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All the Things I Tried In Order to Treat my Depression

2021-05-02

I’m 33 and I’ve been depressed since my teens. I don’t mean I’ve been in a constant state of feeling depressed during all those years, there have been ups and down. Heck, it’s probably safe to say that, excluding sleep hours, I’ve probably spent more of that time feeling “OK” than time feeling like a flaming pile of turds. The reason I say I’ve been depressed since my teens, then, is that even in the periods when I’m “OK”, I generally feel pretty “meh” and I generally don’t get much enjoyment out of things. As I was explaining to my partner the other day, it’s as though magic and wonder have disappeared from my life.

Last year I learned – through being diagnosed with it – that there’s a medical term for this: dysthymia. From the Wikipedia article:

Dysthymia, also known as persistent depressive disorder (PDD), is a mood disorder consisting of the same cognitive and physical problems as depression, but with longer-lasting symptoms.

As I’ve mentioned before, I’ve only recently begun pharmacological and psychological treatment for my dysthymia. I also explained briefly some of the reasons for my reluctance to seek professional care during all these years. Maybe I’ll go into that in another post, but what I want to write about now are all the different ways I tried to help myself overcome this condition. I’m not sure why, or who would care about this, but maybe it will be cathartic.

I should also mention that none of these helped (with some exceptions I’ll note at the end). Additionally, a lot of these things are not typically regarded as being helpful for depression; some are probably more likely to make it worse. But I’ve been so desperate at times that I put my hopes into anything that sounded remotely helpful. It often took nothing more for me than hearing a single anecdotal account of someone somewhere claiming something made them feel somewhat better for me to think “hey, maybe that’ll finally do it!”

Warning: some of the things in this list are probably bad ideas for people with mental health issues, others are probably bad ideas for anyone. Please don’t treat this list as an inspiration or a recommendation in any way, shape or form. Do your research, and be safe.

So without further ado, and in no particular order, here is a list of all the things I tried in order to treat my depression:

* SSRI: Of all the items in this list, this is the only one which came as a result of meeting with healthcare professionals. And while I can definitely say it hasn’t cured my depression; it has helped in managing autistic meltdowns (although I hadn’t been diagnosed with ASD at the time I was prescribed the medication).

** Spirituality: Setting medical diagnoses and explanations aside for a moment, I have always felt rather strongly that at the root of my depression lay some kind of existential or spiritual crisis. I can’t know if spiritual practices will ever lead to a resolution – or if the resolution they might lead to will have any impact on my depression – but I can’t help wondering. At the end of the day, I have to admit I have always had a fascination with this profound dissatisfaction, dis-ease – in a word, suffering; it seems to point towards something… although I have no idea what. As I mentioned elsewhere, this suffering and the desire to resolve it have endowed certain spiritual paths and practices with a very strong appeal for me. The fact that none of these practices have born fruit has made me weary and skeptical, but the primal attraction I feel has not diminished.

*** Friends: Of everything I’ve listed, this is perhaps the most valuable. I can say – without a shadow of a doubt – that I would not be alive today if I had not had the support of close friends willing to listen to my dreary ramblings. If you suffer from depression or know someone who does, do not underestimate the value of an honest discussion. It is not a cure, but it is a solace and for this I am very thankful.


Returning to an Old Path

2021-04-30

I went through a drawn out phase in my twenties in which I was very depressed. It was an existential crisis in many ways. In an effort to heal, I got really into spiritual teachings of various stripes. I hoped I could find solace and perhaps some clearer insight into what the hell was going on. I was also really skeptical of organized religions and cults and so never engaged in anything formal for too long, never had a teacher, I just tried all kinds of different approaches, mostly meditation. I floundered.

Despite my best efforts, I never got anywhere substantial and none of the techniques I put into practice ever gave me any sense of making progress or achieving any sort of insight or peace or anything. Importantly, none of it ever helped me with my depression; if anything it made it worse.

