Good bye, Mirtazapine: 10 things helped to be antidepressant-free
After more than 5 years of taking the antidepressants (Mirtazapine and Lexapro before that), my doctor and I finally agreed that it's time for me to move on.
I have been with the mild depression since I was a teenager. It's a mild depression in a sense that I was never suicidal or anything, but still, it's been tough years. To celebrate that I finally got to this point, I am going to share 10 things that helped me to get better from a perspective from a patient.
1. Suppport from the closest person
My mood used to swing a lot. When I was in a bad mood, my behavior was not fair to the closest people that I was depending on, and I can count the moments that I hurt their feelings. I appreciate so much of their patience and forgiveness. One person who has been so patient with me and also very wise is my wife Yvonne. We both were Ph.D. students at Carnegie Mellon when we met. We came close very quickly, and it did not take so much time before she became aware of my depression. Despite the short period of the time we had spent together, she did not give up on me. Instead, she was wise to encourage me to go to see a counselor.
2. Seeing a doctor
Although I was depressed since I was a teenager, I never was truly aware of my situation, and never saw a psychological counselor or a psychiatrist. I always thought those were for those mentally very sick. It took me a while to overcome the mental barrier before I could go to seek professional helps. After meeting Yvonne, I started to think this way:
Professional athletes have sports doctors on board so they can perform their best. They need doctors because they are taking on an extremely challenging stuff. In the same way, I was trying so hard in the academia that I could use professional help so that I can keep performing well.
I started with a psychological counselor that was easier for me to accept because it did not involve a medication. After establishing the habit of seeing the counselor and building some trust in them, I could open my mind to see a psychiatrist who suggested me to take pills, of course. Anybody with antidepressants knows that they come with side-effects, weirdness when one starts or stops taking. Finding the medicine right for us is also such a long journey. But it was worth having a kick-starter before I could take better control of my life.
4. Better bed
My depression was accompanied with episodes of nightmares. I used to dream them and suffer the feeling that I was not breathing before I could finally manage to wake myself up. I also used to have a very bad backache every morning. When I don't sleep tight, I do not feel right during the day, and I am prone to feel depressed when I am exhausted. So, when I got my first paycheck after I graduated from the grad school, first thing I did was to buy a better bed. I bought one of those memory form mattresses, and it made such a difference in the quality of my sleep, and so to my mood during the day. 1
Being able to expose myself to enough sunlight is crucial for me. I did not realize this until I moved to Pittsburgh to attend Carnegie Mellon University. The winter is cold and snowy over there, but what was even harder there for me was lack of sun light for the majority of the year. Sorry Pittsburgh friends, but I am feeling better after moving out to the places where I see more sunny days.
6. It's OK
After feeling better enough with the support from the closest person, doctor, medication, better sleep, and ample sunlight. It was time for me to work on my attitude to myself. I frankly was too harsh to myself whenever I faced academic stress and work related stress. I used to blame everything on myself. Instead, I started to be more conscious being fair to myself. Before fighting the root cause of the stress, we need to breathe, eat, and rest to gain the energy. I am an impatient person, so I always need to consciously tell myself, "It's OK. I am stressed. Take time to breath first."
7. Stress awareness
It took a while to realize that my depression is related to the level of stress. When I get stressed, I get mentally exhausted. When I am mentally exhausted, I tend to get depressed because I cannot be as productive as I want. Before realizing this, the mood swing always came out of blue. But I finally learned to foresee that it is coming, and I could do something for preventions and mitigations.
I also started to analyze the environments that led me into trouble instead of just blaming my depressive nature. Just realizing the exogenous factors was such a relief to me: "No wonder I was so stressed. It's OK, it is very natural that I feel troubled in this situation."
Over the years, I felt better enough to be more active in enjoying personal life. I enjoyed cooking, making jewelries, gardening, taking pictures, computer programming, and some more personal projects. I also wanted to invest my personal time in my health. So, I started to run regularly. I always feel that all the stresses I get are flushing out of my system with the sweats after I run. Running is also suited for my self-reflective nature because I can let my mind focus on the internal being, and I regain energy that way. I kept the habit long enough now to have finished two of full marathon races. It helped me for my self-esteem.
9. Manage stress
Managing stress is an art, and it's shooting a moving target. Me and my environment get very chaotic as I move fast or I placed myself in a fast paced environment. See the ever changing situations, notice the potential cause of stress, know when to become a warrior to fight and when to retire for the moment to recover. This is something I am working on now.
Towards the 10th point
Above, I sorted things helped me from passive to active. When my mind was deep in trouble, I didn't even have strength to get out of the bed. Back then I could not be pushed to actively fight depression, and I first needed a help. Another thing about me was that I was blaming a lot of thing on myself before the environments I lived in. So for the moment, I consciously stopped asking myself how I could change to get better, and rather focused on avoiding the environments that caused my mood getting depressed. Then I started to become more active, and I was able to determine to actively manage the stress.
So, what is the 10th point? I think it is the realization that I am destined to live with myself for the entire life. I accept who I am, including my tendency to be venerable to certain kind of stresses, and I will need to take care of myself for the whole life. This is not a sickness, and there is no permanent cure. It is my nature. It's fragile but beautiful. So, always treat with care, and enjoy it.
My journey with the mild depression finally came to the point that I could stop taking Mirtazapine. But this is still a trial period and I may come back on medication at any time. But I stopped worry too much about what may or may not come in the future, and I am surely enjoying this new phase of my life.
Although I have not done a sleep study, I also suspect that I am a candidate to sleep apnea. To aid my airway to be open, I started to sleep on a memory form wedge pillow, and it's helping. ↩
Original post: June 6, 2014 | Last updated: June 7, 2014