Good morning everyone. Thank you Cmenot, Mono, Bumble, and GDW for your positive comments and support. I couldn't have made it this far without you.
I wanted to share what happened in my life yesterday. My husband and I took our three "kids" (my daughters are 21 & 23 so not really children anymore) out for the day. We love to go to the local flea market and look for treasure. Our whole family is very creative and artistic. We buy old furniture and restore or rework it. As we walked around the flea market, I became very aware of my surroundings. The temperature was literally perfect and there was a delightful breeze. The air smelled fresh. I realized suddenly that I was noticing these little details...something I haven't done for a very long time.
As we walked around, my husband held my hand and occasionally rubbed my back. The touch was soft, intimate, loving...something that has also been missing for a very long time. At one point, as I walked hand and hand with my spouse, my son grabbed my other hand and the three of us walked. I got many hugs from my son throughout the day and statements like "Mom, I am glad you are happy again."
We all went to our favorite diner for lunch. I had an amazing salad but the real menu was 90 minutes of joking and laughter with my immediate family. We had so much fun. I felt so proud of my kids who simply love each other. They honestly support and respect each other...something I really never had with my brother. My parents raised us to compete and there was so much sibling rivalry that it destroyed the love between us. I was very careful to not promote that same atmosphere with my children. I taught them that siblings are to be treasured and valued...that each brings something unique to the family. I felt so much love and pride when at one point both my daughters hugged and kissed their 9 year old brother when he said something funny and made us all laugh.
After lunch, we headed off to play mini-golf. We laughed until we cried. I was so relieved to be feeling again...to feel something beyond an endless sense of black sadness that has enveloped me this past year. It occurred to me that depression is often linked to opiates and that this is an important conversation for the forum (yes, Cmenot, I agree). How is it linked? Well, for many of us we use the opiates to treat the underlying depression which is what I did. Yes, I had AI too but one of the things opiates do is raise energy levels. I was experiencing extreme fatigue from the depression and opiates offered some relief. Opiates though can actually cause and worsen depression as they skew levels of neurotransmitters specifically serotonin, dopamine, and norepinephrine. SSRI's and SNRI's work by helping maintain the levels better and make the brain receptors more sensitive (they do not actually raise the levels).
What causes depression and what are the symptoms? Depression is partly genetic. It comes from suppressed neurotransmitters listed above. It is often triggered by stressful life events but can just happen spontaneously. What does it look like? Depression causes sadness, anger, irritability, extreme mood swings, apathy, and loss of interest in all things that used to bring one joy. It also leads to difficulty concentrating or remembering and easy agitation. Physically, depressed people either can't sleep (can't fall asleep or can't stay asleep...waking at 4 am is classic depression) or sleep constantly, are extremely fatigued, have extreme appetite changes resulting in gained or lost weight, worsening of chronic pain, digestive issues (heartburn, diarrhea, constipation) and frequent headaches.
What treats it? This is highly personal. I have had great success treating myself and patients with SSRI's and SNRI's. Yes, they are highly individual so work with your doctor to find the right one for you. Treatment is for 1 year then taper and stop. I rarely have issues tapering patients off. If you have recurrent depression, then it is appropriate to consider lifetime treatment. I plan to stay on my Cymbalta. This is the second time I have struggled with this disease and I have a strong family history. I don't ever want to return to thinking that death is a viable option. Eating right and exercising daily are also very important components of treating the mental illness.
I just wanted to write this to let others know that you aren't alone in your sadness. Depression can be treated and managed. The joy can come back, it can. So get off the opiates, treat the depression, and get back to life. It is worth living. Watching my family laugh and smile was such great fun. I felt my heart open and bloom. I want this for all of you.