![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by uncouth on September 23, 2009, at 18:55:14
This post will probably be a bit rambling as my thoughts are not too clear right now. But as of late, I have been questioning whether I'm asking too much of medication, and in fact what I'm calling depression is instead an existential and/or spiritual crisis. And perhaps medication is not the right (or complete) strategy.
Since early August, I have been dealing with suicidal thoughts that have been ever present, and more importantly, have evolved from an acute desire to die to end the current pain of the present - the regrets, ruminations, emotional incontinence, negative self-talk -- you know the drill. I most certainly termed this "depression", like all of my depressions over the past few years, just a more dangerous and serious one. I wrote a suicide note and made a really half-*ss*d attempt at self-strangulation (which I knew probably wouldn't work, but felt the need to act it out anyway).
Thankfully, the acute, throbbing and torrential melancholy responded to a med change - bupropion and zyprexa. I also had a few weeks of meaningful activity - studying for the GMAT - which gave me a goal and something to focus my mind on. The regrets and ruminations faded into the background, by the grace of God and chemistry.
Yet, I'm not feeling "better". Bupropion got me out of bed, got me working out, helped me kill my test, but what I am starting to realize is that there is this secondary "problem" that appears once the acute pain has been taken care of. Some may pathologize it and call it incomplete remission - that may be so - or dysthymia. But I've been doing this for years. It seems everytime I climb out of the pit, I end up simply sitting on the ledge, dangling my feet.
This "problem" -- let's just call it existential despair although the philosophical definition may be different than my usage -- has been in the background for years. What is difficult about this is that the emotions, thoughts, convictions that come along with this are much more difficult to 'pathologize away' as symptoms of an underlying biological disorder.
Stuff like meaninglessness, purpose, the nature and constancy of human suffering. Philosophically heavy stuff. Our inherent isolation and fundamental loneliness. This despair brings with it a sort of hopelessness that is different from the irrational hopelessness of depression. The despair feels in fact closer to the real truth of the situation than anything else. Maybe this is a part of "depressive realism"?
I am slowly coming to realize that perhaps I have been trying to attack with meds and psychotherapy this despair, which is fundamentally not necessarily a pathology of sickness, but a universal human condition/set of questions that may show its face in different ways to different people, depending on their personalities and psychological makeup. I do think that the length, chronicity, fatigue, and losses of recurrent, "biological" depression, increase the tenacity of these thoughts and questions about purpose, meaning, God, suffering. But perhaps I am expecting too much. Perhaps I have been trying to defeat these feelings, to blind myself to the truths my experience has enabled me to see, with a countertop full of pills. Thou shalt have no other gods before me?
Maybe it's better termed existential frustration -- the sense of longing for something, but what that something is we do not know. I see now that these sorts of frustrations are self-reinforcing. My behavioral adaptions and the effects of my depression have created an environment (out of work, too much free time, anhedonia, social disengagement) for the existential despair and frustration to become crystal clear and present. It's like the depression has opened this big can of worms, and i've been trying to shove them back in for years. Perhaps it's time to stop shoving?
All I know is that over the past few weeks, despite doing well on my GMATs and supposedly charting a course for my future (applying to business school), I have felt a more profound sense of dread and a different form of suicidality than I have felt in the past. The acute pain of depression has given way to an emptiness that feels like a fundamental, inescapable truth - unlike the more obvious cognitive distortions of acute depression, I am having a much harder time terming these symptoms of an illness. Recently, I have had this sense that suicide is inevitable, and that I'm essentially terminally ill at present. It feels as though the decision has been made - by my illness, by the effects of my illness on my life, by the resulting existential despair, and of course by a thinking, feeling, me that just doesn't want to go on, doesn't want to rebuild, sees futility where others see hope and opportunity. These suicidal thoughts don't feel pathological, which is why I think they scare me even more. They aren't front and center, top of mind, more like in the background, the context in which I try to get through each day. December, January, who knows - whenever I hear back from business schools, likely hearing rejections. I find myself almost hoping I don't get in, so I have a reason to die: the absence of a tangible reason to live. The irrational, silly part is that I'm not even sure how much I care about going to b-school. It just seems like something to do, and a potentially enriching, social environment (e.g. maybe I can get a do-over on life).
Anyway, I'm not so sure how to deal with this form of suicidality. I'm not in imminent danger, and yet, I'm actively doing (/not doing) things that make the liklihood of my committing the act more probable (i should be working on admissions essays right now, in fact).
I guess the main point of this post is to try to tease out how we pathologize our experience - how the very real illness of depression is related to other higher-order "human" elements of us, that when incomplete or malfunctional may be best described as existential despair. Perhaps this is God's way of getting our attention? Or the remnants of what is left of a life eaten up by chronic, severe depression.
