Getting better?

So are you better?


Before we tackle that question, let’s look at the issues at hand when trying to do a personal depression inventory:

  • Depression as identity – Am I a depressed person or am I a person with depression? I have lived with depression for decades. Sometimes it’s once or twice a year, other times it’s the whole package all year long. Regardless, it’s been a part of my life long enough that sometimes it’s hard to know where it starts and ends.
  • I have removed pretty much every stressor in my life. A leave of absence from work, no daily commute, nothing to raise my blood pressure.
  • One of the issues I’ve identified with my psychologist is that I hold onto my depression, and I have trouble visualizing myself without depression.
  • Right now, depression is my full time job. ECT three times a week, day program three days a week, psychiatrist appointments and psychologist appointments, as well as the face-it foundation group. It’s an awful lot of time spent talking about and treating my depression.

How do you measure depression?

How are you feeling? Sad? Down? Depressed? Is it the feeling of depression or is it something more easily measured? If we look at my current PHQ9 score, that’s a 20 – severe – Warrants active treatment with psychotherapy, medications, or combination. If you want to go by the HAMD, it’s 17 points – Moderate depression. If you compared those to two months ago, you’d likely see much higher numbers back then. So technically, I’m a certain amount of better. Does that track with what we’re hoping to see?

How do you measure progress?

When talking about treatments and potential outcomes, most meds (and ECT) consider effectiveness to be a 50% lessening of the symptoms. I’ve never gotten a straight answer on whether or not that’s cumulative – in other words are two effective treatments likely to equal 100% improvement? So I guess we’re looking at those scores above to see if they’re improved by 50% or more.

So, how are you?

But to answer the question, I really don’t know. I feel that I have more “bright” days than dark, and overall my mood has certainly stabilized — a byproduct of one of my meds, to be sure. But has the depression lessened? Yes? Somewhat? I still feel it in my chest, in my bones, and in my head. But even then, what will I feel when I get out into the “real world” again? And how far do we have to go down the rabbit hole to be sure we’ve done enough? If this were a tumor, we could inspect to see that it’s all gone. If there were blood tests to be done, we would know when things were back within the “normal” range. But since it’s an emotion, a mood, a feeling, a state of mind, it’s much harder to say.

In the perspective of suicidal ideation, that’s certainly reduced – but I still have days where I would prefer not to exist. I still go to sleep at night wondering if tonight I’ll pass in my sleep and finish this adventure. But I don’t spend my sleepless hours trying to come up with a plan, if that’s any consolation. So I guess I still have a ways to go.

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