My doctors and counselor have emphasized that there are four necessary components to my success in coping with depression and anxiety:
- Consistent medication
- Proper nutrition
- Regular exercise
- Adequate sleep
I suppose I could add that a positive attitude helps, but that’s just not always possible, and I don’t want to sabotage myself by requiring a positive attitude when depressed because that will just set me up for failure.
I’m consistent with the medication. I’m still taking generic Prozac, still at 50mg/day. I know that my ability to cope with each day is due in part to my staying on the medication; forgetting or missing a dose for whatever reason will impair my near future, and I’m the one who has to live with me.
I’m doing better with proper nutrition, in part because my husband is taking better care of himself and is therefore better able to help me with grocery shopping, meal planning, fixing healthy meals and so forth. If it were not for his contribution, there are many times I’m not sure I’d eat at all, much less eating healthy. Keeping kosher usually makes it easier to eat healthy. Sometimes it makes it harder, or at least demands more creativity. It is possible to make a fleishig (non-dairy) chicken pot pie from a treif (non-kosher) recipe, and have it taste good.
I noticed today, in fact, that I have lost some weight and the only major change I’ve made is eating better. Plus, I like how it feels and that buoys my mood too.
I am not a couch potato but I could do better about getting aerobic exercise. Cleaning house and chasing after children helps but is not quite the same as a workout. If only I had the room and the money to blog on a treadmill. Our health insurance now offers us a reduced membership at the local Jewish Community Center if I exercise some number of days each month. Time will tell if it is incentive enough for me.
And then there is sleep. Or no sleep. Like last night when I finally fell asleep at 5am and woke at 7am.
The Prozac, even when taken in the morning, will disrupt my sleep. It makes my already light sleep practically non-existent. My doctor tried me out with Lunesta, Ambien CR, and Rozerem, and only the Lunesta had positive results. Over the past few months, I’ve very gradually needed to increase my dose of Lunesta from 1mg/night to 4mg/night. Until recently, it has helped me get to sleep within less than an hour and sleep through the night, waking if I need to without feeling drugged or drowsy. It has brought dreams back into my nighttime, something that has been missing for over a year.
But within the past few weeks it has not been working as well. It’s taken me longer to get to sleep and then I wake at 3am or some other middle of the night time and cannot get back to sleep. So I thought last night I would try going without it. Unfortunately, that meant going without sleep, too.
I know that Lunesta, like many sleep aids, does have a risk of dependency so that going without it may cause a few nights of interrupted sleep before the body’s own sleep cycle takes over again. That appears to be the case with me. I don’t see my doctor for another week, so I’m not quite sure what to do. What I know for certain is that I need my sleep. I need that REM sleep. I need more than 2 hours a night.
I’m doing pretty well on the 50mg/day of Prozac and there’s no indication at this time that last year will repeat itself, despite my worries to the contrary. But staying out of the depression by using medication is resulting in less sleep, which increases my risk of depression, which might cause another meds increase, which will result in less sleep, which increases the risk….
It is enough of a challenge to live with the depression and anxiety/OCD, knowing there is no cure, only management. Why does treatment have to be so challenging too?
It maks me really wonder what G-d wants me to learn from this.