Panadol (acetaminophen)

I’ve recently realised that one of the symptoms of Depression can be pain – usually in the form of headaches, but also in the form of generalised aching or tiredness.

You might think I’d have realised this before, like sometime over the last twenty years. But we aren’t always that observant, especially for things that we take for granted or which are so normal and everyday that we don’t really pay attention to them.

Anyway, it seems like pain accompanies Depression, and significantly, if we reduce or remove the pain, it can help with the Depression. I don’t think painkillers makes the Depression go away, but they help us feel better. And feeling better is a good thing.

In addition, if we reduce the pain of the headaches or general tiredness, we can focus better, which helps us organise to get more things done than we would otherwise do. And that’s also a good thing.

 


Well, actually, I have somewhat known about the pain – Depression connection. For many years I knew that if I started back to exercise after a period of doing nothing, or if I have a hard workout, then the tiredness or the aching could trigger a depression episode. And that if I took painkillers for the next day or so, I could avoid the depression episode.

While I have anecdotal evidence, I don’t have much hard evidence about whether the painkillers do anything, and I would suspect that even if they do, the amount of help would vary from person to person. But over the counter painkillers like Panadol are relatively safe and can be taken for a few days – that’s what we do when we have the flu.

If you are Depressed and still functional, but you are nevertheless finding it hard to get through the day because of tiredness or headaches, it may be worth trying a painkiller to see if it helps out.

 


The usual cautions apply. Take any drug only as directed, and check first to make sure it doesn’t interact with any other meds you might be taking, and that it doesn’t interact with any medical issues you have.

Note that I’m not using any complicated painkillers – I’m using Panadol (acetaminophen) and I won’t recommend any stronger painkillers, and I won’t recommend doses higher than that recommended on the box.

Depression as Pain

I’ve found that if you are somewhat depressed and still able to function, or a lot depressed and forcing yourself to function, then one of the manifestations of trying to get things done is pain.

When we say depression hurts, this is not some existential, woe is me, hurt. It’s real pain that occurs when we are making ourselves, forcing ourselves to do things. And it’s pain that is, well, painful.

For me it’s an ongoing bad headache that just doesn’t stop. And the more that I try to do, the worse the headache gets. It can be bad enough that I think that I’d rather do nothing rather than deal with this level of headache.

Today I’m taking a page out of my parent’s handbook and I’m taking Panadol to see if it will work against this type of headache. We’ll see. I’ll let you know later today.

 

 

Update 1:
Took two 500 mg tablets Panadol (1,000 mg acetaminophen) at 9:40 am on 29 Sep 18.  The pain did mostly go away within one hour, although many of the other symptoms (focus and coordination problems) remained and did not go away. I was still Depressed, but not having the pain made getting things done easier and so the rest of the day went better. At 6:00 pm, I’m still able to function pretty well.

One day’s worth of experimentation with Panadol isn’t enough to make claims of any kind and in fact, I really have no proof that the Panadol even helped. Still, the correlation between taking a painkiller and being able to function better is suggestive (and this is from someone who is extremely skeptical about correlations).

Update 2:
At around 5:00 pm on 1 Oct 18, took my regular daily meds which help with general stability, but by then I was already exhibiting Depression symptoms. At 6:00 to 6:30 pm, it felt hard / painful to focus on what to do next. At 6:30 pm, I took two 500 mg tablets Panadol (1,000 mg acetaminophen). The pain did mostly go away in less than one hour and by 7:30 pm my ability to focus had already returned.

Again, there are too many medications and variables involved. Still, Panadol / acetaminophen is relatively safe as drugs go.  I’m therefore still willing to suggest that if you’re Depressed and you’re experiencing pain of any kind, even the type that feels like it’s just in your head, consider taking a painkiller to see if it will help you cope with Depression.


Remember to use the drugs as directed and remember to check first to make sure they don’t interact badly with any other drugs you might be taking or other health conditions you may have. And more is not better.

Staying Home When I am Depressed

Someone once asked me how I cope with depression. It’s easy. When I’m depressed, I just sit in my house, don’t talk to anyone and wait for the depression episode to pass.

