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What Forgetting the Occasional Medication Dose Taught Me About My Mental Health

Two decades. Two decades of trial and error, success and failure, improvement and relapse. For two decades I have struggled to treat my (very) treatment-resistant depression.

“ICD-10-CM Diagnosis Code F33.2 – major depressive disorder, recurrent severe without psychotic features.” Right there on every piece of paper my psychiatrist has ever given me. F33.2. Over and over, for years and years. Despite its proper medical diagnostic name, I just call it “my depression.” It’s easier that way.

I’ve learned a lot over the years, especially about the value of a psychiatrist who absolutely refuses to give up on you. I’m blessed to have that doctor, and he has truly (quite literally) saved my life. After so much work, so many life changes and medication changes, I was finally at a place where I was actually doing “OK.” In my world — a world full of trips to the psychiatric hospital and years of pitch-black hopelessness — doing “OK” is a big deal. I was in a good place, and all my health was rather stable. So what did I do? What any logical person does — I got complacent.

Every Sunday I would lay out my pill containers and separate out all my medications and vitamins and pills for the week. Every morning and every evening (and often many times throughout the day) I would dutifully take them as directed. I was what you would call “medication compliant.” Despite the ever-changing array of psychiatric medications, I did what I was supposed to do, it was that simple. But after I had been stable for over a year, I started missing an occasional dose. Not just of my antidepressants, but also heart and seizure medications. It is a reckless and dangerous thing to do, but it happened. And for some reason, it kept getting a little worse each week. A little less compliant, and little more complacent. I think some part of me wanted to believe that I didn’t really need medication — that my depression was all “in my head” and I had finally gotten strong enough to “deal” with it.

I was wrong. I was so very wrong.

It was a slow spiral — one I almost didn’t notice. Little things; vacuuming a little less often, struggling more to get to the shower, indifference in everyday things (which became more and more negative rather than just apathetic). I didn’t want to do anything because nothing sounded worth doing. Nothing. I sat on the couch one evening realizing that I didn’t want to be awake because I wasn’t doing any of the things I “wanted” to be doing. (I told myself I “wanted” to paint my nails and water the plants…but really I just wanted to want to.) Still, I didn’t want to go to sleep because it just sounded depressing to have to get up again, and I probably wouldn’t get any sleep anyways. I sat there realizing that, as a sober alcoholic of almost three years, the thought of alcohol didn’t make me sick for a change. It wasn’t as if I was suddenly going to drink again — it wasn’t that severe — but the idea of drinking wasn’t objectionable like it usually was, so my primary coping mechanism for my depression for so many years didn’t sound so awful. I sat there with my heart pounding and beating irregularly and my head spiraling yet stagnant, and it clicked: I’ve been neglecting my medication, and my medical condition is starting to impact my daily life again.

Admittedly that realization started with the heart palpitations, not the creeping depression. I realized that having a defect in my heart which I was born with, and which caused physical symptoms, was the exact same thing as my depression. Two medical conditions, both which cause negative symptoms, both which could be improved with medication, and most importantly: neither of which was my fault. My depression was no less a medical condition than my heart. And the fact that my symptoms were returning should have come as zero surprise, especially after decades of struggle.

I yanked out my pillbox and promptly took each one, just like I should have been. I knew it wouldn’t magically “cure” me in 30 minutes, but I finally had the long-overdue revelation that I was making my life harder in a backward attempt to prove that I was just “lazy and weak.” I hated myself so much that even after decades of struggle I didn’t fully accept that I had a medical condition, one which was through no fault or doing of my own. I just didn’t “get it.” Until that moment.

“F33.2 – major depressive disorder,” my old friend. A medical condition. “My depression” never was and never will be my fault.

By some miracle, it finally sank in. This wasn’t ever going to be something I could just “get over.” I must treat it with the same diligence as any physical condition I was born with – because they are no different.

That doesn’t mean that my not-so-shocking realization will always make my condition decently controlled, as it almost never stays stable for too long. But at least now I realized something I should have realized long ago. It’s not my fault.

It’s not my fault.

My depression is in absolutely no way, shape, or form of my own doing.

It wasn’t a lack of “willpower.” It wasn’t “weakness” or “laziness.” It was a medical condition requiring medical assistance. Period.

I have no idea why it took two decades for that to sink in. Honestly, I’m embarrassed to even admit it. Maybe I just had to get to the best place in my life where I finally had hope for the future, and then throw a landmine in my own path just to see for sure what would happen. If ever I was at a time in my life where I had the best possible chance of coping with my depression without medication, that was it. And you know what? I couldn’t do it. My heart condition is in no part because of weakness or laziness, and neither is my depression. I have fought a long hard battle just to live, better yet to have hope or happiness. I will always be fighting that battle because I have depression.

When I tell my psychiatrist about this little roller coaster I’ve been on, he will just smile a little and tell me he’s glad I’m back on track. He knows that no one is perfect, and that mental illness is a constant struggle. He understands — and it helps me understand as well. His patience has gotten me this far, despite my staunch refusal to accept the reality of my depression. I know that he will have nothing but encouragement, despite all that has happened — and that kind of support is absolutely invaluable.

It is mind-boggling to think that, despite seeing a doctor and taking medication, I could have gone so long without fully embracing the reality that I was treating a condition caused by factors outside my control. Yet here I am, two decades later, finally accepting that I didn’t do anything to “deserve” or “cause” my depression.

It’s not my fault. It never was. It never will be.

Understanding that — and embracing it — might have been the best thing I ever did for my mental health.

Photo by Ashley Byrd on Unsplash