Tuesday, November 4, 2008

Mood Charting a Depression (Part 1)

Last night, I had decided not to post this week, but this morning I realized there might be a value in publicly mood charting this depression. I know there are people who can't seem to do it, and the value of it for me is so helpful, that perhaps it might help others.

As I've mentioned before, I use my Day-Timer, which is an organizing system, but I could use any calendar. What I like about Day-Timer is that I can see the hours of the days and notice changes. That said, I'm going to figure out a way to share the information, if not the actual format.

I do use categories, and they sometimes change. I also use part of the page to keep a quasi-diary. What I intend to do today is to provide the background so that from now on, I can chart without all the explanation.

When a depression hits, I find it's important to look at what I'm doing to determine how I'm feeling, what wellness activities I can add to the mix, which ones aren't working that I need to change, and to determine an action plan. The following is part of my evaluation.

In the last month I have had to increase the Adderall from 10 mg. to 40 mg. (today). That is the highest dosage I've taken in three years. The negative aspect of Adderall (for me) is that it has no residual effect, and a short-shelf life. Yet, I can't use the extended release version because my mood naturally elevates during the day and with extended release it becomes way too high as the day progresses.

So, unlike an antidepressant (when they work), it's not an ongoing feeling of well-being. Rather, I feel awful every morning when I awaken. If I have an appointment, I have my husband awaken me an hour early so I can take the Adderall and go back to sleep. For me, if the dosage I'm taking is going to work, it kicks in within 45 minutes. If not, I have to raise it and I only do it in 10 mg. increments because I know that taking too much is as bad as taking too little.

The worst side effect is a shortness of breath, but that is usually the result of too little Adderall in my system. I felt that way for part of yesterday. Also, it produces a sort of dry mouth and I tend to unconsciously make sucking sounds (not exactly the right description, but close) with my tongue. Since I'm aware of that, I keep hard candy or sugarless cough drops in my purse.

In the past, taking Adderall during the day has necessitated taking Ativan at night. But, because the withdrawal from Ativan is so difficult and takes so long, I am trying to remain off it. The bad news is that I'm staying up too late (until 2:00 a.m. last night), but since I'm not working and my son is grown-up, I can sleep until 10:00 if I need to.

Exercise is an important antidote for helping me sleep at night. However, yesterday was a very difficult day and I was unable to attend my badminton class. I'm hoping to go on Wednesday. The problem is that increased Adderall does place a strain on my heart and I'm not sure if aerobic exercise is the right thing to be doing. But since I no longer have a primary physician I trust, I'll have to research this further.

I know it's important to exercise every day, and I have no patience for walking when I feel like this. However, I might enjoy it more if I do it with a group of people. I'm going to check out Emeritus College to see if they have a walking group I can join. Walking with a partner doesn't work when I'm feeling blue because I'm not interested in chatting.

Last weekend, I spent hours outside cutting down trees that were hanging over the garage. The combination of sun and physical activity is important for me. If I continue to feel this way, and if the weather remains okay, I'm going to paint the garage door, which would be a good project.

Action Item: I need to explore other forms of exercise. It might be a good idea to find an indoor swimming pool. That's a more gentle activity. Riding a bike might be appealing, but I'd have to buy one. I need to think of what else I might enjoy doing.

Because I've been feeling so tired, I have been eating too much. While I know that protein is very important for me during a depression, I need to pay more attention to portion control. I'm far better off eating five small meals a day than three larger ones. I've been snacking too much late at night and eating too many potato chips.

Action Item: I need to reread the chapter in Winter Blues about diet.

I don't believe in taking supplements without discussing them with a doctor because of my experience with the megavitamin quack years ago.

Action items: However, I need to check out Duane Sherry's blog, Recover and Discover, to see what he recommends. Also, I found a new blog by Dr. Gabe Mirkin and he recommends checking Vitamin D levels, which makes sense to me.

Music Therapy
While I know that playing music is a very important part of healing to me, I also know that when I'm depressed, my accordion and Autoharp are too loud, and my recorder is too high pitched. The best instrument is my electric guitar, although I've lately thought that I'd like to learn how to play keyboard.

Action Items: Continue checking Craigslist to see if I can find a cheap keyboard. See if there's a guitar class I might take.

This is only part of my process, but I need to go vote and get a haircut. So, I'll continue this tomorrow.


KJ said...

I love how you take charge of your wellness. It is so inspiring. I am sorry that you haven't been feeling as well as you would like but I am amazed and impressed at how on the ball you are!

Wellness Writer said...

Dear KJ,
Thanks so very much for your continued support and all the nice things you say.

After so many years of hoping that the "next medication might work" and finding that it didn't, and hoping that "my doctors would have insight" and finding out they didn't, I learned that the only way I can feel better is to remain in charge of my own health.

So, I do take charge. And I also have learned that I need to do it quickly and efficiently so that the bad feelings don't remain.

I have experienced too much pain and suffering to allow a depression to go on for any length of time.


Immi said...

Thanks for sharing how you deal with and chart your depression, Susan. I hope your depression eases up soon.

Wellness Writer said...

Dear Immi,
Thanks for your support and kind words.