Since today is Friday, and I'm ready to move on next week and write about something new, I'll end this week with my thoughts about why I initially got so angry about the natural healing webcast, so that I can be done with it and move on.
1. The fact is that having been diagnosed as bipolar in 1993, and having read more than 100 books on the topic and related subjects, and having spent 15 years researching this topic, I can't recommend one book on bipolar wellness that I think is uplifting or helpful and I feel the same way about depression.
2. I believe there is something so fundamentally wrong with current treatment practices that it makes me very angry. I don't believe most psychiatrists ask the right questions during the initial consultation, request the right tests (In fact, how many of your psychiatrists had you tested at all to see if there are health issues that might be contributing factors?), or spend the time to determine why you're depressed (again, if your first presentation was mania, it's a different issue and not one I know about), whether there are unresolved personal issues, whether you have personality traits that are contributing to your illness, whether you have the skills to handle stress, whether your personal relationships are satisfying, whether you enjoy your work, whether you're aware of the causal factors that trigger depressive episodes, whether your diet is a good one, whether you exercise on a daily basis, and so forth and so on.
3. I believe most of the treatment guidelines have been developed in mental hospitals where the sickest people are seen rather than in discussions with people who are highly functional.
4. As far as I know, there is no bipolar or depression wellness program in the universe, which offers an optimal program. I've written about this before and even developed the outline for one on another site.
5. As far as I know, there are no ongoing national or international studies to determine whether medication truly works, what the side effects are, how people feel about taking it, what long-term health problems it can cause, which medications are most effective, and/or whether the people who are "true" success stories take medication and/or use alternative methods of healing.
6. As far as I know, there are no ongoing national or international studies to determine whether alternative treatments work, which types of treatment are most effective, which are an absolute waste of time and money, and so forth and so on.
7. It is becoming increasingly difficult to find truthful information on healing practices because so many doctors, mental health professionals, and consumer groups receive funding from the pharmaceutical industry.
8. It is almost impossible to find true success stories of people who have "overcome" these illnesses and are living "normal" lives. (Perhaps my definition of "successful" differs from most.)
9. It is very disturbing that so many people seem to want to make a profit off other other people's pain and suffering.
10. There are few bipolar and depression sites and blogs that provide upbeat, uplifting information on healing that is truly effective. In the few cases where people do recommend medications or products, it's a profit-making venture and difficult to determine whether it's just another hype.
Friday, November 21, 2008
Since today is Friday, and I'm ready to move on next week and write about something new, I'll end this week with my thoughts about why I initially got so angry about the natural healing webcast, so that I can be done with it and move on.
Thursday, November 20, 2008
(I originally posted this last night, and have changed the opening paragraphs.) Yesterday was a better day although I'm embarrassed I responded so harshly to the Natural Approach to Healing Depression webcast. While my disappointment was genuine, and there was good cause, I usually try to seek some distance and perspective before I write an angry post or email.
Gianna talked with Troy, the fellow who worked on it, and has written to say she now has a different perspective. I would agree that it was the wrong venue and will play far better on You-Tube. I still feel the press release was misleading, and the materials were simplistic.
Having said that, I've been reading James S. Gordon's book, Unstuck, Your Guide to the Seven-Stage Journey Out of Depression, and it's really good. While I'm only half way through it, he discusses issues that few other psychiatrists are aware of, and I'll write more about it.
So, my revised opinion is that there is probably a value in seeing the rest of the webcast series or waiting for it to play on You-Tube. Gianna says the episode on meditation--which she has previewed--is "well done."
I've noted on my mood charts that during the last few days, I've been too emotional, my judgment seems slightly impaired, I find myself getting irritated at small things, and I don't feel like talking.
Sometimes, when I feel like this, I try to use different modes of expression. On Sunday, I took my camera to UCLA and spent hours shooting photographs. A few of my favorite are: 1. A sculpture in the sculpture garden. 2. A detail of a stone totem pole. 3. Powell Library, where my parents used to hang out so many years ago. 4. The sun going down on the central quad.
Hope you like them. Have a nice day!
Friday, November 14, 2008
Because I'm feeling under the weather, I've decided to provide some depression quotes, most of which I found on Depression Recovery Life. Have a happy weekend. See you on Monday.
"In the midst of winter, I finally learned that there was in me an invincible summer."
"It is better to light one small candle than to curse the darkness."
"Many of us spend our whole lives running from feeling with the mistaken belief that you cannot bear the pain. But you have already borne the pain. What you have not done is feel all you are beyond that pain."
