If I were to rate my days (and that’s exactly the sort of thing I would do) yesterday was a nine. Not a ten because I was at work, and I didn’t go running, but I’ll take my nine. For the past three months, I’ve been scoring fives… or less.
Less: After a string of fours, I decided to restart therapy. This was right before Christmas. With the holidays and vacations and a packed patient schedule, the earliest appointment I could get was January 10—a three week wait to get started.
The day after New Year’s I hit a mental health crisis. Four straight days of rock-bottom. Getting out of bed was a notable success. Susan, not one to sit quietly through an emergency, badgered the local psychiatric practice to let me jump their four month wait-list and come in immediately. This appointment was also on January 10.
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I don’t have depression. Or I didn’t. My mental health diagnosis is OCD and anxiety. I have my down-days, but those are rare, and the next day I’m back to normal. In August, I began taking Risperidone. It’s an anti-psychotic primarily given to schizophrenics. An off-label use is to suppress Tourettes tics—those unwanted movements and sounds that make those of us with Tourettes seem odd.
My tics: a low, deep trill in the back of my throat—think of a cat purring or a motor boat in the distance. Scraping the edges of my front teeth together. Punching my outer thighs as I walk. Scratching the base of my pinky on the edge of a table or a door jamb until it’s raw. Excessive blinking and eye rolling. Itching my sternum. I could go on. When I’m elevated, agitated, these all get worse.
Risperidone slowed my tics, reduced them by half, and gave me some relief. Unexpectedly, it stepped on my OCD as well. Those swirling thoughts quieted down; I was suddenly able to focus. Since I started taking Risperidone, Susan and I have had the same conversation countless times.
Me: Yowza, this Risperidone really makes me feel better!
Susan: Really?!! Are you sure?
She saw something that I couldn’t. She saw the spring snipped out of my step. She saw a brooding demeanor. My je ne sais quoi went missing. I felt off too, but it was only noticeable when I sat down to write. Suddenly, I had nothing to say.
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January 10: Therapy with Amy went well. It’s been most of a year since I last went, but we quickly picked up where we left off. When I described my life. My inability to write, my inability to converse with coworkers and friends, my flatness, Amy simply said “You’re depressed. You have depression.” Three months? Four? Five? I had no idea. It’s not like I was sad (except on a handful of days and that week after new year’s). But I was pushed down. Think of a mattress with a suitcase in the middle. The fabric depressed a bit lower than the edges of the bed. Depressed. Not down in a hole, but lower than I’m meant to be.
The psychiatric appointment was part-two of my day-to-understand-depression. I was given a new antidepressant, a new schedule for my Risperidone. Lots of talk, lots of rehashing what I just went over with Amy. But I walked out with a plan. And that’s my placebo. I walked back into work with my spring, my je ne sais quoi. I found myself engaged in a friendly non-essential conversation with a coworker. When was the last time? Weeks at least—maybe months.
Antidepressants require days to take effect. But my first two days on Wellbutrin mimicked my return to work the other day. Possibly, the medicine is already working. Maybe it’s knowing I have a plan, an expected outcome. It could simply be relief at naming what I’ve been feeling for all these months. So far, my improvement is most likely just a placebo effect. I’m told I’ll feel better so I do. But I’ve started keeping a mood calendar; my first two days have smiley faces. And today already feels pretty good.