It is mental health awareness month. 1 in 5 people have mental illness. I am one.
I currently have depression related to chronic pain. It isn't the only depressive episode I have had in my life. I had a depressive episode my first year in university to the point I could not complete my first year, had to take a year off and then return. Medication had an adverse affect on me. Turns out all anti-depressants do have adverse affects on me. I have actually had a suicide attempt on one anti-depressant so it can really get quite bad on them. I am currently on Abilify instead.
Now that depression I had when I was 18 was somewhat typical. Leaving home for the first time. The stress of the university life. What added to that was that I had un-diagnosed fibromyalgia an I was having a difficult time coping with it. I was not pacing myself and I was trying to keep up with my peers, which is simply impossible for me to maintain. It took a downward turn when I was put on paxil and decided I didn't need to get up or eat or function at all. And I didn't need to care about anything at all. Not even the things I should. When I realized this suddenly I tried to turn it around but it was too late for the school year. So i took a year off to sort things out. I read a great book on depression at the time. It had this chapter on cognitive therapy and it rang so well with me I just really implemented its advice. I changed a lot of things in my lifestyle. I began to pace myself. And start getting rid out those negative thought patterns. And slowly, but surely worked myself out of the depression such that when i returned to school I achieved honors. Even though the pain had become worse with the onset of migraines.
When I entered the workforce years later after my Masters my migraines didn't take well to it and became daily chronic, instead of 15-20 a month. This added to the FM had a significant impact on my mood regulation. I was unable to sustain full time work... yet I kept trying to push through the pain. In other words... I was exceeding my coping strategies. All the coping strategies I had hard earned the hard way when I was younger were burned out by pushing myself beyond my limits. And I fell into another depression. With suicidal ideation. Which became suicidal intent on anti-depressants I was put on for the migraines and FM. Leading to one attempt. Actually two, since I had another recently. But that was caused by a different medication and was far more spontaneous due to having had the first attempt. Having crossed that line already. Anyway I thought suicidal ideation was normal. That even the deep bouts of depression were normal. Because of the pain. Because of the migraines. Who wouldn't have those thoughts? Prior to the actual suicide attempt I hid it very well. No one would know for certain. I laugh off my pain. Hide it behind a smile. Don't tell anyone I am seriously struggling with it. And I was. Seriously. For years. And years. I had many missed days of work. Many leaves of absence. In a sense a failed suicide attempt was a good thing. That it failed for one. And that it made it out in the open, for another. I couldn't lie anymore, could I? It was right there. Exposed. And I felt bad about that. Embarrassed. That I couldn't control my suffering the pain. And just buck up, buttercup.
And there is a reason for this thinking. My work insurance company, my doctors and my employer were all telling me I had to work full-time. Just push through that pain. Just do it. Just suffer. And it was inevitable that suicidal ideation let to suicidal intent. It was a matter of time really. My doctor was so indifferent about it. I was on a leave for three months. Back to full-time. I knew I wouldn't last long. That something had to change. There was a long term leave. But insurance companies don't like that. So back to work I went. And ergo second suicide attempt. Which I did what I was supposed to do. I called 911. I realized I had gone too far. Realized soon after. It was as I said very spontaneous and I remember very little about it to be honest.
It was really the pain clinic and my family and my new doctor that initiated the change I needed. That it wasn't alright to suffer. That I couldn't exceed my limits all the time. I could not work full-time. That I wasn't capable of it. And I had to downgrade to part-time. Likely forever. That the depression itself had an impact on my pain and as its own vicious entity I needed to once again focus on it. With medication and with thought control. And with mood regulation. As well as pain management. All things I should have had years and years ago but had the wrong doctor. Just someone who was completely indifferent about my pain let alone how that pain was seriously impacting my mood. I had told that man straight up that the pain was affecting me a great deal and I was unable to emotionally cope with it. He simply didn't care. I would have been more direct but there is that stigma of suicidal ideation and depression I didn't want to deal with. I was as direct as I was comfortable with. And if he wasn't capable of addressing the pain issues or the mood issues he certainly wasn't capable of digging deeper. It was my mother that firmly suggested I find a new doctor. It was the most fundamentally important decision I ever made that directly affected the course of my treatment for the better.
- Be aware of medication side effects that may affect your mood.
- Don't be afraid of taking medications for mood regulation when needed. It has been such a great thing for me. The psychiatrist was able to find one suitable for me, in my specific case of side effect issues.
- If you have an indifferent doctor or are aware of mental illness stigma affecting your care please find a new doctor. It can dramatically change the course of your treatment.
- Please seek help for suicidal ideation. And immediate assistance for suicidal intent. I waited far too long and then I could have easily died had I not been interrupted at that time. It is terrifying how easy it is to cross the line from thought to action. But it is different ideation and intent. And you can tell when the intent... the plan of action is there. And that is when immediate intervention is needed.
- If you have chronic pain as well, pain management is never to be underestimated. It can mage a significant difference. Just not right away. And if there is comorbid mental health issues it does take time.
- Seeing a psychologist is very benificial as well. Helps reinforce coping skills. I needed the extra support with the depression on top of the pain. I just wan't coping well at all. I needed the extra guidance along the way. A game plan if you will and someone to hold me accountable to that game plan.
- Take care. Self-care sometimes goes to the wayside but it is very important. We have to take care of ourselves first and foremost.