"When women are depressed they eat or go shopping. Men invade another country. It's a different way of feeling."
Thursday, November 13, 2008
While I had intended to continue my posts about managing a depression, I'm not able to at this point. I'm not feeling well and it's taking too much effort. I'll continue the discussion when I can. Yesterday was one of the worse days yet. After taking the Adderall, I had the energy to get out of bed, but as I've mentioned before, the medication doesn't make me happy.
I couldn't go to my badminton class, and I realize now that I'll have to drop the class even though there are only a few weeks left. The additional dose of Adderall puts too much strain on my heart for an activity that requires so much effort. And I'm unable to socialize with so many people right now.
In the past, quitting badminton or some other activity would have made me feel bad. Now, I realize it's okay. Rather than feeling bad that I have to quit, I've decided to feel happy that I was able to play for the last few months...and will be able to continue in spring when I feel better and stop taking Adderall.
That said...I spent six hours doing the one activity that I know I can always do when I'm blue, which is gardening. Probably the better description is lawn maintenance, because I spent hours trimming bushes, weeding, and raking. We have Eugenia trees in the backyard and they have these red berries that fall all over the lawn and wreak havoc with everything. So, raking them was a perfect chore for me.
After all these years, it's nice to know that I can always garden (or do home improvement chores outside) during the difficult times. And rather than feeling bad that I have to quit other activities and become more insular, I can feel happy I've figured this out, feel grateful I'm still productive, and thankful that I live in a climate where the sunlight helps me heal.
P.S. Mariposa has said that a Vitamin B complex really helps her during the difficult times, and today she's written an entire post about it that I found very helpful and quite interesting. It's something I intend to pursue and I so appreciate all her effort in writing about it.
Wednesday, November 12, 2008
For me, the most difficult part of managing a depressive episode is dealing with people. When I was working full-time it wasn't a problem. My depressions weren't as bad then and I was able to do what I needed to in order to succeed.
Having worked in television news, for two different colleges, for a magazine, and for a number of other organizations, I never really had difficulty dealing with my coworkers. But I imagine other people have had different experiences at work.
What I do know is this: During a depression, I'm far more sensitive and my feelings get hurt more easily. I feel more vulnerable, and it's difficult for me to deal with unpleasant people. I don't feel like being as social and I'm glad that for the last 20 years I've worked as a writer, which is a solitary profession and doesn't require as much social interaction--even in an organizational setting. When I'm depressed, it's far more difficult for me to listen to criticism about something I've written.
Knowing these things about myself was an important coping mechanism. I realized that the people around me hadn't changed, but I had. So...I tried hard to pretend things didn't matter even when they did. I tried not to show hurt feelings or to respond to irritating people. I didn't act defensively if a client wanted to make corrections to my copy.
So, for much of my working life--before I began taking medication and everything became so much worse--I could work in an organizational setting even through I was experiencing a low-level undiagnosed depression. As many of you know, it took 25 years for me to get a diagnosis, so quite honestly, I never knew what was wrong during the "low periods." I didn't know I was clinically depressed. I just thought I was unhappy at work, and that I hadn't found my true calling.
Years later, after the diagnosis and the medication, the depressions got far worse. But, by then I was freelancing. For the most part, what that enabled me to do was to set up meetings when I felt well, and work at home when I didn't. The biggest problem in those days was to try and sound "normal" rather than "wounded" on the telephone. When I truly wasn't well and couldn't attend meetings, I pretended I had the flu or some other physical illness.
For years, I had the same clients and that helped tremendously. Since I had built up a relationship with people for many years, and since they knew the quality of my work, I had far greater flexibility than I might otherwise have had. When the medication wreaked havoc, and the depressions became intolerable, my ability to work greatly diminished.
How do you cope at work? What problems do experience when you're depressed? How do yo overcome them?
Tomorrow I plan on focusing on managing personal relationships during a depression.
Tuesday, November 11, 2008
During a depression episode, I have learned it's very important to reduce stress to its bare minimum. So...I look at everything I'm doing, the people I'm spending time with, and all other aspects of my life to see what I find most stressful, and what I can eliminate.
When I was working full-time, and had two annual six-week depressive episodes, it used to take all of my energy just to go to work every day. Although I was married, that was before we had a child, so my husband and I pared back social activities on weekends so I could rest, do my chores, and we could spend times together. Even when I haven't felt particularly well, I usually enjoyed going out to dinner and a movie with my husband, or spending time browsing in bookstores, or even going to museums.
Once our son was born and I worked part-time, he became our top priority. So again, if I had a low energy level, I still was able to work three days a week, and take care of him. When he was an infant and later a young child who took naps, I would nap when he did.