The reason I’m ok about sitting in my house is that I treat depression as a physical disease – thinking of it as, say, a really bad fever. If I have a really bad fever, I would stay at home and sleep and feel miserable, but the fever would pass after a week or so. If I have depression, I stay at home and sleep and surf the internet and feel miserable, but the depression would pass after a week or so. I don’t feel guilty about doing this for depression, because it is a real physical disease. It’s not just in my head. Continue reading Staying Home When I am Depressed

Still Not Depressed

It’s been 11 days since I took the 20 mg of Ketamine. I still haven’t gotten depressed yet.

This is exceptional because according to my experiences from the last 15 years, I should have gotten depressed already. More to the point, I’ve taken no other medication since I took the Ketamine.

Quite frankly, I’m quietly celebrating. If I can take one dose of a medication once every 10-15 days and then have no mood swings for the intervening period, I’d be happy. Continue reading Still Not Depressed

Depression and taking Ketamine

I tried Ketamine yesterday.

I had been in a depression episode that lasted through all of September, which is a very long episode for me. This is problematical, because while many of the antidepressants have some effect in preventing me from getting depressed, none work to actually get me out of depression.

So there I was, with my parents getting ever more worried about me. I really was doing nothing – staying at home and sitting in front of the computer reading Fark.com and Cracked.com articles all day. That’s all I did. All day. Literally.

Well, I fed the dogs too, but they were also upset because for the entire month I took them out walking perhaps three times. They are used to going for walks twice a day.

The Ketamine was a sort of a desperation measure, Continue reading Depression and taking Ketamine

Eighteen Symptoms of Depression

Here is what I go through when I’m depressed. These aren’t exactly the official symptoms, but they give a better feel of what it is really like to be depressed. See if any of this sounds familiar.

The First Signs of Becoming Depressed are

1» I start waking up later. At first it doesn’t slip by much, just 10-15 minutes. But after a few days I may be getting up as late as half hour to an hour later than usual. Then when I wake up, I feel slow, as if I haven’t gotten enough sleep, although I have gotten 6-8 hours of sleep. Or sometimes even more.

It also becomes more difficult to follow my usual morning schedule of getting changed and getting out of the house. I often leave the house late, with some regular morning tasks undone, and often in more disarray than usual.

2» It becomes harder to do things. I know what I have to do, but I just can’t seem to take the next step and actually do it. For example, I might know I have to put the garbage out, but I just can’t get around to actually doing it.

I would see a set of books to put away, but there would be no true connection between the mess and the need to clean it up. I might understand in an abstract distant way that the two should be linked, but I still don’t actually link them together in any concrete terms of desire or need or obligation.

It’s not laziness or forgetfulness – it’s more like the idea of taking action keeps slipping out of my mind immediately after I think of it.

Alternatively, immediately after I think about doing something, I feel an equal impulse not to do it. It’s not that I don’t think I should do the task, it just feels as my body / mind is rebelling, and often it feels as if my chest or muscles tense up in refusal.

3» It becomes harder and harder to understand the task I am currently doing, and what the next step should be. My attention doesn’t wander – I just can’t figure out what is going on. It’s as if my intelligence level starts falling.

This affects even the day to day tasks that I can usually do effortlessly. They start to feel very difficult and if I can get away with it, I’ll put off whatever I’m doing until tomorrow. This inability to concentrate will affect any work or studying that you are doing.

4» Any decision becomes harder to make, from complex issues at work to simple things like whether to go to the supermarket this evening. Very often I waver back and forth on what to do and usually I tend to put off making any decisions at all. Or if I have to do something, I’ll take the path of least resistance.

For example, if I’m driving home, I’ll keep on changing my mind on whether to stop off at the supermarket (or the drug store, or the dry cleaners, or to visit a friend) until I pass it – and then decide I won’t go today. At office, I’ll put of decisions until the next day.

5» I forget things. If I realise I have to do something, I might forget about it within minutes. I might have something to do this evening and realise tomorrow that I forgot completely about it. I may have to meet someone tomorrow and forget about the meeting until they call to find out where I am.

