to focus on the positive, rather than the negative. That doesn’t make you depressive - it makes you normal.

On edit: re: cnslng, I’m dubious about being able to select the counselor who is right for you. My wife and I feel what a good counselor is MOST is someone who will listen to you and who cares about you, and who will work with you to explore options. We’ve decided that we fill that role for each other better than some person we pay by the hour (IF we pick the right person and AFTER paying them to get them up to speed…) I suggest viewing your wife and yourself as each others’ best teammates. No one else in this often cold and nasty world cares about the 2 of you as much as the 2 of you do.

13

I found myself in much the same situation as you, with the added fun of dealing with my wife miscarrying. Between my wife and I, we concluded that I must be depressed, and I basically went and researched depression counseling (I wasn’t suicidal, or having it really affect my work performance overly much), and found a counselor who practices the style/method I thought might be most helpful (cognitive behavioral therapy), and decided I’d try him out.

Turned out we really clicked well- I went for about 3 months once a week, and at the end of the term, I had what amounted to a toolkit of mental techniques that allow me to avoid and arrest depressive thoughts. Of course, that doesn’t mean that you can’t still have problems- I actually went back for about a month or so earlier this year for a sort of “tune-up”; I just needed a sort of prod and reminder of a few of the techniques and practices that hadn’t firmly ingrained themselves.

14

A few kinda-sorta contrary opinions just to put it out there…

  1. Consulting your doctor is a good idea, consulting PCP isn’t. Sure it’s fun for a while, but then you’re eating your roommate’s face off and it just gets worse from there.

  2. On a more serious note, go into therapy with an open mind and try to see if it works for you…but don’t beat yourself up and think you’re worse if it doesn’t. I’ve fought with depression/anxiety all my life and going to the therapist made it way, way worse. I hated those stupid meetings. I tried multiple doctors, multiple versions (one-on-one, group, regular, semi-regular) and always I felt worse about myself every time I left. Am I an outlier? Absolutely. But that doesn’t mean it never happens.

Something that I found really helped me was identifying my triggers and staying away from them. Unfriending ex’s from Facebook, not visiting certain websites and actively avoiding certain thoughts are just a few of the things I actively do every day. Working on a plan to cut out some of the things that might bring you deeper into your funk will help immensely.

15

There is something to be said for self care. This is what I would do

  1. Mention it to your wife…don’t make a big deal of it if it triggers her - just say “I’ve been feeling blue and I think I’m going to start talking to someone.”

  2. Get thee to your PCP…yes, they can run tests to make sure its not something else, and they can start prescribing antidepressants or anti-anxiety meds - it may take a bit to find the right one, and its likely with minor (non-suicidal, are still functioning) depression your PCP will be taking care of your meds.

  3. Make an appointment with a therapist. In a lot of parts of the country it can take weeks to get in - and it might take longer to find one who is a good fit - and then therapy is s slow process. So therapy is a long term investment that you want to start asap. Medication is a medium term investment (likely a few weeks or months to find something that works), this last step is the short term investment.

  4. Practice self care. Self care is 1) eating well 2) sleeping well (if you need to talk to your PCP about sleeping, do so - not enough sleep makes things worse), 3) getting exercise - even if its walking the dog every day 4) doing something creative (this is why they have you do arts and crafts if you end up hospitalized) - color, take up stained glass, knit, woodworking, paint, cook, write bad poetry, play the guitar. 5) Keep yourself and your space clean. You should check these things off every day (and sometimes I need to create a checklist to get them done)

(I’m also not a huge fan of therapy…I’ve spent thousands of hours in therapy and I think about four of it was useful…but I know a lot of people who swear by therapy - at least give it a good chance…and even though I’m not a huge fan of therapy, when I start getting bad, I make an appointment - I just don’t waste time with it in my normal state - which is still depressive)

16

I laid out of work for a week when I felt stuck in the black pit of despair, and finally did a Google search for low self esteem, doctor, my town, and a few other symptoms. I found a psychologist, who after a few sessions referred me to a psychiatrist for medication prescriptions. I continued seeing the psychologist for a few months, then came back to him about a year later. I’m still seeing the psychiatrist every 6 months for mental check-ups.

It’s too difficult to fight this on your own. You will feel so much better when you can finally unload on somebody who’s trained to diagnose you, and you’ll learn some physical reasons why you’re suffering from depression. It’s a lot more layered, and in my case stems from inert nerves in my brain.

