I have depression. I have had depression for some time. It should be said I had a depression episode that was diagnosed as chronic depression when I was 18. I felt it was a response to chronic pain, of the fibromyalgia I had not been diagnosed with and was having trouble coping with. It lasted 4 years. Then around when the migraines became chronic I began to have bouts of depression related to the migraines in the prodome that were pretty severe. When the migraines became daily, I developed comorbid depression associated with chronic pain.
This would be about 7 years ago. I hid it extremely well because I have a very stoic facade. And also I have a facade I use to help me manage my pain where I laugh things off a lot. People who know me think I have a great sense of humor, maybe reserved, introverted and intelligent. They can only tell I am in a great deal of pain when the facade fails. When I can’t hold a smile. When the eyes get dim. When i get very quiet. When i cannot move anymore. But the depression? Well that I hid. But it was serious. I was severely depressed. Antidepressants made it significantly worse, but I was depressed all the same. I had suicidal ideation. A lot. I had no life, just struggling to maintain work and crashing at home because I had not a scrap of energy left for anything; like housework, shopping or socializing. I wanted the pain to stop. So I tried to kill myself but my brother found me and stopped me. For that I got a short term leave from work. Then back at it. I felt so hopeless. Like things would never change. And no one cared. I kept struggling in survival mode with the pain and the depression. Until I went on long term leave but they decided I was significantly improved and sent me back to work. Full time. I tried. Again. I was so tired to this survival mode, this existence without a life. I tried to kill myself again, but an online friend convinced me to call 911. Another leave. Back to work. But this time the pain clinic said outright I could not work full-time so part time it was to be. Except I couldn’t function that way either. The pain, the missed work, the lack of productivity. I was aiming for another suicide attempt and I knew it. My stability was suffering. Suicidal ideation was amping up. So I have decided to go back on long term, if I can get through there tricky, bias appeal process.
Point is depression has haunted me for years. And i didn’t get treatment for it until i tried to kill myself the Second. Here is why: 8 reasons I masked my depression for years It was the second time that got me treatment because I was at the pain clinic so they sent me to see a psychiatrist. Who determined antidepressants make me more suicidal and should be avoided and put me on Abilify for depression.
The Abilify has saved me and I am more than aware of that. I have not had any massive plummets of mood that generally lead to suicidal ideation and intent. Those drops were deep as you cannot fathom getting out of them. It evens that out. But I still am depressed. According to a screening test Moderately Severely Depressed. Which sounds about right. And I still have suicidal ideation, just not intent.
Comorbid depression has to be treated. With medication if that is right for you. With a psychologist. I see one regularly. It is hard to manage it with chronic pain. It makes things so much harder, darker, emptier.
I tell you my depression tells me thinks that seem so rational. I understand the cognitive distortions. But I can rationalize myself into suicide quite fast. My brain can come up with a scenario where it makes sense. Like I can’t work because I am unable to function with the pain and issues actually being able to work functionally. So i am going on leave. Insurance companies being what they are will resist that notion since this is an appeal of long term. They sent me back to work on a whim before. They could deny me. And then I cannot work and I will have no money coming in. The most logical solution is to get out of the picture, and insurance can pay out my death benefits and life insurance and make my mortgage payments as well. So my death would be beneficial. That is a scenario that occurred to me last night in fact. Based on my experience with insurance companies and all. … what I am saying is that these thoughts occur. As long as it is Thought and not Intent it is fine. Something to tell my psychologist.
With the depression we not only have to worry about our thoughts about our pain and our general thoughts, we also have massive fatigue, concentration problems, appetite issues, sleep issues. Already added onto conditions with fatigue, concentration issues, sleep issues.
As far as I can tell pain and depression do not mix well. Chronic pain is a great thing for depression to latch onto. Depression needs no reason for its existence. But it always finds them. And pain is one hell of a reason. It is its target for me.