There is no rhyme or reason for the forgetting. And I can’t say I’ll write it down because either I won’t (see item 2), or I’ll forget to look at my reminder list. Really. This happens.

As you can imagine, this can create havoc at work, and upsets friends whom you have stood up.

 


Very often these symptoms start at a low level, so I don’t notice them. And any or all of the symptoms could be mistaken for tiredness or not having the time to finish things in our modern fast paced life.

So if I left stuff off for later because I felt tired or if I don’t feel like doing anything because I had a hard enough day already, what’s wrong with that? This feeling of being justifiably excused for not getting things done is particularly strong if I’ve just come off a manic high where I’ve been incredibly productive.

It’s possible to continue for quite a while (measured in days or weeks or months) in this state of low level depression. Particularly if you have activities that must happen, like going to work, or carrying children to school and taking care of them. You’ll just feel tired all the time and all the optional things you have to do or would like to do just don’t happen. Your life gets dull, boring, lustreless.

Well, in addition to the lustreless life, you’ll start piling up lots of things, big and little, that need to get done. The groceries will sit on your countertop, your credit card bill won’t be paid, you won’t have carried the car for servicing, you won’t get around to buying the tickets for the concert you want to go to, you won’t have done laundry, you won’t have gone through the pile of papers on your work desk yet, you won’t have called your friend or your client. The dogs need to get bathed, the house needs to be swept, the DVDs need to be returned to the rental shop. You’ve been missing classes. You won’t have picked up a present for the birthday party. You won’t have watered the plants or collected your clothes from the dry cleaners.

 


You get the idea. No single thing is a critical problem, but you won’t do any, and you’ll find your life starting to crumble around you because of all the things you are failing to do. You’ll be aware of all the things that need to get done, but you just can’t get around to, well, doing them. And this is going to really really stress you out.

It is usually said that stress causes depression. I think this is flat out wrong. My experience is that depression causes stress, because low level depression creates all of the little problems that add up over the course of a week or two or more to create one big heaping pile.

Then you’ll really be stressed.

And the stress then makes the depression worse. For me, it takes only about one week of deepening depression and skipping out on the little things to create a huge enough backlog to drown me. If you have a hectic lifestyle, it can take even less time to derail you.

To make matters worse, you will also have annoyed your family, friends and co-workers by not doing what you are supposed to do. So in addition to knowing that you are failing on your responsibilities and your competence, you have to deal with angry people.

Depression is very much a downward spiral. The worse things are, the worse they get.

 


Incredibly, so far the things I’ve been describing, I classify as mild depression. The following are additional symptoms that I also get. I tend to think that they appear later in the depression episode. But it’s not so clear cut.

I suspect that all the symptoms all appear at the same time, but when the symptoms are mild, the following are either easier to miss or easier to overcome / work around. Then as the depression worsens, these start becoming more apparent because I can’t work around them any more.

So as depression episode deepens, what happens next?

1-5» More of the same. The 5 signs / symptoms mentioned above continue to happen. Of course by now, my life is starting to derail in a big way and I am now clearly recognising that I cannot fix what is happening because of these depression symptoms.

6» My self confidence falls drastically. I don’t feel as if I will ever succeed in anything. Which of course is made worse by the fact that I’m currently not succeeding in anything.

The loss of self confidence is not just because things are going wrong – it seems to be an intrinsic part of the depression itself. But like all parts of depression, the two pieces feed upon each other. You won’t do something because you don’t feel confident to do it, and then not doing it lowers your self confidence even more.

My self confidence usually fails to the point that I don’t like seeing myself a mirror. I try not to look in one, and when I do look, I do not see myself in the mirror, just a face that had no particular meaning to me.

7» I start losing a clear sense of identity or who I am. I feel as if I am acting in public all the time, or putting on “a public face,” or wearing a shell which does all the chatting and smiling, when all I feel like doing is staying at home and not talking to people.

It’s quite an effort to pretend to act like normal in public, but nobody seems to notice how fake my actions are. Which somehow makes me feel worse.

