a chihuahua and a pack of Newports

If you've been keeping up with my blog, you'll know that I've been fighting melancholy and/or depression for a while. It's a fact of life, part of my family inheritance as much as musical talent, religious fervor, creativity, and good cooking skills have been passed on. It's the other side of the family coin, so to speak. Because of that history, though, I've been very reticent to try any sort of pharmaceutical solution to the problem. My main defense of that position is my late grandmother, whom we called Nanny.

I did not really know Nanny, even though I spent time with her when I was growing up, and even stayed at her strange house on the Eastern Shore on occasion. Nanny lived alone, and had a truly hideous, bad-tempered rat of a dog named Lisa for company. Lisa had the run of the house, could relieve herself wherever she liked, and noisily ate cooked chicken every day from a little bowl near the radio stand in the kitchen. Patsy Cline was always on the radio, some Country-Western station, and the breakfast nook had a lazy-Susan filled with odds and ends, including little triangular blue pills with a V on them. V is for Valium, kids.

The local doctor was apparently not concerned that my grandmother had been steadily taking these little pills for about 3 decades. Indeed, Nanny wasn't concerned either. She really could not be concerned about much of anything save the dog, the TV, and cigarettes. She'd sit, staring at the TV, cigarette in her trembling hand, and come out of her reverie to make tuna casserole or run the bath for me, or walk the brick path to the mailbox for her Avon catalogs.

I could say that in those benighted times, women's health was so mysterious, and blanketed over with male-dominated medicine's assumptions about weakness, "hysteria," irrationality and over-emotionalism. In fact, many of these women probably had malfunctioning thyroids, forced hysterectomies without hormone replacement after childbirth, and just the plain gamut of unseemly emotions that women have always had, but men feel are out of place in our modern times. Honestly though, with all the developments we have made in medicine and psychology, it really seems to me that women's medicine remains largely mysterious. New disorders are discovered, but they really aren't new at all--they are just things for which women had been dismissed as crazy and now have a legitimate medical name.

One of those new disorders is what I think might be causing many of my issues: PMDD, pre-menstrual dysphoric disorder. It's like PMS but more extreme. It feels kindof shameful to talk about PMS, since it's pretty much a joke byword for being a bitch. So PMDD is like, ooh, she's an uber bitch then, watch out! The symptoms line up pretty well with me, with an added dose of family melancholy, so I went to my doctor and told him about it. The response was not surprising.

In the past few years, when I have gone for checkups or for completely unrelated causes, I have mentioned feeling low occasionally, and almost before the words are out of my mouth, the doctors have recommended an anti-depressant. "There are some really effective ones now," they say. "You should really consider it." It's as easy to get these pills as it is to receive God's grace, it seems. There was never a suggestion that perhaps counseling could address these feelings, or the fact that therapy is recommended along with anti-depressants so that one is not merely putting a pill-shaped bandaid on emotional traumas that require selective surgery. Studies have proven that the meds and cognitive behavioral therapy really do a great deal to alleviate depression together. I know this, but I don't think a lot of people who go in to their own doctors know this as well. It costs more to go to therapy, even though in the long run the improvement is much more significant.

Up until two weeks ago, I have said no thanks to these easy offers of anti-depressants. I used them once before, when panic attacks kept me from going about my daily life, and these pills were a pair of crutches for a broken leg; they were obviously necessary to treat the malady, or I would just not go to work at all. In this new situation, though, I have vacillated for it seems like years on whether or not to try them again, what it means personally to cave in to the considerable pressure to mess around with my brain chemistry.

I will spare you the lists of pros and cons, the hemming and hawing I've gone through over what to do, to just sum it up with this: I wonder what does it mean for my identity--does it change who I am essentially, to take medication that changes my moods, my chemical makeup? Is it worth suffering a bit more than the average person, when suffering has done so much to shape my spiritual life, my understanding of the world, my creativity? That suffering has also probably cost me days and weeks of potential productivity, though, sluggishly going through life at half-speed and wasting precious time. The pros and cons feel equal to me at this point, and I have decided that no, medication is not forever--it does not need to become a life sentence, nor would it be impossible to stop taking it if I feel like the new self is completely foreign to who I really am. What, really, do I have do lose here?

So about a week ago, I started taking a very popular anti-depressant along with medication that regulates those pesky PMDD hormone levels. So far I am not sure how I feel, literally. My brain feels a little scattered, squirrely, and last week I had a day or two that scared the hell out of me--I was so apathetic. All I needed were Nanny's trusty props and a dim room to complete the generational picture, something that filled me with dread. The saving grace was that I had an awareness of the apathy, and not just a catatonic stuopor; as long as I am concerned about doing the right thing, the meds have not completely taken over. If I ever get to the point where I could give a crap one way or another, that is the time to back off and live with the melancholy me instead of the automaton space cadet. But those feelings have not resurfaced and I'm giving it a month to get balanced in my body. After that, I think I can make a more rational assessment and go on from there.

I honestly don't know what to expect. People who have taken anti-depressants don't describe the exact feelings so much, just that they feel better, they can cope, they have more energy perhaps. Some don't, some are tired, some become it seems, shadow-versions of themselves. It feels like I need as much faith in this solution as I do to pray, maybe more.