I'm searching for some answers but I don't think there are any. I'm praying, believing, talking with God, trying to trust in Him, but feel as though I am failing. I'm wondering if this is all a result of being overeducated, overprivleged, and in possession of unrealisticly high expectations. If what I'm feeling isn't depression anymore, if it's something else, then maybe I'm doing far more harm than good by continuing to tweak, continuing to expect better living through chemistry. Thou shalt have no other gods before me.
I don't feel like I'm in a mixed state, I feel as though recent med changes have actually been a net positive, and yet I'm still a fractured self, so wanting to end this suffering, this meaninglessness, this personal history of such disappointment, maladaption, and pain - intermixed with a self who is desperately afraid and desperately trying to save my life - the clock is ticking, do I have 2 months? 3 months? 4? The certainty of my suicide has become the only form of certainty I experience in my life. My success is no longer certain. My experience of love is no longer certain. Having a family, enjoying the simple pleasures of life, no longer certain. It is mindboggling to me that there are (many) people on this earth who have this sense of certainty with the positive aspects of life - love, work, family - a baseless optimism that things will be ok. What a wonderful psychological defense/adaptation.
I'm tired of fighting -- for what? But I'm still here. I guess this is when you "push". When you put your hope in things that seem absolutely hope-less. When you admit your brokenness and go to God, asking for forgiveness and trusting that there is some meaning in this meaninglessness. For two years I have tried to open my heart to God. I have worshiped, read, prayed. And I continue to do so. But I feel no different than I did 2 years ago. I despair in my inability to trust Him fully, to ask him to share my burdens. I believe God loves me, accept that this is not inconsistent with the presence of suffering in my life and in the world, and know that there are no easy answers.
Thanks for reading, i know this post is pretty self-indulgent. 50 years ago if I started thinking this way, someone would have "knocked some sense into me", told me that all I needed to do was get a job and a girlfriend, and that would be that. Perhaps I'm making it too difficult, maybe it's as simple as that? Probably not.
thanks,
uncouth
Posted by PC_Load_Letter on September 23, 2009, at 22:57:00
In reply to Depression or existential despair? So lost..., posted by uncouth on September 23, 2009, at 18:55:14
All existential and spiritual despair that I have experienced resolves itself completely during those fleeting times I am able to achieve a full response to meds, so I vote for depression.
Such is the slippery nature of the beast - it is able to manifest itself as many kinds of despair and anguish.
Hang in there, bud.
Posted by Phillipa on September 24, 2009, at 0:45:43
In reply to Depression, posted by PC_Load_Letter on September 23, 2009, at 22:57:00
Sounds a lot like what I do question the meaning of life if it's not forever and just aging. I'm older and watch the even older just waiting for the inevitable which they accept. The ruler time line gets shorter. I say young and healthy get out there and fight and when engaged in life school from my past experiences I feel you will then feel like wanting to live. My thoughts only. Love Phillipa
Posted by Sigismund on September 24, 2009, at 2:55:01
In reply to Depression or existential despair? So lost..., posted by uncouth on September 23, 2009, at 18:55:14
Despair is a valid philosophical position, with, (it has to be said), the most interesting writers such as EM Cioran, Samuel Beckett, Dostoyevsky, Camus.
Posted by Sigismund on September 24, 2009, at 2:58:00
In reply to Re: Depression, posted by Phillipa on September 24, 2009, at 0:45:43
>watch the even older just waiting for the inevitable which they accept
Maybe they've had enough and are glad to get out of this place?
Posted by Ceran on September 24, 2009, at 3:39:53
In reply to Depression or existential despair? So lost..., posted by uncouth on September 23, 2009, at 18:55:14
uncouth... I am somewhat like you. instead of business i am in a foreign medical school that my parents payed for me to get me into. my challenges are ahead of me ...i will have to try to return with the degree back to north america, but i dont really feel motivated
i have always been unhappy with how I look, with my demanding, strict and controlling father, with my lack of independance, with my lack of social and sexual development (no, not puberty) which only began in university.
maybe its me being too comfortable, selfish, whiny, whatever - well actually im sure it is. but i am convinced that im a sum of my genetic and upbringing parts and that i was broken before i reached my 20s. i long to have the core confidence, the self-assuredness of my colleagues, always ready with some story or anecdote, INTERESTING.
suicidal thoughts are like a drug, if you are negative in that way for such a long period of time, your brain rewires itself to crave that stimulation, that fantasy. it doesn't know any better.
as for the existentialism - i had a few experiences with drugs, mainly salvia and weed, that really set it off.
imagine suddenly zooming out of yourself, feeling like an outside observer scrutinizing your own actions and speech, like you're in a TV show - look its some depressed guy writing on the internet!, how boring, lets change the channel to a more interesting life. and you zoom out, to millions, billions of other stories going on and you're so f*ck*ng insignificant... its terrifying. The finality of it - you don't get to step out of your little sideshow, this is all there is.
what a mindfuck
Posted by SLS on September 24, 2009, at 6:14:25
In reply to Depression or existential despair? So lost..., posted by uncouth on September 23, 2009, at 18:55:14
I couldn't read your entire post. That kind of volume is still beyond me. I am hoping that I recover the ability to read as my recovery from depression continues.