8» I begin to feel slightly lightheaded all the time. Everything feels as if it were a bit distant or dreamlike. I see and understand everything that is going on around me and will have a coherent discussion if someone asks me anything, but I don’t feel completely connected – as if everything around me isn’t quite happening to me.

Other people can notice this sense of disconnection – someone who talks to me will feel as if I am not paying attention or as if they are talking to someone who is not completely there. Or as if they are talking to a blank wall or a black hole. I’ve been told that this can be extremely disconcerting or very annoying.

9» I get anxious and nervous dealing with people. I feel as if everybody is going to accuse me of some little thing I did wrong, or shout at me. I feel as every little thing I do is being judged and that I am going to be criticised for doing it stupidly. I feel as if I ask for help or a favour I will be turned down or laughed at.

It doesn’t matter whether I’m at work requesting information from someone else, or if I am asking a friend if they want to go to the movies this afternoon. It doesn’t matter if I actually did something wrong or if I am doing a favour for someone, and it doesn’t matter if what is being discussed is important or trivial or silly. I always feel as if I am going to be yelled at.

There is no logic or sense to these feelings – the sensation comes from inside me, not from what is actually happening. As a result I send to avoid calling people or answering my phone, or even opening letters.

10» I stop talking much with friends and family or I don’t attend any social functions, even if I have told people I would go. I beg off at the last minute or I simply don’t show up.

This is a combination of three things – nervousness in dealing with people (item 9), the inability to think make decisions (item 4) and the sheer inability to get things done (item 2). It doesn’t manifest as the separate symptoms – I just think “I don’t want to go out – it’s too much effort to get organised,” to “There will be so many people there and I don’t want to deal with them,” to simply not being able to decide what to do, so I eventually end up with the default and stay home.

I can understand that attending the function is important – like a sixtieth birthday for an uncle – but I just won’t be able to get my my act together to go.

11» I tend to want to break off relationships. I feel that the relationships are too much work, or that I am not good enough to be in one, or that I don’t have the energy to spare to cope with a relationship while the rest of my life is failing.

Usually, up to this point I am still able to act and move around in public. I’ll be slower starting off and not getting all that much done as I should and not dealing with people well, but I’m still functioning of sorts. By this point, however, it is taking huge amounts of my energy and willpower to maintain a semblance of normal life. But at some point I fall into what I would call serious depression.

 


The I’m Seriously Depressed Symptoms

The onset period of serious depression for me is very sharp. It usually starts on an afternoon when I return from work into the safety of my house. I would have been fighting the depression symptoms for a few days, but when everything becomes a burden to do, I can fight for only so long. Once home, I stop fighting, because I can’t keep it up any longer, and I let the depression take over. It’s a battle lost. It’s a battle I always lose.

What happens next is

12» Communications fail completely. I don’t call my family or friends, and I don’t return phone calls.

I don’t answer my cell phone – if it is ringing I will ignore it or hide the phone under cushions so I can’t hear it. I’ll turn it off or put it in silent mode or not bother to recharge it when it discharges. I’ll unplug my land line from the outlet so I don’t have to hear the telephone ringing.

I don’t listen to my answering machine. Heck, I’ve asked the telephone company to deactivate my voice mail because I’ve realised it is pointless – I never listen to the messages.

I don’t read text messages or my e-mail and I don’t reply to them. I may lurk on social networks but I will not actively respond to any requests to contact me.

I may or may not answer my door bell.

I don’t want anyone to get in touch with me and I don’t want to get in touch with anyone. This includes my parents, my brother, my partners, my closest friends. Nobody.

I can’t call for help because by the time I realise that I won’t be able to fight the depression anymore, my ability to communicate or reach out to others has already failed.

13» I become terrified to talk to or hear from people. When I say terrified, I mean terrified – the fear factor is huge. I cringe at the thought that someone might talk to me. This is item 9, but magnified one hundredfold.

14» I hide in my house. I don’t go to work and I don’t go visiting people. I don’t want to go outside for any reason.

Any activity that requires me to leave the house stops happening. I stop going to the gym, I stop meeting with friends, I stop talking walks.

Well, I go out when I need food. But that’s I usually after I have rummaged through the entire house and eaten everything that is in a box or bag that needs only microwaving.