I still get in funks every now and then, but nearly as bad as I used to. The meds really help.

17

Recognizing you have a problem is, as others have already pointed out, an important milestone.

Be aware, however, that some people— I’m one of the noisy and outspoken ones — do not regard the medical profession as having much useful that they can do about depression. And that some of us doubt that classifying it and thinking of it as a medical condition in the first place has been a very useful or productive decision.

Having said that, let me unpack it a bit.

• Some people would say that psychiatric medication may help some of the people some of the time, but would quickly acknowledge that as well-intentioned as the field of psychiatric medicine may be, our species is still in the stone knives and bearskins zone as far as being able to address this kind of problem. At best, they aren’t perfect and your mileage may vary.

• Other people are a lot more vehement about the quality of psychiatric medications for depression and other psychiatric ailments: they cite studies that show the meds create a physical dependency in the brain, that they aren’t addressing a specific neurological or chemical insufficiency or condition, they are all less tailored and less configured to fix the problem and are, in fact, no more than symptom relief. That to the extent that they work, no one knows how they work. That they create paradoxical side effects (suicidal ideation, etc) in some people instead of or in addition to relieving their symptoms.

• Other people, overlapping with those other two categories somewhat, think that depression, like all states of feeling and mind, are processes and that using medication slows down or derails those processes; that, unpleasant though they may be, the processes themselves are healthy and normal and the interventions not only address only symptoms but interfere with long-range mental health as well.
A second and unrelated issue I’d also like to bring up is that psychiatrists have the legal power to incarcerate and to force treatment upon the unwilling, and although that power is not an absolute and unrestrained power, the one place where it is particularly likely to make an appearance is in any case where someone is so miserable in their state of depression that they express anything that can be interpreted as an urge toward self harm.

And to that, I will add that for every person who says “I am glad they incarcerated me on an involuntary basis” there are more who say “It was awful, the institutional experience was far more dehumanizing and cold and uncaring than my life had been previously… the way they treated me really made me want to kill myself but of course that wasn’t a possibility. I felt punished for being depressed, not helped out of it”. Or express dismay that a passing comment intended just to illustrate how morose and miserable they were feeling was jumped on as a sign that they were going to attempt suicide and they got locked up, lost their job, separated from their family, and it was humiliating and messed up their lives for quite some time. So be careful. Take this into account.

[climbs off soapbox, puts it under his arm, walks off the village green]

18

First see a physician and make sure this is not a side effect of some physical problem. And apparently you are in your 40s, so you may be suffering from an affliction known as getting old. It is depressing, but most people get over the depression part. The getting old part will eventually kill you, but most people live with it for a long time after the onset of symptoms.

19

A couple of quick thoughts and an update:

Thanks for responding, everyone. I actually just turned 50, so I am well aware that some of my issues may be “getting old,” but I don’t think it’s a significant factor. I don’t currently have a PCP (we’re still getting settled in to the area), but I did have a significant physical including stress echo, major blood work-up, and colonoscopy in late March. Aside from my cholesterol getting higher than I’d like (but not dangerously high) and my fasting blood sugar being, again, slightly higher than I’d like, I’m physically in as good a shape as I can reasonably expect. And the cholesterol and blood sugar numbers are, I am certain, going to come down with physical fitness.

I will be doing a deep dive into searching for a mental health provider over the weekend. Medication is not my first thought, as my mood doesn’t seem (to me, anyway) too severe. I’m not rejecting it out of hand, but I would prefer to try non-medicinal approaches first.

The update: I talked to my wife Wednesday night. It actually came up pretty organically in conversation over sushi that night. I immediately felt like some of the weight came off - like i’d been keeping something important from her for months, and now that it was out in the open there was measurable relief. She’s been having a rough time at her job, and I think we have both just…drifted for a while. We’d been moving a tiny bit apart without really noticing it. It was one of those resets that happens periodically in a marriage, where you’re reminded that you have a friend and an ally and a co-worker and a support team all wrapped up in that beautiful person sitting next to you.

So - still work to be done, but the first couple of baby steps turned out to be not so scary as I thought they might. I needed that reinforcement.

20

I didn’t have a PCP either when I first looked into therapy. That came later, with the diabetes. Hate to break it to ya, but when you get past 50, you’ll be visiting doctors a lot.

/still procrastinating setting up my third colonoscopy…