My husband has always been great about marketing and cooking. My chores are laundry and cleaning--and because my husband is neater than I am, and it matters to him--I've always tried to keep the house as clean as possible. For much of our lives, we had a house keeper come in once a week. But we haven't for the last eight years or so, and actually I'm one of the few people I know who finds house cleaning relaxing.
The most difficult aspect of dealing with a depression for me is being with other people--aside from my immediate family and my mother (when she was alive). And that's what I'll write about tomorrow.
Monday, November 10, 2008
In the last few years I've learned to think of depressive episodes in a new way. Rather than feeling there is nothing I can do about them--aside from taking medication and hoping it works--I now realize there's a lot I can do to minimize the symptoms.
In my case, during a depression, I take Adderall in order to get out of bed in the morning. For me, the depression saps so much energy that without the medication, I would sleep all day--until it lifts, and that's presuming it does lift.
However, unlike an antidepressant (when it's effective), Adderall doesn't make me feel happy, it just gives me energy. So, it's really important for me to start my day quickly and get out and about or at least begin moving.
First thing, I eat protein for breakfast, which is something I need. I also drink one cup of coffee. I need it as a stimulant although I only drink one cup a day. If I take more than 30 mg. of Adderall, I can't drink coffee, however, because the extra dosage gives me a "bad" stomach and the acidity of the coffee is too much. In that case, I eat yogurt for breakfast because it's soothing and I eat whole wheat toast for roughage.
During a depression, it's particularly important for me to make lists--before I go to bed--of what I'm going to accomplish the following day. When my son was younger, and when I worked as a freelance writer, I made different kinds of lists. Early on, I learned that depressive episodes affect my memory, so I made sure that I listed all the tasks I needed to do for my son, husband, and my clients.
Now that my son is older and I'm semi-retired, my lists are different. While I go to class twice a week, and while I am writing a book, I have far more freedom to do what I want during the day. But if I'm not feeling terribly well when I awaken, it's very important to know what tasks I want to accomplish, or what activities I want to participate in, so that my days are pleasurable, and yet I also feel I'm doing what needs to be done.
What I've learned is that if I have activities lined up, I'm always happier. If I complete tasks, I feel a sense of accomplishment. If the weather is good--and it usually is in Los Angeles--it's very important for me to spend part of the day outside--whether it's weeding, gardening, doing home improvement chores, or exercising. Sunlight is a key element of my wellness program, and the earlier in the day I spend time outside, the better I feel.
Unlike years past, the book I'm working on is a long-term project, and I don't have a deadline. So...I don't have to spend time indoors writing every day. And for me, that's very important. I spent about 20 years writing indoors--working at least eight hours a day--and I now know that it contributed to my depressions.
At the time, I was happy I could work even though I felt depressed. What I didn't know was how important sunshine is for my well being. Now that I do know it, I make sure I get enough sun to "melt the blues."
(to be continued)
Friday, November 7, 2008
Now that I've mostly explained the evaluation process, I'll show you what my mood chart looked like for yesterday. Once again, because I use my Day-Timer, I've got my day set up in hours. So, if I awaken at 9:00, like I did today, I just write in the word "awakened" at 9:00. But since I can't seem to scan the mood chart and have it work, I'll give you an approximation.
9:00 Awakened. Took 30 mg. of Adderall and went back to sleep.
9:45 It wasn't enough so I took 10 mg. more and felt fine within a half hour.
Breakfast: Had one egg, and whole wheat toast.
10:30-12:00. Wrote my blog post this morning, answered emails, and posted on a few other blogs. Folded laundry.
12:00-1:30. Reread chapters of Winter Blues about diet and exercise. Wrote marketing list for tomorrow. Called two local swimming pools and learned I can swim laps as well as participate in exercise programs. Checked out bikes and piano keyboards on Craigslist. Have an appointment tomorrow to see a keyboard.
Lunch: Tuna salad with avocado and a piece of cheese.
1:30-3:00. Decided to weed instead of painting the garage.
3:00-6:00. Worked on book.
Dinner: Stir-fry chicken with vegetables and noodles. Popsicle for dessert.
7-9:00. Watched Seabiscuit video.
9:00-11:00. Wrote blog, answered emails, finished reading The Friday Night Knitting Club.
I felt much better today. I think it was because I now have a plan, which I've begun implementing. I'm really excited about the piano keyboard. I know that music is an important wellness activity for me, and I've been wanting to learn piano for some time.