But

When the fear becomes high enough or when I have not left my house in a few days, I become scared that my family or friends might come looking for me. I no longer feel that my house is a safe haven. So I disappear.

I get in my car and go driving. I can drive for hours. Or go to the beach, or anywhere the people don’t know me and won’t talk with me. Or I might hang out in a KFC or a restaurant where they won’t throw me out and read for an hour or two.

I’ll stay out until very late, often going to a late movie so I have somewhere to be. I’ll return at midnight or later so I won’t have to see anyone. I sneak up to my apartment to see if anyone is there. If anyone is there, I don’t go inside. I get back in my car and go driving.

If there is no one there, I gratefully get into bed, but the next day I’ll wake up and leave the house early so no one can see me. And so the days go. From my family’s point of view, I disappear completely.

When I disappear, I don’t relax. The purpose is escape and all I want to do is to put my body somewhere reasonably safe and comfortable so I can shut my mind down to escape the terror I feel.

I spend days like this with an almost completely blank mind. Just enough of me is alive to make sure I eat and sleep and to be cunning enough so that the average person doesn’t suspect what is going on.

Because my mind is so blank, I usually have a hard time remembering what went on. I can only remember if I put a bit of effort into it.

On some occasions the terror factor was so high that even though I am home alone, I have hidden under my bed and read and slept just so that in case someone comes visiting, they won’t find me. This was when I was 35 years old.

15» I spend a lot of time trying not to think. I read the same magazines over and over again, and I read a lot of trashy sci-fi novels. Good science fiction, good literature and text books are usually beyond my ability to understand properly.

I watch television six to ten hours a day if I get the chance. Or more. I can easily watch television from 5 pm to 4 am without even getting up for dinner.

I can’t study or do anything productive that requires concentrated thought.

I don’t have the desire to do anything. Everything piles up to do. Clothes to be cleaned, dishes unwashed, garbage to be taken out, books strewn everywhere, bed unmade, clothes in the living room. You name it, it’s not done.

The inability to do things is not just for housework. It includes studying, work, social activities, brushing my teeth, bathing. I may abstractly think they might be important, but really, I am not thinking enough to care.

16» My sleep patterns become odd. I stay up until two or three in the morning, reading. I like being up after midnight because no one will bother me and so I feel “safe.” I dread that in the next few hours another day will start and people might want to talk with me.

I can spend sixteen or more hours a day sleeping. I would often sleep hoping I would not wake up, or that the world would disappear before I woke up.

17» I tend to crave food, particularly sugar. I can eat an entire box of chocolate cookies in half-hour. And then be disgusted with myself. And nauseated because I don’t particularly like sugar.

I tend to eat a lot. I can put of 2-6 pounds over the course of a three week depression. Which really doesn’t help my self confidence.

18» I become self destructive because I stop caring enough about anything. It’s not important to me if my relationship fails, or if I don’t go to work.

I tend to end up in a loop of destructive thinking – “Nothing matters anymore,” or “I don’t care” or “So what, I’m failing anyhow.” Or if the idea is sufficiently painful or requires thinking, I let it slip from my mind and I don’t think about it – because if I don’t think about the problem I don’t have to deal with it.

I become suicidal because of a combination of not caring and because it feels too difficult to continue living. And yes this happens in every depression. Most times I don’t do anything about it, but sometimes I try.

Official Signs for Depression and Manic Depression

The following are the official signs of what consists a manic or depressed episode and what Bipolar Disorder is. The information is taken from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-IV), published by the American Psychiatric Association.

Personally, I think this information is confusing or vague and is not quite as useful as the signs of mania and depression I’ve noticed in myself. However, since this is the information used by psychiatrists to decide whether you are depressed or manic or bipolar, I’ve decided to include it. Continue reading Official Signs for Depression and Manic Depression

September 2011 to Now

It has been an interesting ride for the last 5 months. This is a quick note mostly to let you know that I’m back to writing…

Coffee
First off, the use of coffee seems to do something. I’d like to say it works, but that’s not entirely true – I been in and out of depression for Dec 2011 and Jan 2012.

