When I was diagnosed with PTSD I was also diagnosed with mild depression and prescribed a low dose SSRI. I haven’t upped the dose in the two years I’ve been on it, and based on my rapid tolerance increase for Xanax and alcohol (is there such a thing as having a pre-conditioned liver from a family history of substance abuse?), I am pretty sure the SSRI is useless at this point. I have a choice to make this winter, increase the dose or stop taking it, because it really isn’t having much effect for me and I like to take as few medications as possible.
I think the management of mental health by medication is an individual choice, and I have very little to say about other’s choices. What I know for me is that the goal is to gain enough stability through thought and behavioral changes that I can be medication-free, after using medication to help me through the process of getting stable. However, that means there will be not as good days. Depression kills my motivation to do ANYTHING, particularly anything that is good for me (I never want a salad when I’m experiencing depression, ya know?).
I am getting my ambition back, some of my creativity back, a lot of ME back. Depression kills all of that and stuffs it in a hole. Because I can’t predict depressive episodes, I never know when I will not be having it. Once upon a time I had the discipline to keep going and push through, but after doing that for two years following severe trauma, I can’t anymore. It isn’t there. The strength to push through is gone, and it’s incredibly frustrating because I want so badly for it to be there. I have things to do!
I am finally able to put those feelings into words, and the first step for me in any aspect of my recovery is usually understanding and acknowledging what is happening so that I can address it. I can say then, “I am experiencing depression. Depression causes a lack of motivation toward accomplishing things that are important to me. I can find a way to address this.” And that, y’all, is why I pay a therapist!