I'm also excited about swimming. The downside is that I need to buy a new bathing suit and I'm not thrilled about how I'm going to look in it. The upside is that swimming is very relaxing for me, and it's a great aerobic activity. If I can join an exercise class, that may be the impetus I need to make myself do it a few days a week. If I can find a used bike and begin riding the other two days, plus two days of badminton, that should be all the exercise I need.
I think my new diet should work out well. The concentration needs to be on protein and vegetables and I need to eat much less carbohydrates. Rosenthal recommends snacking on nuts and string cheese, which I like.
I'm still not pleased about taking 40 mg. of Adderall, but the side effects weren't as apparent today. And I'm concerned that now that I've begun taking Ativan (even 1/2 mg.), it will be difficult to go off it. Still, I slept much better last night and that may account for feeling better today.
40 mg. Adderall (Perspired a bit, made smacking sounds with lips, but didn't have shortness of breath.)
1/2 mg. Ativan (The low dosage didn't make me awaken feeling slightly depressed or groggy.)
Slept 8 hours last night.
Didn't feel depressed or hypomanic today.
Thursday, November 6, 2008
I was going to write more about all the components I evaluate, but I've decided to try and summarize the process. The way I usually do this is by writing lists, and coming up with action items. While I shared my process on Tuesday, perhaps this post is more to the point.
1. Trigger. My depression started in October because there is always a seasonal element to it. So, my first step is to reread Winter Blues: Everything You Need to Know to Beat Seasonal Affective Disorder by Norman E. Rosenthal. I've read it before, but I need to read it more carefully now.
In skimming the book, it's clear that October is a "start" date for some people suffering from Seasonal Affective Disorder. The reason my mood worsened a few days ago was that we set the clocks back for Daylight Savings Day, and that is also a problem for people with SAD. So...that's clearly the trigger.
2. Medication. While increasing the Adderall to 40 mg. has helped, it also presents problems. The increased dosage causes symptoms I don't have with lower dosages, including shortness of breath (periodically), increased perspiration, dry mouth, and certain hypomanic behavior (if I don't monitor it carefully) in the later afternoon.
Also, I can't fall asleep until 1:00 or later, and I don't sleep as well. For the past two nights, I've awakened in the middle of the night feeling very depressed (something that hasn't happened to me in years). Last night, I decided this was a real problem and I took 1/2 mg. of Ativan, which solved the problem. While I dislike taking this medication, it's better than the alternative, which is feeling terrible.
My goal is to come up with wellness activities that will allow me to reduce the amount of Ativan I'm taking, and eliminate the Ativan.
3. Diet. I need to read the chapter from Rosenthal's book on Diet, and come up with a new marketing list. I've skimmed that chapter and I know I need to begin eating more protein in general, particularly for breakfast, and I also need to try and eliminate sugar. He also recommends snacks, so I'll go and buy string cheese and nuts, which I enjoy, and which can help.
4. Sunlight. I've got to begin spending more time outdoors each day, starting today. So, I've talked with my husband yesterday and he's going to buy paint for the garage door, and I'm doing to start painting it today. We've come up with a list of other outdoor projects that I can work on for the next few months.
While Rosenthal recommends a light box and a dawn simulator, I've tried both and neither works for me. However, we have done other things to the house that make a difference. When we recently remodeled, we bought new shades for the bedroom, which make it much brighter. We've repainted the interior in a warmer white color (and I have noticed the difference). We have a much lighter carpet, which also makes a difference.
Action Item: I need to read more about light therapy.
5. Exercise. While I discussed this on Tuesday, I need to check out the hours of the indoor swimming pools in the neighborhood, and check online to see if I can find a used bike. Also, I need to see what exercise classes are available through Emeritus College. I will need to buy a new bathing suit (Ugh!).
6. Wellness Activities. In the next few days, I will look at my list of wellness activities to determine which ones I feel might help.
7. Research. I realize that while I have spent years researching depression, bipolar mood disorder, and related subjects, I have spent very little time researching Seasonal Affective Disorder. So, I'm going to begin researching this topic so that I can put together a SAD Wellness Program for myself. Also, I will see if I can identify online sites as well as blogs that deal with SAD.
8. Finding a Doctor. A number of months ago, I had intended to write to Dr. Rosenthal to determine if my initial diagnosis should have been SAD rather than bipolar disorder. Then I decided it didn't really matter because since I'm not big on labels, I felt my wellness activities would apply to SAD. But now I realize it's important to meet with a doctor who specializes in SAD to see what, if any tips, that person might have. So, I will contact Dr. Rosenthal to see if he has a recommendation.
