Posted by uncouth on September 23, 2009, at 18:55:14
This post will probably be a bit rambling as my thoughts are not too clear right now. But as of late, I have been questioning whether I'm asking too much of medication, and in fact what I'm calling depression is instead an existential and/or spiritual crisis. And perhaps medication is not the right (or complete) strategy.
Since early August, I have been dealing with suicidal thoughts that have been ever present, and more importantly, have evolved from an acute desire to die to end the current pain of the present - the regrets, ruminations, emotional incontinence, negative self-talk -- you know the drill. I most certainly termed this "depression", like all of my depressions over the past few years, just a more dangerous and serious one. I wrote a suicide note and made a really half-*ss*d attempt at self-strangulation (which I knew probably wouldn't work, but felt the need to act it out anyway).
Thankfully, the acute, throbbing and torrential melancholy responded to a med change - bupropion and zyprexa. I also had a few weeks of meaningful activity - studying for the GMAT - which gave me a goal and something to focus my mind on. The regrets and ruminations faded into the background, by the grace of God and chemistry.
Yet, I'm not feeling "better". Bupropion got me out of bed, got me working out, helped me kill my test, but what I am starting to realize is that there is this secondary "problem" that appears once the acute pain has been taken care of. Some may pathologize it and call it incomplete remission - that may be so - or dysthymia. But I've been doing this for years. It seems everytime I climb out of the pit, I end up simply sitting on the ledge, dangling my feet.
This "problem" -- let's just call it existential despair although the philosophical definition may be different than my usage -- has been in the background for years. What is difficult about this is that the emotions, thoughts, convictions that come along with this are much more difficult to 'pathologize away' as symptoms of an underlying biological disorder.
Stuff like meaninglessness, purpose, the nature and constancy of human suffering. Philosophically heavy stuff. Our inherent isolation and fundamental loneliness. This despair brings with it a sort of hopelessness that is different from the irrational hopelessness of depression. The despair feels in fact closer to the real truth of the situation than anything else. Maybe this is a part of "depressive realism"?
I am slowly coming to realize that perhaps I have been trying to attack with meds and psychotherapy this despair, which is fundamentally not necessarily a pathology of sickness, but a universal human condition/set of questions that may show its face in different ways to different people, depending on their personalities and psychological makeup. I do think that the length, chronicity, fatigue, and losses of recurrent, "biological" depression, increase the tenacity of these thoughts and questions about purpose, meaning, God, suffering. But perhaps I am expecting too much. Perhaps I have been trying to defeat these feelings, to blind myself to the truths my experience has enabled me to see, with a countertop full of pills. Thou shalt have no other gods before me?
Maybe it's better termed existential frustration -- the sense of longing for something, but what that something is we do not know. I see now that these sorts of frustrations are self-reinforcing. My behavioral adaptions and the effects of my depression have created an environment (out of work, too much free time, anhedonia, social disengagement) for the existential despair and frustration to become crystal clear and present. It's like the depression has opened this big can of worms, and i've been trying to shove them back in for years. Perhaps it's time to stop shoving?
All I know is that over the past few weeks, despite doing well on my GMATs and supposedly charting a course for my future (applying to business school), I have felt a more profound sense of dread and a different form of suicidality than I have felt in the past. The acute pain of depression has given way to an emptiness that feels like a fundamental, inescapable truth - unlike the more obvious cognitive distortions of acute depression, I am having a much harder time terming these symptoms of an illness. Recently, I have had this sense that suicide is inevitable, and that I'm essentially terminally ill at present. It feels as though the decision has been made - by my illness, by the effects of my illness on my life, by the resulting existential despair, and of course by a thinking, feeling, me that just doesn't want to go on, doesn't want to rebuild, sees futility where others see hope and opportunity. These suicidal thoughts don't feel pathological, which is why I think they scare me even more. They aren't front and center, top of mind, more like in the background, the context in which I try to get through each day. December, January, who knows - whenever I hear back from business schools, likely hearing rejections. I find myself almost hoping I don't get in, so I have a reason to die: the absence of a tangible reason to live. The irrational, silly part is that I'm not even sure how much I care about going to b-school. It just seems like something to do, and a potentially enriching, social environment (e.g. maybe I can get a do-over on life).
Anyway, I'm not so sure how to deal with this form of suicidality. I'm not in imminent danger, and yet, I'm actively doing (/not doing) things that make the liklihood of my committing the act more probable (i should be working on admissions essays right now, in fact).
I guess the main point of this post is to try to tease out how we pathologize our experience - how the very real illness of depression is related to other higher-order "human" elements of us, that when incomplete or malfunctional may be best described as existential despair. Perhaps this is God's way of getting our attention? Or the remnants of what is left of a life eaten up by chronic, severe depression.
I'm searching for some answers but I don't think there are any. I'm praying, believing, talking with God, trying to trust in Him, but feel as though I am failing. I'm wondering if this is all a result of being overeducated, overprivleged, and in possession of unrealisticly high expectations. If what I'm feeling isn't depression anymore, if it's something else, then maybe I'm doing far more harm than good by continuing to tweak, continuing to expect better living through chemistry. Thou shalt have no other gods before me.
I don't feel like I'm in a mixed state, I feel as though recent med changes have actually been a net positive, and yet I'm still a fractured self, so wanting to end this suffering, this meaninglessness, this personal history of such disappointment, maladaption, and pain - intermixed with a self who is desperately afraid and desperately trying to save my life - the clock is ticking, do I have 2 months? 3 months? 4? The certainty of my suicide has become the only form of certainty I experience in my life. My success is no longer certain. My experience of love is no longer certain. Having a family, enjoying the simple pleasures of life, no longer certain. It is mindboggling to me that there are (many) people on this earth who have this sense of certainty with the positive aspects of life - love, work, family - a baseless optimism that things will be ok. What a wonderful psychological defense/adaptation.
I'm tired of fighting -- for what? But I'm still here. I guess this is when you "push". When you put your hope in things that seem absolutely hope-less. When you admit your brokenness and go to God, asking for forgiveness and trusting that there is some meaning in this meaninglessness. For two years I have tried to open my heart to God. I have worshiped, read, prayed. And I continue to do so. But I feel no different than I did 2 years ago. I despair in my inability to trust Him fully, to ask him to share my burdens. I believe God loves me, accept that this is not inconsistent with the presence of suffering in my life and in the world, and know that there are no easy answers.
Thanks for reading, i know this post is pretty self-indulgent. 50 years ago if I started thinking this way, someone would have "knocked some sense into me", told me that all I needed to do was get a job and a girlfriend, and that would be that. Perhaps I'm making it too difficult, maybe it's as simple as that? Probably not.
thanks,
uncouth
poster:uncouth
thread:918206
URL: http://www.dr-bob.org/babble/20090921/msgs/918206.html