Of course you are lost!
My first reaction to your post was to "keep it simple". Most of your questions are complicated and largely unanswerable. Furthermore, your thought time and energies are being tied taking all of the Universe into consideration when it might be easier to live in the moment and take care of yourself first. Pondering philosophy is often a luxury to indulge in when it is not pertinent to your immediate needs. You will have plenty of years left ahead of you to indulge in what is often an academic exercise. Deal with what you know and those things knowable that affect you immediately or directly.
Keep it simple.
Live in the here and now.
Create your own philosophies as you go along.
This works for me. Of course, it might not work for everyone.
Another aspect to all of this is that a depressed mind will not be able process answers to such large questions as it must work with cognitive deficits and negative colored thinking. Perhaps now is not the best time to take on such an enormous project as developing a philosophical framework that encompasses all that exists along with all that does not.
Keep it simple.
- Scott
Posted by linkadge on September 24, 2009, at 19:47:06
In reply to Re: Depression or existential despair? So lost... » uncouth, posted by SLS on September 24, 2009, at 6:14:25
The times in my life when I didn't know where I was going (in terms of direction in my life) were the absolute hardest times - and the most resistent to medications. More recently, I have had meaningful employement and a positive medication change to amitriptyline. Its so hard to separate which were the more important factors in my recovery. But is sure feels damn good to feel needed.
Linkadge
Posted by linkadge on September 24, 2009, at 19:48:43
In reply to Re: Depression or existential despair? So lost... » uncouth, posted by SLS on September 24, 2009, at 6:14:25
But I do believe that sometimes there are issues and feelings that the brain finds so hard to process that it really denies that they are problems. Sometimes its just a matter of tick tocks till things fall into place - one way or another. I guess.
Linakdge
Posted by Phillipa on September 24, 2009, at 19:51:21
In reply to Re: Depression or existential despair? So lost..., posted by linkadge on September 24, 2009, at 19:47:06
Link congrats and I do know what you mean about being needed. Phillipa
Posted by alchemy on September 24, 2009, at 23:26:18
In reply to Re: Depression or existential despair? So lost..., posted by linkadge on September 24, 2009, at 19:48:43
The happy jolly people that I envy don't seem to really think about deep "stuff". I have always been what I guess you call a deep thinker, as well as having mood difficulties. Do they go hand in hand? My existential thinking can sometimes make me go crazy trying to figure everything out. And my fear of dying, having to live after death is the scariest thought to me. I want this to be over. I probably think about what death is more than others I know because I am familiar with wanting to die pretty much all of the time.
For example, my 8 yr old nephew has some type of slight aspergers/bipolar, and very smart. I am sure that he is going to take religion very serious, question, think, etc. He asked me if dinosaurs came before Adam & Eve.
His happy easy go-lucky brother will probably just think of church as a social event.
I found it interesting that on a day I was having a lot of thoughts about the world, pain, meaning of life; and feeling crazy and down, I had forgot to take my daily xanax.
This venting probably doesn't really address your question, but thanks for letting me vent :) I wish I had a simple happy head.
Posted by ace on September 25, 2009, at 5:20:56
In reply to Depression or existential despair? So lost..., posted by uncouth on September 23, 2009, at 18:55:14
> This post will probably be a bit rambling as my thoughts are not too clear right now. But as of late, I have been questioning whether I'm asking too much of medication, and in fact what I'm calling depression is instead an existential and/or spiritual crisis. And perhaps medication is not the right (or complete) strategy.
>
> Since early August, I have been dealing with suicidal thoughts that have been ever present, and more importantly, have evolved from an acute desire to die to end the current pain of the present - the regrets, ruminations, emotional incontinence, negative self-talk -- you know the drill. I most certainly termed this "depression", like all of my depressions over the past few years, just a more dangerous and serious one. I wrote a suicide note and made a really half-*ss*d attempt at self-strangulation (which I knew probably wouldn't work, but felt the need to act it out anyway).
>
> Thankfully, the acute, throbbing and torrential melancholy responded to a med change - bupropion and zyprexa. I also had a few weeks of meaningful activity - studying for the GMAT - which gave me a goal and something to focus my mind on. The regrets and ruminations faded into the background, by the grace of God and chemistry.
>
> Yet, I'm not feeling "better". Bupropion got me out of bed, got me working out, helped me kill my test, but what I am starting to realize is that there is this secondary "problem" that appears once the acute pain has been taken care of. Some may pathologize it and call it incomplete remission - that may be so - or dysthymia. But I've been doing this for years. It seems everytime I climb out of the pit, I end up simply sitting on the ledge, dangling my feet.
>
> This "problem" -- let's just call it existential despair although the philosophical definition may be different than my usage -- has been in the background for years. What is difficult about this is that the emotions, thoughts, convictions that come along with this are much more difficult to 'pathologize away' as symptoms of an underlying biological disorder.