At some point, following an acquaintance’s glowing recommendation, I even went on a 10 day silent retreat at a meditation center where I diligently practiced from morning to evening with about 11 hours of formal sitting meditation every day. Even that intense experience failed to produce anything noteworthy for me. I was pretty disillusioned with mediation at this point. That was about 8 years ago or more.

In the interim I have had a few other short periods where I did daily meditation; I guess despair drove me to it again and again despite the fact that it didn’t seem to help. Despair, and a profound and seemingly unshakable fascination with the enlightenment discourse. The claims to insight made by so-called Buddhas, Zen masters, mystics of all stripes and the like seem so similar across time, space and socio-cultural contexts that I can’t help concluding there must be something there.

I don’t know what that insight is, or what it might look or feel like. To be honest, I don’t fully trust it’s actually possible. But I’ve been fascinated with this stuff since childhood and I’ve felt for about just as long that there’s just got to be something “more” to life. Something feels “off”, “missing”, or “not quite right” and when I read these sorts of texts with their promises of “Truth”, “primordial awareness” or whatever, it resonates with me on a profound level. Maybe it’s a wild goose chase. Maybe there’s just nothing to be gained but a bunch of wacky experiences. (There’s a famous quote from the Buddha where he asserts to have truly gained nothing from enlightenment). Yet, my curiosity has kept me coming back. And every time it’s been the same; I’ve banged my head against the wall to no avail at all; or so it’s seemed to me. Eventually, I just gave up. I put all this stuff out of my mind and went on with my life. I thought I was done with this.

Enter Daniel Ingram who I recently discovered in a podcast interview. Daniel is an American emergency room doctor who claims to have achieved spiritual enlightenment by following precise meditative practices based in the Theravada Buddhist tradition. He’s written a book: Mastering the Core Teachings of the Buddha: An Unusually Hardcore Dharma Book (MCTB) in which he lays out a pragmatic distillation of various Buddhist practices and roadmaps on the path to enlightenment. Against my better judgment, my interest was piqued. Daniel has a very down-to-earth, results-oriented approach which immediately appealed to me. It seemed this might be exactly the sort of book I wish I had had in those harrowing periods in my twenties.

I started reading MCTB (available free here) and it’s been thoroughly engrossing so far. And with this newfound interest, I began meditating again…

Following some directions in MCTB I chose to begin with daily breath concentration meditation and this put me face to face with my old problem described above. Namely, that meditation doesn’t seem to “do” much of anything for me.

Putting this in perspective with my recent diagnosis of being on the autistic spectrum. I began to wonder if there might be something about my neurodivergent brain that could explain my difficulties.

For one thing, I’m an extremely intellectual person. I don’t mean that in the sense that I’m a bookworm, or that I like to philosophize all the time. What I mean is that on very basic experiential level, I am nearly always “in my head”. From what I understand, developing concentration and insight in meditation has a lot to do with connecting with bare sensory input; and this is something that just doesn’t come naturally to me. I live and breath in a world of concepts and ideas; sensations are always distant and peripheral, almost alien. And don’t get me started with emotions…

There’s definitely a strong intellectual component to the world of meditation – and Buddhism especially – in the form of seemingly innumerable frameworks, concepts and philosophical systems built to help navigate the spiritual realm. Setting that aside, pretty much all the practical advice I’ve ever seen seems to point back towards a focus on ordinary experiential reality, rather than cognitive understanding. Hence my difficulty.

It’s not quite that I can’t focus on sensations without intellectualizing them, it’s just that I don’t know what to do with these sensations when I have them in my sight. They just seem to come up and fade at random, like raindrops on a windshield. But I fail to engage or feel much curiosity or genuine interest. It’s like “OK, but what now? Where’s the puzzle for me to solve? What’s there to understand here? This is boring!”

Without that genuine interest and curiosity, the whole process quickly becomes very labored and tedious.

I realize this isn’t unique to me, but I do feel I’m facing a higher barrier-to-entry than most. I think.

