How to save a life

You’re on a boat in the middle of the ocean and you’re taking on water. You suddenly find yourself with your head barely above the water in the middle of nowhere. The depths of the ocean here are unfathomable, you’re tired, you hurt, the ocean keeps fighting your every move. You’re one wave away from death. No salvation is coming because this is depression and to everyone around you, you look perfectly normal.

Mental health is taboo. You’re more likely to find people comfortable sharing intimate details of their sex lives than you are to find people who are willing to share intimate details of their mental health. It’s a societal issue that everyone deals with regardless of gender. For me, as a man, we’re told not to show emotion because emotion makes us weak. Personally I couldn’t give a shit less, but I wasn’t always that way and I know what it’s like to be the rock of support for those around you until you’re crushed to dust by the weight of the emotions you have to hold back.

Which is why talking about mental health is so important. The fact of the matter is people are drowning all around us. There’s no respite for them and because as a society we are taught that talking about mental health is a sign of weakness, or that it makes us less than, we bottle it within ourselves. It just sits there, rotting away at your core while you smile and laugh and pretend everything is okay. Then one day the timing is just wrong and you catch a giant wave when you really just need a breath and suddenly there’s no hope that you’ll be able to come up for air.

Since we’re being overly honest, let’s imagine you were actually stuck in the middle of the ocean. In the literal sense. No amount of exercise, mindfulness, or changes to your diet could solve the situation. The thing about depression is that while you’re not stuck in the middle of the ocean literally, the same thing applies. You are drowning and the “just think yourself happy” attitude is about as useful as telling someone to fuck off. In fact, telling someone to fuck off would be more helpful because at least you’re making your position clear.

That’s what makes me angry. People have found a new and exciting market to tap into to make money. Selling books, workout routines, diets, etc. that promise to help you beat your depression. When in reality they don’t lighten your load, just your wallet. But where you find desperate people, you find bottom feeders who are willing to take advantage of people to make a profit. It makes me angry because people are literally killing themselves over it and this crap keeps on going. I mean, could we agree as a species to stop being assholes for five minutes? Imagine all the positive changes in the world we could make.

Unfortunately, like any disease, mental illness is complex. There’s no cure, no one size fits all, no magic pill, magic diet, or simply magic that can fix it. You are stuck in the middle of the ocean and the only way out is to swim. If you’re lucky land isn’t too far away, or you have a support system to help you along. If you’re not, well if we look at the statistics for suicide, you can see that no matter your income, no matter how far the odds are stacked in your favor, you may not find relief. Sometimes luck is really the only thing you can hope for.

There are treatments, therapy, medications, and even things like TMS (transcranial magnetic stimulation) which all offer promising improvements over doing nothing. Even then there’s a far amount of luck. Here in the US not everyone has access to any of those treatments. Most of us don’t fall into the “poor” category, which is defined so far below the minimum you need to live that not many people who have a roof over their head probably fall into this group. Most of us are stuck in the middle, not wealthy, not even really comfortable, but in a place where we don’t get help. We don’t get healthcare provided to us. Because here in the US healthcare is not a right and even teeth are a luxury item.

So it’s a struggle and one I know all too well. I’ve fought with the government for care as a veteran. I’ve fought to have my problems acknowledged, I fought for the benefits I was supposed to have. And it damned near killed me. But that’s the problem, you’re already drowning so doing extra work feels like an insurmountable challenge. That’s probably the point, again since we’re being overly honest.

I wish I had the answers. I wish that, if you desperately stumbled upon this post searching for a cure, I could offer you one. The best advice I can give you is to just keep swimming. Whatever is wrong with me, depression, PTSD, anxiety, tons of sleep issues, etc. if it’s all related or not, has been painfully treatment resistant. I’ve been on medications that have had all sorts of side effects, none that have improved my symptoms to the point that I could function like an adult.

That is until I managed to stumble upon, through sheer dumb luck, something that actually worked. A while ago I wrote about my struggles getting that medication (here). Modafinil isn’t normally prescribed for depression, it’s prescribed for “excessive sleepiness” and even then it’s not great. It’s not actually a stimulant and its mechanism of action isn’t known. But for whatever reason it fixes (at least partly) whatever the hell is going on with my brain. It’s the closest thing I could find to magic.

Well long story short, it was taken away very suddenly and for about ten years (not quite I guess, it’s hard to keep track especially with the pandemic where time no longer exists) I was fighting to find someone to prescribe it to me. I had a breakthrough, and now after a week of being back on my favorite antidepressant that isn’t actually an antidepressant, I’m happy to say it’s still just as magical.

Mostly, I’m still at the lowest dose so I frustratingly get a few good hours and that’s about it, but even a few hours of semi-solid ground under my feet after being stuck in the water for so long feels amazing. Now this isn’t a post extolling the magic of modafinil. It’s a post reminding people that medication does work… eventually. Everyone is different and playing medication roulette is never a fun way to spend the bulk of your adulthood, but my case is (I hope) on the extreme side.

The point of the post is to remind you that if you’re like me, stuck out in the middle of the water trying to catch your next breath, just keep swimming. Easier said than done, I know. I like to think that we can all find some relief eventually and I will be perfectly honest, while those few hours are the most normal I’ve felt in my adult life, it still isn’t perfect. I still have my issues and I don’t know that those will ever go away. So really, I’m just hoping that you make it one more day, because tomorrow may be the day you find the medication that makes you feel more normal than you ever have before. And somehow just aiming to make it to tomorrow is a little easier than holding out for a lifetime.

For those of you who are lucky enough to not be in the water, don’t be afraid to check on your friends. I’m lucky to be alive today because I had people check in on me. If no one else will come to rescue us, we need to help each other. It’s the least we can do for each other in this painful, but too short existence.

And maybe, just maybe, that’s how you save a life.