>
> Stuff like meaninglessness, purpose, the nature and constancy of human suffering. Philosophically heavy stuff. Our inherent isolation and fundamental loneliness. This despair brings with it a sort of hopelessness that is different from the irrational hopelessness of depression. The despair feels in fact closer to the real truth of the situation than anything else. Maybe this is a part of "depressive realism"?
>
> I am slowly coming to realize that perhaps I have been trying to attack with meds and psychotherapy this despair, which is fundamentally not necessarily a pathology of sickness, but a universal human condition/set of questions that may show its face in different ways to different people, depending on their personalities and psychological makeup. I do think that the length, chronicity, fatigue, and losses of recurrent, "biological" depression, increase the tenacity of these thoughts and questions about purpose, meaning, God, suffering. But perhaps I am expecting too much. Perhaps I have been trying to defeat these feelings, to blind myself to the truths my experience has enabled me to see, with a countertop full of pills. Thou shalt have no other gods before me?
>
> Maybe it's better termed existential frustration -- the sense of longing for something, but what that something is we do not know. I see now that these sorts of frustrations are self-reinforcing. My behavioral adaptions and the effects of my depression have created an environment (out of work, too much free time, anhedonia, social disengagement) for the existential despair and frustration to become crystal clear and present. It's like the depression has opened this big can of worms, and i've been trying to shove them back in for years. Perhaps it's time to stop shoving?
>
> All I know is that over the past few weeks, despite doing well on my GMATs and supposedly charting a course for my future (applying to business school), I have felt a more profound sense of dread and a different form of suicidality than I have felt in the past. The acute pain of depression has given way to an emptiness that feels like a fundamental, inescapable truth - unlike the more obvious cognitive distortions of acute depression, I am having a much harder time terming these symptoms of an illness. Recently, I have had this sense that suicide is inevitable, and that I'm essentially terminally ill at present. It feels as though the decision has been made - by my illness, by the effects of my illness on my life, by the resulting existential despair, and of course by a thinking, feeling, me that just doesn't want to go on, doesn't want to rebuild, sees futility where others see hope and opportunity. These suicidal thoughts don't feel pathological, which is why I think they scare me even more. They aren't front and center, top of mind, more like in the background, the context in which I try to get through each day. December, January, who knows - whenever I hear back from business schools, likely hearing rejections. I find myself almost hoping I don't get in, so I have a reason to die: the absence of a tangible reason to live. The irrational, silly part is that I'm not even sure how much I care about going to b-school. It just seems like something to do, and a potentially enriching, social environment (e.g. maybe I can get a do-over on life).
>
> Anyway, I'm not so sure how to deal with this form of suicidality. I'm not in imminent danger, and yet, I'm actively doing (/not doing) things that make the liklihood of my committing the act more probable (i should be working on admissions essays right now, in fact).
>
> I guess the main point of this post is to try to tease out how we pathologize our experience - how the very real illness of depression is related to other higher-order "human" elements of us, that when incomplete or malfunctional may be best described as existential despair. Perhaps this is God's way of getting our attention? Or the remnants of what is left of a life eaten up by chronic, severe depression.
>
> I'm searching for some answers but I don't think there are any. I'm praying, believing, talking with God, trying to trust in Him, but feel as though I am failing. I'm wondering if this is all a result of being overeducated, overprivleged, and in possession of unrealisticly high expectations. If what I'm feeling isn't depression anymore, if it's something else, then maybe I'm doing far more harm than good by continuing to tweak, continuing to expect better living through chemistry. Thou shalt have no other gods before me.
>
> I don't feel like I'm in a mixed state, I feel as though recent med changes have actually been a net positive, and yet I'm still a fractured self, so wanting to end this suffering, this meaninglessness, this personal history of such disappointment, maladaption, and pain - intermixed with a self who is desperately afraid and desperately trying to save my life - the clock is ticking, do I have 2 months? 3 months? 4? The certainty of my suicide has become the only form of certainty I experience in my life. My success is no longer certain. My experience of love is no longer certain. Having a family, enjoying the simple pleasures of life, no longer certain. It is mindboggling to me that there are (many) people on this earth who have this sense of certainty with the positive aspects of life - love, work, family - a baseless optimism that things will be ok. What a wonderful psychological defense/adaptation.
>
> I'm tired of fighting -- for what? But I'm still here. I guess this is when you "push". When you put your hope in things that seem absolutely hope-less. When you admit your brokenness and go to God, asking for forgiveness and trusting that there is some meaning in this meaninglessness. For two years I have tried to open my heart to God. I have worshiped, read, prayed. And I continue to do so. But I feel no different than I did 2 years ago. I despair in my inability to trust Him fully, to ask him to share my burdens. I believe God loves me, accept that this is not inconsistent with the presence of suffering in my life and in the world, and know that there are no easy answers.