Maybe I need to learn to relax before I can actually see some benefits of meditation. It’s not easy! And to be honest, I’m not interested in meditating in order to become more relaxed or to have pleasurable experiences (although if that happens, I won’t complain). But I am interested in gaining insight into the nature of reality. Experiential reality, at any rate. That said, I’m beginning to think it might be worthwhile to try out some relaxation techniques if this is part of what’s holding me back.

There are also all kinds of relaxation and meditation techniques out there, and I definitely should do some more experimenting. It’s possible I just haven’t yet found a method that works for me.

I can’t say I have a die-hard conviction about any of this stuff. I’m just really curious and hopeful; and sick of feeling dissatisfied, detached, numb, jaded, depressed, cynical, etc. So I’ll give this stuff my best shot. I don’t have much to lose anyway, and I have the luxury of free time so why not!


A First Step

2021-03-31

About a week ago I was diagnosed with Autism Spectrum Disorder (ASD), Level 1 – commonly known as ‘Asperger’s Syndrome’.

I’m still not sure how I feel about the diagnosis, or even if I fully agree with it. Then again, being unsure about how one feels is a common trait among those on the spectrum… Whatever the case may be, I suppose this is a step forward in figuring out what makes me tick.

It is exceedingly rare for anyone to receive only an ASD diagnosis. Usually, the condition comes with so called comorbidities such as ADHD, anxiety, OCD, depression, etc. In my case, the doctors determined I suffer from something called dysthymia – aka Persistent Depressive Disorder — which, to put it simply, means I’m somewhat sad most of the time, and very sad some of the time. It’s been like this for me for the past 15-20 years; I had simply accepted this reality as an immutable part of my personality by now. To complicate things further, the psychologist who evaluated me strongly suspected I have something called ‘intellectual giftedness’ which is not a medical condition, but could explain some of my behavior and thought patterns. Determining that, however, would require taking an in-person IQ test and I’m really not convinced it’s worthwhile.

It took me nearly twenty years to get the professional help I need. Twenty years of recurring depression, spiritual torture and suicidal despair. Twenty years of banging my head on the wall trying to figure out why I was feeling this way when everything else in my life seemed to be going well.

In that time I tried all sorts of self-help techniques: Yoga, diets, meditation, sports, drugs, you name it; nothing worked. So why was I so reluctant to seek professional help?
I’m not entirely certain myself, but I think a big part of it has to do with internalizing certain toxic views and values such as the Protestant work ethic and notions of masculine invulnerability. (To be clear, I wasn’t raised in a religious or overly patriarchal household; but I think these ideologies permeate Western society and play an important role shaping peoples inner and outer identities) Men are expected to ‘bite their lip’, ‘take it on the chin’ and ‘man up’ when times get tough. And as much as I loathe that kind of rhetoric, I have to recognize that it forms a substantial part of my self-image and world-view. Of course, not all men take these social expectations quite as seriously, and so the question as to why I didn’t seek help remains to be fully explained.

But better late than never, right? I should add that were it not for my loving partner and their concern and insistence, I might have never taken that step.

After contacting a shrink for the first time last summer. I began taking an antidepressant (cetilopram) for the first time in October. (Not sure how much it’s helped with the dysthymia, but I’m less anxious than I used to be) Now I’ve learned I’m autistic and have begun practical therapy aimed at learning to adapt my life to my condition — basically, to recognize my strengths and limitations — to try and avoid my recurring meltdowns and persistent depression. Keeping a journal is one of the first things my therapist suggested, so here I am.

I think the goal of this exercise is for me to learn to introspect and express my emotions, which is something I’ve always struggled with. By honing this skill, maybe it will become easier for me to relate to other people’s emotional landscapes.

As always, I remain skeptical and cautious, I don’t want to get my hopes up unrealistically only to have them crushed later on. I’ve been down that road too many times already.

So, in brief, here it is: the first post in, hopefully, an ongoing series. And if it turns out not to help, at least I’m getting some typing and writing practice; I’ve always admired writers 😅