I’m not sure if the depression was caused because I stopped taking the coffee regularly or at a proper dose, or because I became resistant to the coffee, or because the coffee never worked and I had a rare spell of no depression. I was hoping for a relatively clear cut test with a clear cut answer, but that didn’t quite materialise. So I’m starting back testing again, effective today 1 Feb 2012. The experiment will need to go on for a minimum of three months or until I next get depressed, whichever comes first. Will keep you up to date this time around.

Although the testing I did wasn’t as rigorous as I would have liked, and I have to do it over again, it appears the coffee does something. Enough so that I think that adding coffee to whatever drug regime that you are on may offer some benefit against depression (notice the word ‘may’). The amount of coffee that I am drinking is equal to the caffeine in one double espresso Starbucks every 3-4 hours. This is a lot of caffeine, by the way – you should probably start with drinking less coffee (or less strong coffee) to see what happens.

The side effects are typical caffeine side effects – hyperactivity, tense muscles, twitchiness, peeing a lot, nausea if you happen to overdo the coffee. And beginning to hate the taste of coffee. For me, none are particularly bad, though having to pee frequently can become awkward. I will add details about my experiences last year in my next post.

WARNINGS:
I am NOT a doctor. The only reason I am suggesting this is that coffee is drunk by millions of people daily with no real side effects, so I figure it would be difficult to harm yourself. I do not recommend using caffeine tablets as I am not sure what such a concentrated rush of caffeine will do.

However, if caffeine makes you very hyperactive or manic, or if your mania is not well controlled, or if you are currently manic or hypomanic, do NOT try this. Coffee does make one hyperactive, so it is likely to intensify any manic symptoms you are exhibiting or make them harder to control.

I also recommend that you talk with your psych about the coffee suggestion the next time you talk with them.

What Depression Is
I’ve been refining what depression seems to be. Here are my second or third draft ideas so far.

Depression is  a failure of the connection between the ability to think and the ability to act. I can think of what to do, but it doesn’t translate into actually doing anything. The mind continues to work, and I can be articulate and knowledgeable if someone asks me about something, but nothing I say will cause me to actually take action. An example: I can know why I need to take my medication, and I can tell you precisely why I should, but that won’t translate into me going into the kitchen and taking it. Or even taking them if the tablets and the water are on the table in front of me.

Depression is the loss of personal connection or meaning in situations. For example: I can know that I have a good relationship and I can know intellectually that the my relationship is important and that if I don’t talk to my partner then I am screwing up the relationship. But knowing about the situation intellectually doesn’t translate it having any meaning to me, almost as if what I am talking about is happening to someone on the other side of the world and not me. It’s simply not relevant to my life. The same thing happens in other situations – it’s not happening to me, it’s not important to me, it’s not relevant to me, it has no impact on me. Even when it does.

Depression is the fear of other people.  I don’t want to talk with people or discuss anything, or have them visit me. I am afraid that they may shout at me or criticise me. Having someone talk to me can feel as if they are hitting me with a stick. I can’t cope with talking about anything serious or meaningful with people – it’s too hard or painful.

Cause and Effect, Depression and Stress

The traditional and common model has it that there must be some event or stress in your life that causes depression.

I think that’s just wrong.

And my experiences over the years generally have borne me out. Stress does not cause depression. Getting depressed creates stress in your life.

For example…

One thing that correlates with the onset of my depression periods has been staying up late reading science fiction. Now, there are two possibilities of cause and effect.

One is that when I find a good book and stay up until 2 or 3 am, I screw up my sleep cycles, become sleep deprived, have low productivity the following day, possibly create stress and thereby trigger a depression episode. Sounds logical, yes? Especially if I do it two days in a row. So this theory is “Staying up late to read triggers a depression episode.”

The second one possibility is that when the depression episode starts, one of the symptoms is that I try to hide myself from the real world by escaping into a fictional one. And as for staying up late, well, 2 am feels safe, because no one else is awake. So this theory is “Depression causes me to stay up late reading”.

