The first time - a story

The haze has gradually lifted over the last couple of days to where my mind is almost as clear as usual again. I spent most of Wednesday in a miserable daze and on Thursday I was back into the swing of looking after my daughter and pushing the limits of activity so as to maintain, but not exacerbate, the remaining haze on my mind. This morning it has been good.

Perhaps a story. It was back in the mid months of 1999 and I was continuing my undergraduate degree in Arts/Science. I had just come off two years of admission to the Dean's Honours list for outstanding academic achievement and was again achieveing well in my academic pursuits ( I don't think I was quite going to have a third successive year on the Dean's Honours list as I picked up a couple of new subjects at second year,but I might have scraped across the line). By this time I had completed my majors in psychology and politics and was picking up the last few subjects I needed to graduate. I did have an offer to complete an Honours year which may have pushed this out by 12 more months but I was not sure that I was going to accept the offer.

I came through my midyear exams quite well and enjoyed the break between semesters. I was at the time the president of a university club as well so the break for me was doubly appreciated. As second semester resumed I noticed that my attendance to lectures and campus was not as often as previous and eventually my attendance stopped alltogether. All I felt was that I couldn't be bothered going to uni and consequently I didn't. During the same time I slowly but surely dropped out of my normal social world and began spending more and more time alone in the house and in front of the computer (playing games, surfing the net, emailing, chat, reading e-books - totally useless stuff). I was also alienating myself more and more from my wife by not paying any attention to her and was essentially a foreigner in our own home.

While my social behaviours were changing dramatically so were my personal habits and state of mind. I ceased being motivated to do anything at all, my mind was always agitated so I was unable to concentrate, emotionally I felt nothing at all - I was neither happy, nor sad, nor angry, just nothing - and I soon ceased the little communication I had maintined. I was in a constant state of agitation, my mind was unable to cope with normal stimuli - someone talking to me became unbearable, I was unable to read, all I could do was lay down and be blank, play basic games on a computer, or watch TV without being able to follow the story. Any interuption to this blankness caused me to react angrily but the worst part of it was I just didn't even feel the anger.

This went on for some weeks and as you can imagine the state of my marraige relationship was at a low. My wife was as isolated as I was and she just saw her life crumbling before her. This was not the man she had married or got to know over the last 6 years and it was unbearable for her. It was also embarassing - who could be told about what was happening and what could be said? Consequently my wife began avoiding her social networks to avoid answering questions about the whereabouts of her husband and the polite 'how's the husband' chit chat.

At the time of my first episode of major depression I had already majored in psychology (and had a minor in beahvioural neuroscience) and was therefore well acquainted with the processes and symptoms of abnormal psychology. Yet I was completely unprepared for, and unaware of, what I was falling into. It was not until 3-4 months after the first significant symptoms began to appear that in a moment of mental respite I considered the possibility that I had depression. I remember speaking to my wife and suggesting the possibility and it resonated with her too (my wife was already working in the health industry and had been exposed to depressed patients). So we went to see my doctor and I was diagnosed with major depression that week.

I remember the peace that occured between my wife and I after we realised what was really happening with me. The marraige was still tough and I still had most of the depressive symptoms, including severe agitation, but we were both able to process what was happening in a completely new way.

Once I had been diagnosed there was a day we decided to spend together as a couple - it was essentially my wife hanging out with a sick guy. It was the weirdest 'date' I had ever been on. We went for a picnic in the hills. To this day I have never felt so week or frail as a man. The torturuous understanding of my crumbling life remained painful but I was able to relax to the extent we finally knew what was going on. My body and brain was absolutley exhausted and I just shuffled around like an octogenerian with a blank but agitated mind that no longer perplexed us with what was occuring. When walking through the park I actually felt like I was walking on the moon and I was so very worn out. My mind too was in as complete a daze as it has ever been and there was my wife with me, the torture of not knowing what was happening gone, walking slowly at the side of a healthy looking invalid.

Throughout the entire experience of falling into depression I had insight into what was occuring. But I just felt guilty about being a lazy and about being a no good husband. I just couldn't understand why I was like that - it was so out of character - but it was how I was and it was awful to live with myself through that time. However, after being diagnosed, I looked at the official dignostic measures for major depression (DSM IV) and it became clear what was happening. The key thing for me was to be reassured that I just wasn't turning into a lazy jack-ass. The truth couldn't have been any more different and the diagnosis helped me see that.

It is interesting to note that the only symptom I did not have throughout this time was "Abnormal morbid thoughts of death (not just fear of dying) or suicide." I will get around to blogging why i think that was the case one day but for now I will leave you with copy of the diagnostic criteria for major depression from the DSM IV manual.

Diagnostic Criteria
A) At least one of the following three abnormal moods which significantly interfered with the person's life:

1. Abnormal depressed mood most of the day, nearly every day, for at least 2 weeks.
   
2. Abnormal loss of all interest and pleasure most of the day, nearly every day, for at least 2 weeks.
3. If 18 or younger, abnormal irritable mood most of the day, nearly every day, for at least 2 weeks.

B) At least five of the following symptoms have been present during the same 2 week depressed period.

1. Abnormal depressed mood (or irritable mood if a child or adolescent) [as defined in criterion A].
2. Abnormal loss of all interest and pleasure [as defined in criterion A2].
3. Appetite or weight disturbance, either:
   -Abnormal weight loss (when not dieting) or decrease in appetite.
   -Abnormal weight gain or increase in appetite.
4. Sleep disturbance, either abnormal insomnia or abnormal hypersomnia.
5. Activity disturbance, either abnormal agitation or abnormal slowing (observable by others).
6. Abnormal fatigue or loss of energy.
7. Abnormal self-reproach or inappropriate guilt.
8. Abnormal poor concentration or indecisiveness.
9. Abnormal morbid thoughts of death (not just fear of dying) or suicide.

C) The symptoms are not due to a mood-incongruent psychosis.
D) There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode.
E) The symptoms are not due to physical illness, alcohol, medication, or street drugs.
F) The symptoms are not due to normal bereavement.