9. Health Insurance. While this is the topic for another post, about five years ago we had to drop my health insurance because we could no longer afford it. We were paying $12,000 a year because the only insurance we could get was through HIPPA--since I had a previously existing condition. And that insurance was not only exorbitant, but it barely paid for any of the services I used. They paid only $33 for a $100 psychiatric visit. I applied for a less expensive policy and it was denied. I never went to arbitration, although I should have.
Anyway, as a result, I have not seen a primary care physician in five years and have not had a physical in ten years. (I do regularly go to my gynecologist, and I do see a psychiatrist a few times a year.) But I want to have a full physical examination as well as covering myself for catastrophic illness. So I need to take care of this.
10. Setting realistic goals. Since my list is fairly long, I need to come up with a realistic "To Do" list. It is as follows:
Thursday. Begin reading Winter Blues again. Plan to finish it by the weekend. Start painting the garage door. Use diet chapter in Winter Blues to write marketing list. Begin eliminating sugar in my diet. Walk around park every day.
Friday. Draft letter to Dr. Rosenthal to get a referral. Begin finding SAD sites/resources. Market for new items for new diet. Go online to see if I can buy a used bicycle. Buy a bathing suit.
Saturday. Send letter to Dr. Rosenthal. Go to the library and to a bookstore to check out books on Seasonal Affective Disorder. Draft letter to insurance company seeking arbitration.
Sunday. Send letter to insurance company. Look at what I've learned. Redo my "To Do" list. Evaluate how I feel after spending more time outdoors each day, increasing my level of exercise, and changing my diet.
Wednesday, November 5, 2008
Since I felt so much better today, it was easy for me to get out and about and do what I needed to do. After I voted for the president of the United States (and yes, my candidate won), I went to get my hair cut from a new hair dresser.
As she and I were getting to know each other, she mentioned that she had taught music in the Los Angeles school district for nine years, and that she played the keyboard, and sang. And I told her my story about performing at my mother's assisted living facility (before she died), and my love of music. I mentioned the music theory class I had begun but had to quit because it moved far too fast for me, but I said I'm looking for another class at Emeritus College next semester.
And then she said, "I've got two boxes of song books that are for beginners. Would you like them?"
"Yes," I said. "I'm so thrilled. I'm semi-retired and I could never afford a collection like this one."
"Oh, I'm so glad," she said. "They've been sitting here for months and I've been looking for someone who would like them as much as I have. This is how I learned to play the keyboard, but I haven't used them in years."
There must be 100 books, and they are just the ones I would have chosen. It is a perfect way to learn how to play the keyboard, and to learn to read music. And it seemed like it was a gift from God.
I love it when people are so kind and generous and expect nothing in return. After a few days where I felt so down, it was a godsend to have someone reach out and help me pursue a goal that is a key component of my wellness program. It truly made my day!
(Tomorrow, I'll continue my series on mood charting a depression.)
Tuesday, November 4, 2008
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.
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.
P.S. I don't intend to spend much time online so while I will moderate comments, I won't be visiting other blogs until next week.
Monday, November 3, 2008
Despite all my best efforts I am experiencing a low-grade depression, and have been for the last month. What's different about it this year is that I'm accepting it for what it is, and I don't feel bad that I've got it.
In years past, I've been very disappointed that I've done everything "right" and still experience a seasonal depression that usually lasts from October through March. But this year, I've said to myself, "It's okay. The Adderall is working at 30 mg. You get up every morning and live your life despite the depression. You're still playing badminton twice a week even if you have to force yourself to go sometimes. You're still playing music. You're going to volunteer at the pet rescue organization.
"You're continuing to write your blog. You're doing your household chores. You're actively participating in your son's and husband's lives. You're participating in the presidential campaign--albeit with a small effort. You're learning about digital photography. You're spending time outdoors every day. You're walking, and listening to music. You're reading, and learning how to knit.
"You're recognizing your limitations and accepting them, but you're fully engaged in activities you enjoy. You're spending time with people you find uplifting, and for your own health--you've stopped spending time with people who aren't.
"This isn't a bad depression. You may not have a high energy level, but you're neither terribly tired nor do you need to nap. You're pacing yourself better than you have in the past.
"Maybe, the answer is that you finally realize it's okay to have low-energy periods. You no longer feel you have to apologize to people for experiencing these lulls. You no longer have responsibilities--either work or a young child--that require you to be 'up' all the time. A change in mood truly doesn't have to be a problem as long as you're feeling okay about it."
How do you handle low-grade depressions? What are the greatest challenges? What tips and advice can you give to others?