I feel very depressed today. Drained and despairing. I was supposed to go with my parents to see my sister’s new house (I’m ridiculously easy to manipulate into doing things I don’t want to do – just guilt-trip me), but I feel too ill, partly my cold, partly depression. To be honest, it’s probably largely depression, despite the fact that I felt like I was burning up before. I can barely move, I feel so depressed.
The best book I’ve read on depression is Depressive Illness: The Curse of the Strong by Dr Tim Cantopher. He argues that people with depression are almost always highly reliable, conscientious, diligent, responsible and morally strong. They become depressed because in a difficult situation, where most people would back away from the difficulty, they carry on trying to work through it until, in his words, they try to put 100 amps through a 13 amp fuse and it ‘blows’ causing depression. The cure is medication, to stabilise the situation, but also counselling or psychotherapy to resolve the problematic situation or find a new way to cope with it, as well as learning not to overdo things. Otherwise the result is recurrent bouts of depression.
Unfortunately, although I’ve had his book for years, and in many ways it has been helpful, he explicitly states that it won’t help with “depression complicating other illnesses… [or] depression as part of long-term personality problems”. I’m not sure exactly how autism would fit there (it’s not technically an illness or a personality problem per se), but his general point, that depression that is caused by another medical issue is not easily treatable in the way he describes, seems to be true. I’ve tried so many of the ‘normal’ depression treatments (many different antidepressants, psychotherapy, CBT, exercise, occupational therapy/work) without much success. This can happen with ‘just’ depression, but it does make me think that there is something else to my state than ‘just’ depression.
I don’t know how to cope, though, what I should be doing when my life just seems so unbearable and so out of control. I guess “out of control” is an odd thing to say, as it summons up images of mania or drug abuse, not the motionlessness of depression, curling up in bed for hours unable to face the day, but that is how I feel. I don’t know how to live my life with depression and autism and the things I read seem to only deal with one of those issues, not both, even though autism has a lot of comorbidity with depression and anxiety.
I’m not sure that I’m explaining myself very well. I’m sorry.
I just found this comment online:
Depression and autism is such a challenging dual diagnosis because traditionally the autism diagnosis coincides with rigidity, perseverating, and rule governed behavior. However when you spend all of your time perseverating on what makes you feel depression, create rules that you will never feel happy, and are rigid enough to be stuck in those ways – you are digging yourself deeper and deeper into a huge hole of despair.
This seems a lot like me. According to this site, depression in autistic adults correlates with higher IQs, perhaps because they are more aware of their social difficulties, triggering depression.
I wish I was in therapy of some kind at the moment. I know my psychodynamic psychotherapist has at times said my problems are too all-pervasive for her to help with, but I would just like to talk to her. Or to try CBT, as I was hoping to do, to see if it can help practically with my low self-esteem, which I think is a key factor in my depression and social anxiety. But I’m stuck on the NHS waiting list.
My rabbi mentor hasn’t responded to my emails lately, which is unlike him. I’m worried about him, but I’m also worried about getting answers to some questions. It also adds to my feeling of being lost and abandoned.
I’m a bit nervous about the depression/resilience class I start tomorrow and very nervous about the new job that starts on Tuesday. I haven’t been told about where to go or anything yet (I assume to where I went for the interview, but I’m not sure). I’m also nervous about speaking to my GP tomorrow about being referred for another autism assessment, as I’m worried he will say I can’t have another assessment on the NHS.
We’ve also got decorators coming in from tomorrow, which always makes things difficult for me both from an autistic point of view and a religious OCD one, as I worry they will bring in non-kosher food. Hopefully once this room is finished, that will be the end of the intermittent redecorating we’ve had for over three years, since we moved in to this house.
I feel lonely, despairing and lost. I also feel run down from my cold and my lips are painfully chapped, which seems trivial, but is somehow harder to cope with when I feel so bad in other ways. I want to be happy, loved and comfortable in my life (and in my own head), but it doesn’t seem possible. Failing that, I’d prefer to be dead, but I’m not suicidal, so no one really takes that seriously. Plus, I’m scared to mention it to most people.