Two Levels of Mood

Living with depression is hard. Yes, I know, I’m stating the freaking obvious. But I want to write about something that doesn’t come up that often, in my experience at least. And when I say ‘living with depression’, I mean going through repeated bouts of depression over a period of time. I’m not diminishing the difficulty of going through an isolated experience; I just want to point out something specific to the continued one.

Being at your lowest is excruciating but it’s simple, when it comes to the complexity of emotions. Depression is overwhelming; it blots out everything. The world is one colour. But as you start to move out of that place, it becomes emotionally confusing. A lot of you is still depressed but there’s also a part of you that’s trying to move forward. And that conflict is exhausting. Your emotions are constantly clashing and that takes up so much energy.

I recently landed in the lowest place I’d ever been. I feel like I say that every time but I know that this was the worst I’d ever felt. I had a very emotionally traumatic meltdown – again, the worst one I’ve had – and ended up sitting in the middle of my local park, crying my eyes out at eleven o’clock at night. And it was that heaving kind of crying where it feels like it’s coming from a place inside you that’s deeper than physically possible. It was horrible and when I woke up the next morning, I was in such a deep depression that I couldn’t do anything. I literally couldn’t. I lay in bed all day, staring at the wall. I felt completely hopeless. I couldn’t see the point in anything. There was no point in trying to be happy, in trying to do anything, because the only real thing is misery.

It took days to start functioning again (move around, interact with people, eat, etc), but I was still firmly locked in that point of view. I couldn’t see the point of anything but the oppressiveness started to lift and other emotions started to creep in. I was able to smile again and sometimes I’d even laugh and that was really hard because I still felt so hopeless. It felt wrong. I didn’t feel ready to be okay.

I feel like I have two levels of mood, my surface mood and my inner mood. The labels speak for themselves but I want to elaborate a bit further. My inner mood is what I feel at the centre of myself (my automatic thought was to name it my ‘real’ mood but I know the surface mood is real too – please bear with me: words are hard!) and at the moment, that is depressed. If I had to choose one emotion to associate with myself, it would be a sad one, like depressed or disheartened. My surface mood reacts to outside stimuli: good weather, spending time with people I like, a new episode of my favourite TV show. Those sorts of things do create spikes in my mood. It can be really easy to brush those moments off because they feel so wrong when I’m depressed. But they’re both real and both deserve to be recognised. That’s why I like the two levels of mood idea. By having two levels, one emotional reaction doesn’t invalidate another. I can feel really depressed and kind of okay – even optimistic – at the same time. It’s too simplistic to think that we only feel one emotion at a time but when they’re so opposite, it just makes the whole thing more difficult, more confusing, more exhausting.

The only time the two seem to synchronize is when I’m really, really depressed. It sounds sad when I put it like that but right now, it’s the truth. I know that my surface mood can change so hopefully the inner mood can too. Hopefully I’ll reach a point where it’s not so low.

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Side Effect City

Just over a month ago, I started taking Venlafaxine for my depression. I’ve tried lots of different anti depressants in the past, many of which I had a bad reaction to, so I was nervous. Weaning myself off the Phenelzine was hard and I was very, very depressed but somehow, I reached a point where I felt ready to feel different. It was a bit like breaking the surface after being underwater. I was, and still am, desperate to feel better.

Week 1

I started on a very low dose, half the lowest therapeutic dose, so that my body could get used to it. But despite that, I felt the effects straight away and incredibly strongly. I was very nauseous. It was so bad that I couldn’t really concentrate on anything else; all my concentration was focussed on not throwing up. It made me dizzy and I was tired all the time. I did check with my psychiatrist to make sure it was okay to keep going with it and he said it would pass so I focussed on tolerating it.

The other immediate change was my sleep. I went from struggling to wake up before eleven (and I mean really struggling: it felt like I was drowning) to being wide awake at eight o’clock in the morning. It was bizarre.

Week 2

The nausea faded around the beginning of the second week, which I was very grateful for. My mood, while still pretty low, was stable, and I was still waking up much earlier than I had been able to previously. However I started having headaches and I was exhausted all the time, which made it very hard to do anything.

Week 3

In the third week, I went up to the lowest therapeutic dose. This caused a pretty dramatic reaction. For the first few days I was so tired that I fell asleep in the middle of the day, something I haven’t done in years. But despite that, I was waking up even earlier, between six and six thirty am.

By the middle of the week, I couldn’t concentrate at all. I couldn’t hold a conversation, I couldn’t follow the storyline of a forty-minute TV episode, I couldn’t even play a game on my phone… That was scary, but I couldn’t even really feel that because I couldn’t seem to process the emotion. I started to feel faint and very shaky and that went on for several days. If I stood up for longer than a couple of minutes, my legs started to shake and my hands shook so badly that I couldn’t hold a pen. That was very unpleasant.

Week 4

Most of the fourth week was lost because of severe, unexplained leg pain that had me in tears. My psychiatrist didn’t think it had anything to do with the medication and DVT was ruled out but other than that, we don’t know what caused it. I’ve been taking painkillers since and it’s been better. So that tired me out and overwhelmed everything else. But since then, the shaking has mostly stopped and I’m back to waking up between eight and nine in the morning.

This week is the first where I’ve felt different mentally and emotionally while taking Venlafaxine. I wouldn’t say I feel better but I’ve been feeling a bit lighter. That feels very strange and a bit scary. With this new lightness, I’ve been feeling a bit lost which I’ve written about here. I’ve been so depressed for so long that I can’t remember what it’s like to not be depressed. But despite all of those confusing emotions, I am pleased that this medication is starting to work. It will probably take another month or so to really know how it’s affecting me but it’s looking positive and I’m really grateful for that.