What is some good advice you have ever received? There is a lot of good advice floating around this world. Many of it comes from trusted family and friends. Sometimes it comes from unfamiliar places. One of the best pieces of advice I ever received came at a pretty low point in my life.
I have been pretty open about dealing with depression and anxiety. I have pretty much all my life. In present day I have a really good doctor, a very supportive husband, and a good medication regimen, selfcare, and schedule that helps keep me on an even keel. But, as most now, depression is no joke and it wasn't always this way for me. Depression, anxiety, and other mental illnesses still carry stigma today. An unfair stigma, in my opinion, and not just because I deal with them. I went into Dr. H's office once many years ago, exhausted, down, and generally hating life and myself. After discussing my symptoms he asked why I hadn't come in sooner. I told him I was trying to be strong and handle it all myself. He smiled kindly and said, "If you came in here with muscle cramps, low potassium, and I prescribed you a potassium supplement to help your levels, would you take it?"
My answer was immediate, "Of course I would." I trust Dr. H, his treatment plans, and opinions. I would take it without question.
He smiled again and said, "Ok, your serotonin is low. I am going to prescribe you a supplement."
"Oh,'" I said, completely floored. "I guess that makes sense." That smile, again from him, the one that says he knows he is right but he also knows I am unsure but I do trust him.
So, like many times before and since, I trusted Dr. H. I filled the script he wrote for me and began to take it. Most people know antidepressants and other drugs that treat these kinds of issues are not definitive. It isn't as easy as muscle cramps = potassium supplement. There are many studies that can be accessed that show which patients with which symptoms did better on one medication versus another but there is no blood test to say, "Ok, you get Prozac and you get Lexapro. And your labs show you need Seroquel for sleep." Unfortunately these type of drugs tend to be narrowed down to a few and then have to go through a trial and error period.
Y'all, I'm 38 years old. It has taken almost twenty years to find a combination that worked really well for me. And almost ten years ago I went through what was termed a major depressive episode. It was not fun. It was scary and dark and lonely. Dr. H actually put me on medical leave from work for a few weeks so I could rest and recover. I used to be very hesitant to share personal information like this but looking back I realize had I known others that seemed to be as pulled together as me and as confident and successful in their jobs as I was, it would have helped me tremendously. So, here I am. Exposed. Please be kind.
As sometimes happens, the medication I had been taking faithfully had ceased to be as effective. I kept on keeping on, not realizing my depression was coming back. It is really hard to be on the inside trying to monitor yourself. My husband has been very helpful and careful to try to help me in that respect. And at times, I can resent it when he tells me he sees issues because I don't want to be told I am struggling. But, I need that. I think everyone needs someone to watch out for them in some sense. It is part of the human connection.
Photo credit: Autumn Dozier
I did go back to see Dr. H. He was kind and understanding and concerned. He pointed out sometimes medications do loose efficacy after a period of use and we likely just needed to change some things. It was a big deal to me but he was so gentle he put me at ease. He also knew what I did for a living and how it was a very fast paced, high functioning, high stress environment. When he told me he wanted me to take a break from work I was stunned. And I tried to refuse. My husband, who had accompanied me, was also surprised. We had not expected this suggestion. But, Dr. H had been our doctor for years. He had seen us in his office sick and we had told him we would return to work despite his advice, to rest, as soon as he would allow. He often advised an extra day to rest. Neither my husband nor myself had the desire to do that. We enjoyed staying busy, we enjoyed working. It was not in our nature to lay out. As soon as we knew we were well enough to return we would.
So, when I tried refused Dr. H put this plainly, "I will not let you return to work until you have some rest. You need it. Your brain needs it. And this is a legitimate medical reason to miss work." I had never seen him be so firm. He usually didn't have to be. He had never gotten that kind of opposition from me before. That is part of the stigma that still remains, even today. Mental health is not a reason to miss work. Rest and recovery is not a reason to miss work. Those that do this are often considered weak. But, he was right. This was a legitimate medical reason to miss work, as much as I wanted to disagree. No one could ever say I wasn't committed to my work. My work ethic is pretty dang good, still today.
So I agreed. I called my supervisor, told him I wouldn't be working for at least a few days, and my husband filled the new scripts Dr. H prescribed. He advised me to ease off my current one and then start the new one. We were hoping it would be effective. With most of these types of drugs you do not want to stop them cold turkey. It can lead to withdrawal symptoms that can be harmful. Along with the new long term medication he prescribed he also prescribed a fast acting, short term one to help ease the transition from one medication to the other. You see, when changing medication for depression and/or anxiety (they often go hand in hand) there can be what is termed "break through anxiety" while the body is adjusting to the change in medicines. He advised me to take this fast acting medication every morning when I got up. He said I would gradually realize I didn't need it anymore and slack off of it until I could stop completely.
I did not want to take the fast acting medication. I felt bad enough I was having to take medicine at all (there goes that stigma again). I wanted to be strong and not have to depend on it. But, doctor's orders, my husband filled it and brought it home. I took it for two or three days because Dr. H said to, then I woke up and thought, "Do I really have to take this?"
Not his actual nurse
I called his nurse, a lovely, kind lady who had been so gentle and understanding with me. I asked her, "Dr. H says I have to take this every morning. Do I really NEED to? I don't want to have to take it everyday."
She paused, then she said, "My advice is this: Don't rob yourself of a good day. If taking that medication right now means you can have a good day, I say do what Dr. H advised and take it."
That was profound. I thanked her and hung up. I sat there in the chair, just stunned. Was that what I was trying to do? Rob myself of a good day? In being "strong" was I actually prolonging my rest and recovery?
So I followed Dr. H's orders and took the medication as prescribed. True to his word, after awhile I began to realize I didn't need it anymore, gradually at first and then every day. Things got better. I returned to work. I returned to a pretty normal life.
Yes, there is still a stigma surrounding mental illness and medications for them. A colleague of mine, a thirty year pharmacist, once said he thinks of these medications like this: Better living through chemistry. I think he is right.
My hope is you have a doctor you trust and can count on. My hope is my telling this story helps some who are struggling. My hope is the stigma surrounding these things continues to lessen. If you are struggling and feeling alone, please reach out. Tell someone. You are important and you matter.
Be well, y'all
***None of the above information is to be used in lieu of a medical professional's evaluation and diagnosis. All information here is a reflection of my own knowledge and experiences.***
***If you or someone you know struggles with depression, please know you are not alone. If you do not know where to start, you can here with the National Suicide Prevention Hotline. Simply call 800-273-8255. It is staffed 24 hours a day, 7 days a week.***
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