Bill Doskoch: Media, BPS*, Film, Minutiae

Curated knowledge, trenchant insights & witty bon mots

My tussle with severe depression – an update

Back on Feb. 7, I thought I was on enough of an upward track in my recovery from severe depression that I concluded a blog post with some of my summer plans.

That turned out to be erroneous. As a result, life hasn’t worked out exactly as anticipated.

Since Feb. 10, I’ve been on long-term disability from my job at At six months, I’ve now been on LTD more than on short-term disability (four months and change before an unsuccessful return to work that played out over eight months). This has been the worst lost-time incident of my working life.

The depth of the depression has lessened. One scale a doctor has me fill out weekly has a maximum score of 57 (three points times 19 questions). She would like to see me consistently below 20 points. I score consistently in the high 20s, but I have been as low as 24.

If you’re interested, here are the questions (Answers: Never = 0 points; sometimes = 1 pt.; frequently = 2 points; most times = 3):

  • Sad or depressed mood
  • feeling guilty
  • irritable mood
  • Less interest or pleasure in usual activities
  • Withdraw from or avoid people
  • Find it harder than usual to do things
  • See myself as worthless
  • Trouble concentrating
  • Difficulty making decisions
  • Suicidal thoughts
  • Recurrent thoughts of death
  • Spend time thinking about a suicide plan
  • Low self-esteem
  • See the future as hopeless
  • Self-critical thoughts
  • Tiredness or lack of energy
  • Significant weight loss or appetite decrease
  • Change in sleep pattern
  • Decreased sexual desire

In comparison, while at my sickest in the early winter of 2011, I would have likely broke 50 on that particular scale.

Using his scales, my family doctor rates my depression as moderate. In late July, CTV’s physician said demeanour-wise, I haven’t really changed to him in the past six months.

For me, moderate depression means rarely being functional in the morning. Most days, I’m not active until at least 2 p.m., if not later (I generally go to bed about 12:30 a.m. and would like to be up by 8 a.m., which would be in keeping with my work schedule).

When I am up, my mental and physical energy levels can still vary widely. For example, composing a curated blog post one recent evening about social media innovations at the New York Times took me one hour and 40 minutes to complete.

If I was back to normal, I should be able to bat something like that out in a maximum of 30 minutes.  I often posted three or so blog items per night after working all day and commuting for 2.5 hours. Now, my commute and work hours are down to zero — as is my productivity, sadly enough.

(Writing the above paragraphs took about 25 minutes. After that, I needed a break.)

Most of the time, my brain still doesn’t work very fast. Nor does it even feel very normal in my skull. If I get stressed out, my head feels like it is caving in on itself.  More typically, however, it doesn’t feel “right.”

What to do about it?

My doctors say I’ve been a good patient. I take my three medications daily. I try and at least work in a good walk on days I don’t feel up for a trip to the gym. Frankly, my family doctor would like to see me in the gym every day.

I’m wondering if the medication mix is right. One suggestion I’ve heard is that a consultation with a psychopharmacologist might be useful. These specialists review your medical condition and current drug regime and make recommendations to your physician on whether a different approach might be warranted.

One non-pharmacological technique I haven’t formally tried yet is cognitive behavioural therapy. It attempts to lift your mood by changing your thinking patterns. A popular book on the subject is Mind Over Mood (the scale I fill out weekly is from that book).

I have done some CBT work through the MoodGYM website. There is also a CBT component in the Mindfulness Based Cognitive Therapy program I’m currently wrapping up through the Centre for Addictions and Mental Health here in Toronto (I’ll be doing a full post on that in the coming days).

Unfortunately, MBCT is designed to prevent relapse back into depression, not cure a depression you’re currently experiencing. That being said, I think it will also help me in the short term by helping calm my mind when it becomes stormy. It also seems to be useful in breaking up poisonous ruminative thoughts, which are the single most damaging phenomenon of depression.

The course instructors say CBT is a good follow-up to MCBT. I think some formal teaching would be useful because I get put off by the examples I see in written materials. I also don’t know if I fully agree that depression simply stems from your thought patterns. In my case, I don’t feel like my thinking is particularly distorted, but I can feel something wrong with my brain and mood, something that then manifests itself physically.

Ah well. One of my doctors is big on CBT, and she’ll be available in mid-October. Maybe talking with a professional will help assuage my doubts.*

* Good help is hard to come by. I had to wait about eight months to get into the CAMH MBCT program. The lack of timely access to services is why some people suffer much more from mental illness than they should.

In the meantime, I schlep through my days. There’s some blue sky, but most of the time, the world is viewed in shades of grey, the LP record of my life turning at 30 rpm instead of 33.

One telling episode was being out on a boat in early July, bass fishing on an eastern Ontario lake. While I could function, there was no spark of joy in this activity, normally a summertime favourite.  Might as well have been washing dishes at home.

My thinking is that when I get pleasure from my favourite hobbies again, and can function at the same level I used to as a journalist and person, then this depression will be over.

Until that day comes, I can only follow my medical advice and do the best I can to assist my own recovery. It would help if there were a goal line in sight, but there isn’t. I just have to deal with that simple but dismaying fact.

Fri, August 10 2012 » Main Page, Minutiae