The first possibility sounds more logical, doesn’t it? There’s a clear reason why I should have gotten depressed. See, stupid me had to stay up reading. What an idiot, especially if he knows it from past experience!

The second possibility sounds airy fairy, even to me. I mean, how could depression cause something like that. And what caused the depression to start with? This isn’t even worth mentioning.

Except…the second possibility seems to be the correct one. Here’s why.

I’ve been tracking my moods daily since I started taking Seroquel at the beginning of June. And around the same time my brother gave me a new science fiction trilogy to read. Now it turns out that I couldn’t read anything for the first week because I was sleeping. Interestingly though, I didn’t read much in the second or third weeks either. I did start the trilogy, and it was not great fiction, but it wasn’t bad either – so I’d read a few pages here and there over the days. There was no burning enthusiasm to find out what happened next, and overall, given a choice of doing something or reading, I chose doing something.  And since the Seroquel tended to put me to sleep, I didn’t read much at night.

Until the Seroquel stopped working at the dose I was taking and I started into a depression episode.

Usually, my depression episodes have a swift onset – usually over a day or so. However, the Seroquel interfered with this, so I have a few days of records of complaining of the onset of depression and days of low productivity. And then I have the nights where I stay up until midnight or 2:30 am, reading some books which I didn’t think were particularly fascinating a week earlier.

The late night readings follow the onset of the depression.

So in this case, the logical sounding cause/effect of possibility one is not correct. The more subtle scenario – in which the depression episode started and then external symptoms of it, like staying up late, became visible – is the correct one.

I’d actually like to extend that. Given my years of experience, I’ve generally found that there are very few external triggers for depression episodes – and daily stress is not one of them. My explanation has been that the depression episodes are probably triggered due to some biochemical process / failure within the body. The depression episodes then change our behaviours which are visible to other people.

However, since the biochemical changes are invisible to other people, the first they see of the depression episode are the changes in our behaviour. And then as the depression episode becomes worse, they then see the more radical changes in our behaviour, and assume these were caused by the first visible changes in our behaviour.

So while the general idea is that
incidents / behaviours in my life  —cause—> depression episode

my experience has been
internal biochemical changes start a depression episode —which shows up as—> incidents / behaviours in my life  —which then become—> more severe incidents / behaviours in my life

Notice that cause and effect are reversed. Depression is not caused by incidents. The incidents are a symptom of a depression episode that has already started.

 

Panic Attacks

Since my major meltdown in 1997, I haven’t gotten panic attacks. Or at least nothing compared to what other people write about. I’ve often wondered why, because I get depressed as much and as intensely, as other people.

On the other hand, I do tend to retreat into my house when I’m depressed and read trashy science fiction and not think of anything at all. Most people don’t seem to do that.

I’m wondering if there is a relationship between the two effects – panic attacks vs retreating and doing nothing.

I do know that when I am depressed and I try to force myself to do something, I get the following effects:

  • First I get a feeling of not wanting to do whatever I am trying to do. It’s as if my mind says  ‘Let’s get dressed to go out’ and then my mind immediately replies to itself – ‘No, I don’t want to do that’.
  • If I continue to force myself to get dressed, I get distracted and do pretty random things, like pick up a book to read, or wander into the kitchen looking for food. Random things.
  • If I really force myself to continue, I start triggering panic attack symptoms – the feeling as if a hand is clenched around my heart, an extreme desire to run away or hide from people, a feeling of terror.

I don’t get the panic attack symptoms anymore mostly because if I start feeling that way, I back off and stop doing whatever I was forcing myself to do.

There’s a good reason why I start backing off when panic attack symptoms start to show up. Once upon a time many years ago when I was a teacher, I tried to make it to school while depressed. I really didn’t want to leave the house, but I forced myself because it was my job. As I drove closer and closer to school, the feeling of “I don’t want to do this” and the associated terror got so bad that about two blocks from school, I turned around and fled. Course, I then crashed into another car at an intersection because I was in such terror that I couldn’t concentrate on the traffic. I just wanted to escape now!

Since then, I back off from those symptoms.

So. When I’m depressed, I don’t get panic attacks. But, I don’t do much either.