>
> Thanks for reading, i know this post is pretty self-indulgent. 50 years ago if I started thinking this way, someone would have "knocked some sense into me", told me that all I needed to do was get a job and a girlfriend, and that would be that. Perhaps I'm making it too difficult, maybe it's as simple as that? Probably not.
>
> thanks,
> uncouth
>This is very good. Thankyou so much for writing this out. I am going to print this out and re-read thoroughly and get back.
Until then, even in light of the above, keep smiling.....period.
Ace, Nardil man:)
Posted by morganator on September 25, 2009, at 9:26:07
In reply to Depression or existential despair? So lost..., posted by uncouth on September 23, 2009, at 18:55:14
Simply finding answers through God and prayer will not get you better. You need to find a way to find peace withing yourself through yourself and not just through God.
Have you tried-Therapy? Group therapy? Exercise? Finding things you are good at and enjoy and refining and developing them? Surrounding yourself with friends?
There must be things about yourself that you do not love that are competing against and winning the battle against the things about yourself that you do or should love. Have you taken time to try to figure out what those things are that you do not love about yourself and why you do not love those things. I do not believe depression can take full control of us if we truly love ourselves-if we love more things about ourselves than we do not love about ourselves. I am confused as to why this is not considered more and talked about more. The focus is way too often put on medication and chemical imbalance and genetics. For example, you could be predisposed to depression/bipolar, but if you have a talent that you love and have success with it is less likely that your predisposition will take the form of the morbid monster it has potential to. The same applies to having good relationships, having a well nurtured very loving childhood, having strong faith in God(I am agnostic by the way), knowing how to have fun with yourself and others, having high healthy self esteem, knowing how to treat your body and mind well through diet/exercise/yoga, etc.
One thing we have to understand is that anxiety and depression are a part of life, even for people that do not suffer from them clinically. The root of all of our anxiety and depression is death. So for those of us that are super sensitive and biologically predisposed to suffering and being affected, our feelings/questions about our existence is even that much more difficult to deal with. We do not have the typical shield that many have from the fear of the inevitable. Maybe I am not making sense but this is the best I can do right now. Ugh...
I believe that if we knew that we would never die and we knew that we would never grow old, we would have a much better outlook on life. We would feel like we had an eternity to work on what ails us. The future would always be bright, knowing that one day we would be able to beat down the grim gremlin inside making room for the person that we truly love to shine. I think aging and death is getting in the way. Sorry for sounding pessimistic. This does not mean that I do not believe that we can still find peace and happiness as we age. One way to heal is through our children. Of course, in order to do this we would have to heal enough to be able to attract the right person and be strong enough to maintain a healthy relationship with them. One problem is that many of us do not truly love ourselves. We have been deeply hurt in the past and are afraid of being hurt again. This results in a classic use of a coping/defense mechanism in which we sabotage our relationships. We hold on to our misery. We do so because we are afraid of being vulnerable. Because we were hurt and still are hurting, we subconsciously do not allow ourselves things that may make us truly happy and content. If we find ourselves truly content than we are suddenly vulnerable, and if we are vulnerable we can then be hurt once again. The one coping mechanism that allows us to stay in a state where we are unaware of the fact that we are doing this is the most powerful mechanism of all, denial.
Posted by linkadge on September 26, 2009, at 16:08:49
In reply to Re: Depression or existential despair? So lost..., posted by alchemy on September 24, 2009, at 23:26:18
I used to be a deep thinker about such issues. Now I seem to have become apathetic towards that. I have felt that the nature of God as I see him/her depends on what state of mind I am in. When I am not depressed, he/she is more forgiving and accepting.
I still have issues, but they have been more related to unfufillable obsessions. Sorry, no details.
Linkadge
Posted by Dr. Bob on September 27, 2009, at 4:08:00
In reply to Re: Depression or existential despair? So lost..., posted by morganator on September 25, 2009, at 9:26:07
> I do not believe depression can take full control of us if we truly love ourselves-if we love more things about ourselves than we do not love about ourselves. I am confused as to why this is not considered more and talked about more. The focus is way too often put on medication and chemical imbalance and genetics.
Sorry to interrupt, but I'd like to redirect follow-ups about loving ourselves to Psycho-Babble Psychology. Here's a link:
http://www.dr-bob.org/babble/psycho/20090907/msgs/918683.html
That'll be considered a new thread, so if you'd like to be notified by email of follow-ups to it, you'll need to request that there.
It's fine to keep posting about medication-related issues here.
Thanks,
Bob
Posted by theunnameable on September 30, 2012, at 11:28:36
In reply to Depression or existential despair? So lost..., posted by uncouth on September 23, 2009, at 18:55:14
i would recommend dropping god, pills, and thoughts of imminent suicide. pick up the bottle instead. i get to die for a little while every night as an alcoholic. believe that i truly understand the desire for oblivion, to not be. but, i like myself, and a lot of other people to much for suicide to ever be an option. getting blackout drunk and beating the sh*t out of myself tyler duden style actually works, for me, you should try it.
> This post will probably be a bit rambling as my thoughts are not too clear right now. But as of late, I have been questioning whether I'm asking too much of medication, and in fact what I'm calling depression is instead an existential and/or spiritual crisis. And perhaps medication is not the right (or complete) strategy.
>
> Since early August, I have been dealing with suicidal thoughts that have been ever present, and more importantly, have evolved from an acute desire to die to end the current pain of the present - the regrets, ruminations, emotional incontinence, negative self-talk -- you know the drill. I most certainly termed this "depression", like all of my depressions over the past few years, just a more dangerous and serious one. I wrote a suicide note and made a really half-*ss*d attempt at self-strangulation (which I knew probably wouldn't work, but felt the need to act it out anyway).
>
> Thankfully, the acute, throbbing and torrential melancholy responded to a med change - bupropion and zyprexa. I also had a few weeks of meaningful activity - studying for the GMAT - which gave me a goal and something to focus my mind on. The regrets and ruminations faded into the background, by the grace of God and chemistry.
>
> Yet, I'm not feeling "better". Bupropion got me out of bed, got me working out, helped me kill my test, but what I am starting to realize is that there is this secondary "problem" that appears once the acute pain has been taken care of. Some may pathologize it and call it incomplete remission - that may be so - or dysthymia. But I've been doing this for years. It seems everytime I climb out of the pit, I end up simply sitting on the ledge, dangling my feet.
>
> This "problem" -- let's just call it existential despair although the philosophical definition may be different than my usage -- has been in the background for years. What is difficult about this is that the emotions, thoughts, convictions that come along with this are much more difficult to 'pathologize away' as symptoms of an underlying biological disorder.
>
> Stuff like meaninglessness, purpose, the nature and constancy of human suffering. Philosophically heavy stuff. Our inherent isolation and fundamental loneliness. This despair brings with it a sort of hopelessness that is different from the irrational hopelessness of depression. The despair feels in fact closer to the real truth of the situation than anything else. Maybe this is a part of "depressive realism"?
>
> I am slowly coming to realize that perhaps I have been trying to attack with meds and psychotherapy this despair, which is fundamentally not necessarily a pathology of sickness, but a universal human condition/set of questions that may show its face in different ways to different people, depending on their personalities and psychological makeup. I do think that the length, chronicity, fatigue, and losses of recurrent, "biological" depression, increase the tenacity of these thoughts and questions about purpose, meaning, God, suffering. But perhaps I am expecting too much. Perhaps I have been trying to defeat these feelings, to blind myself to the truths my experience has enabled me to see, with a countertop full of pills. Thou shalt have no other gods before me?
>
> Maybe it's better termed existential frustration -- the sense of longing for something, but what that something is we do not know. I see now that these sorts of frustrations are self-reinforcing. My behavioral adaptions and the effects of my depression have created an environment (out of work, too much free time, anhedonia, social disengagement) for the existential despair and frustration to become crystal clear and present. It's like the depression has opened this big can of worms, and i've been trying to shove them back in for years. Perhaps it's time to stop shoving?
>
> All I know is that over the past few weeks, despite doing well on my GMATs and supposedly charting a course for my future (applying to business school), I have felt a more profound sense of dread and a different form of suicidality than I have felt in the past. The acute pain of depression has given way to an emptiness that feels like a fundamental, inescapable truth - unlike the more obvious cognitive distortions of acute depression, I am having a much harder time terming these symptoms of an illness. Recently, I have had this sense that suicide is inevitable, and that I'm essentially terminally ill at present. It feels as though the decision has been made - by my illness, by the effects of my illness on my life, by the resulting existential despair, and of course by a thinking, feeling, me that just doesn't want to go on, doesn't want to rebuild, sees futility where others see hope and opportunity. These suicidal thoughts don't feel pathological, which is why I think they scare me even more. They aren't front and center, top of mind, more like in the background, the context in which I try to get through each day. December, January, who knows - whenever I hear back from business schools, likely hearing rejections. I find myself almost hoping I don't get in, so I have a reason to die: the absence of a tangible reason to live. The irrational, silly part is that I'm not even sure how much I care about going to b-school. It just seems like something to do, and a potentially enriching, social environment (e.g. maybe I can get a do-over on life).
>
> Anyway, I'm not so sure how to deal with this form of suicidality. I'm not in imminent danger, and yet, I'm actively doing (/not doing) things that make the liklihood of my committing the act more probable (i should be working on admissions essays right now, in fact).
>
> I guess the main point of this post is to try to tease out how we pathologize our experience - how the very real illness of depression is related to other higher-order "human" elements of us, that when incomplete or malfunctional may be best described as existential despair. Perhaps this is God's way of getting our attention? Or the remnants of what is left of a life eaten up by chronic, severe depression.
>
> I'm searching for some answers but I don't think there are any. I'm praying, believing, talking with God, trying to trust in Him, but feel as though I am failing. I'm wondering if this is all a result of being overeducated, overprivleged, and in possession of unrealisticly high expectations. If what I'm feeling isn't depression anymore, if it's something else, then maybe I'm doing far more harm than good by continuing to tweak, continuing to expect better living through chemistry. Thou shalt have no other gods before me.
>
> I don't feel like I'm in a mixed state, I feel as though recent med changes have actually been a net positive, and yet I'm still a fractured self, so wanting to end this suffering, this meaninglessness, this personal history of such disappointment, maladaption, and pain - intermixed with a self who is desperately afraid and desperately trying to save my life - the clock is ticking, do I have 2 months? 3 months? 4? The certainty of my suicide has become the only form of certainty I experience in my life. My success is no longer certain. My experience of love is no longer certain. Having a family, enjoying the simple pleasures of life, no longer certain. It is mindboggling to me that there are (many) people on this earth who have this sense of certainty with the positive aspects of life - love, work, family - a baseless optimism that things will be ok. What a wonderful psychological defense/adaptation.
>
> I'm tired of fighting -- for what? But I'm still here. I guess this is when you "push". When you put your hope in things that seem absolutely hope-less. When you admit your brokenness and go to God, asking for forgiveness and trusting that there is some meaning in this meaninglessness. For two years I have tried to open my heart to God. I have worshiped, read, prayed. And I continue to do so. But I feel no different than I did 2 years ago. I despair in my inability to trust Him fully, to ask him to share my burdens. I believe God loves me, accept that this is not inconsistent with the presence of suffering in my life and in the world, and know that there are no easy answers.
>
> Thanks for reading, i know this post is pretty self-indulgent. 50 years ago if I started thinking this way, someone would have "knocked some sense into me", told me that all I needed to do was get a job and a girlfriend, and that would be that. Perhaps I'm making it too difficult, maybe it's as simple as that? Probably not.
>
> thanks,
> uncouth
>
Posted by theunnameable on September 30, 2012, at 12:02:33
In reply to Re: Depression or existential despair? So lost..., posted by alchemy on September 24, 2009, at 23:26:18
the "happy simple head" people are only keeping us down. inquisitive intelligence is not a f*ck*ng problem. idiocy, redundancy, bureaucracy, these are problems. breeding and profiteering are not in and of themselves bad, but, when taken to extremes by people who don't, can't, understand what they're doing, could destroy the world. so be damn proud of being smart and depressed. stay on your feet and do what you can to make things better. it's not going to be easy, but please trudge on-wards, be stubborn, don't ever let bigger or happier people make you feel bad about yourself even if they hurt you. the meek shall inherit the earth? i for one don't want to wait. let's do something with big brains other than create apple products. non-violent subversion is my suggestion.
Posted by 4WD on October 2, 2012, at 19:10:26
In reply to Depression or existential despair? So lost..., posted by uncouth on September 23, 2009, at 18:55:14
I have to think more before answering fully but I want you to know you are not alone in your thoughts, especially about God. I too despair of ever trusting Him fully and I wonder sometimes if He means to teach me to by taking away absolutely every/any hope I have or have had of making it myself-like if he takes all but my very life I will finally have to trust Him or die. And as much as I am hurting, tI don't want to die. Not really. And I don't think you do either. Not really. I want to escape and it often feels like that's the only way too but when I reached the suicide note point in January, 2007, I called my pdoc instead at the last minute instead. And you are writing here.
As I said, I want to think more but my heart guess out to you.
Marsha
Posted by Angstridden on June 9, 2013, at 16:22:13
In reply to Depression or existential despair? So lost..., posted by uncouth on September 23, 2009, at 18:55:14
The post compelled me to join this website. Now after registering, I see that the post is over 3 years old. So I see the chances of having any dialogue with "uncouth" as kind of remote.
But, for what it's worth, here's what I am driven to put out there: Great Job, uncouth! Well articulated. I feel for you. For the first time in my life, I see my own experience with depression well described.
Now I know the name for what is wrong with me. It's not a "brain disease." It's called "existential despair." I'm not the only one who has it. Yeah, we're depressed. Maybe we do have encephalopathy. But there is more insight shown in this post than in all that I've been told by all the psychotherapeutic professionals I've ever talked with.
Wherever you are, uncouth, I hope you didn't off yourself. I hope you did find a nice job and a nice girlfriend. I hope there is a way out of existential despair. Maybe you found a way . . . for you. Good Job! - if you did. You were pretty far gone in that direction. I hope you found your way. I'll bet it wasn't simple . . . and still isn't. I hope you are okay . . . or more okay than you were in 2009. I'm sure you are much beloved of God, if there is God.
Posted by Phillipa on June 9, 2013, at 20:38:28
In reply to Re: Depression or existential despair? So lost..., posted by Angstridden on June 9, 2013, at 16:22:13
Uncouth is still around on the board. Phillipa
Posted by Dr. Bob on June 11, 2013, at 20:34:19
In reply to Re: Depression or existential despair? So lost..., posted by Angstridden on June 9, 2013, at 16:22:13
> Wherever you are, uncouth, I hope you didn't off yourself.
He didn't. He was one of the Babblers I saw in San Francisco last month. :-)
Bob
Posted by uncouth on June 13, 2013, at 10:03:33
In reply to Re: Depression or existential despair? So lost..., posted by Angstridden on June 9, 2013, at 16:22:13
thank you for your kind note. often i am afraid to even re-read my old posts because they were written in such states of illness that it boggles me. but i'm glad you got something out of this post. this board has been a big resource for me in years past but thankfully now I am doing much better. but it took a long time, and i went through it all, and i am still on a host of medication. but today i am significantly more functional and mentally and physically more stable than i was at the time of this post, which was the lowest point of my life -- after failed ECT.
it is possible for things to get better. i am glad you liked my post. and i made it through, didn't off myself, and don't intend to...
Posted by Willful on June 13, 2013, at 11:34:15
In reply to Re: Depression or existential despair? So lost... » Angstridden, posted by uncouth on June 13, 2013, at 10:03:33
Uncouth, I'm glad to hear that you're doing better than you were at the time of those posts. I remember them from before.
Bob is creating a thread of stories of people who've gotten better and are therefore success stories. Maybe your story could contribute to that thread, which is meant, I think, to stand for the fact that while there are many dire stories here about the dangers of drugs-- there are also times when people do become more stable, more functional- and living in better lives.
I hope your better life continues... Maybe you could tell us a little bit of how that came about?
Willful
Posted by sigismund on June 15, 2013, at 6:38:32
In reply to Re: Depression or existential despair? So lost..., posted by Willful on June 13, 2013, at 11:34:15
Yes, uncouth, I can certainly remember your posts too.
Can I ask how you did it? Or is it somehow a silly question?
Posted by uncouth on June 15, 2013, at 20:20:57
In reply to Re: Depression or existential despair? So lost..., posted by sigismund on June 15, 2013, at 6:38:32
it was via a combination of a lot of things, and im not sure i've even really "done" it. maybe if anything, more accepting of reality?
this particular thread was during low point. but there may be future postings in the year after that when i discovered PEA and how it helped "resolve" my depression...except it really didnt, it made me crazy, i made terrible decisions, gained 50lbs in months, and got metabolic syndrome cuz i was also on zyprexa. and ended up in rehab. which was good experience, but when i got out, there was another 1.5 years of joblessness, anxieties, crazyness, and then near the end, insanely bad sleep quality that caused total daytime drowsiness and nonfunctionality. oh and more crazyness/hypomania. eventually though through that i managed to quit smoking and eventually got diagnosed with sleep apnea, which after a ton of fits and starts is being treated about 85% now.so i dont know. i would say combo of the right medications (im still on the same merry go round though), more activity, joining a church, getting sleep apnea fixed, putting to rest my obsession with the girl i was obsessing about when it sunk me into despair, and much greater physical activity, like, once i was able to sleep halfway decently, i started swimming, lifting weights, hiking, almost as if it was a full time job (cuz i dropped to part time consulting). so ive felt better cuz i look and physically feel nbetter
but im still on i think last count total of 10 medications for across th board medical issues? im 33 now. still minimally/marginally epmloyed, though at least now trying to work on a startup of my own when concentration affords. dating/having sex which is a definie change (oh, the transdermal testosterone def helps too). and if you'd met me in real life you probably wouldnt' think anything was the matter, if anything, you'd say wow what a attractive smart dude. if it was a good day/week/month...but like my friends at church for instance who see me almost weekly for the past two years, they have seen me regularly, during good and bad times, and have definitly seen me all over the map health and mood and sanity wise.
also since its satuday and im on my way out, im a bit casual in my writing delberately, but compare this post, with my original one in this thread. whihc one shows more insight, and even erudition and intelligence?
tells you something about the intensity of thought that exists sometimes in states of acute suffering...and the lack of it when things are ok enough that you are too busy "living life".
p.s. also im no big fan of SSRIs anymore...
currently on (may forget some:)
strattera 80
buspar 90 + melatonin 5mg time release (see other thread about this combo which i do like, though we are also using high dose buspar for mood and anxiety independently)
vyvanse 50mg -> 30mg (trying)
phentermine 37.5
victoza 1.8
namenda 10mg
gabapentin 1200-1800 (mostly for sleep)
metformin 2000mg
edarbi 40mg (hypertension)
axiron 2-3 transdermalmay have missed some. oh and plus a ton of supplemenrs/vitamins
i think though exercise, like intense exercise 5 days a week, ws really the secret. most of these are for the metabolic syndrome effects which hopefully i will eventually stop and for attention/focus
This is the end of the thread.
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