I hate it that I need to post about Prozac and depression, but here we are again. My doctor suggested last year that I experiment with lowering my dosage by skipping a pill one day a week, and then increasing it to two, etc. Of course, with my habits, all I heard was "It's okay to skip," which is what started happening anyway as I began to get used to being healthy, and then, in one seamless step, to take that good health for granted and turn my attention back to creating new work.

Consequently, I began skipping not just the Prozac but the thyroid as well, relaxed my vigilance about sugar, and oh yeah, exercise--although I still made and make valient attempts--is hard to schedule when you're working, writing, and dating.

Which leads me to to today; PMS, a semi-sleepless night after a lovely evening with C at the hot tubs--and I awoke with a headache to the familiar awful old feeling of depression--a tight gray plastic rain-bonnet tugged down over my skull. Deep bone-crushing fatigue.

At least now I can recognize the symptoms clearly, and I've had enough experience not being depressed to know that it is an illness and not part of me. It does not mean I suck; it doesn't mean that there is anything wrong with my life. I managed to make it to Carla's and help her unpack and hang curtains and then the car drove itself across town and home where I collapsed into bed for a bottom-of-the-ocean nap.

I feel better now, but will see my doc in a few weeks. Meanwhile, I know what I have to do: more serious animal protein (potatoes not Prozac diet.) More serious exercise. Supplements. Back on meds.

My career is going great, my relationship more intimate than any I've had before. Friends and family are wonderful. Depression is not about any of those things. Depression is a collection of physical sensations and mental aches and pains that add up to a state of being unable to cope with daily life. I'm not all the way there yet--thank God, I still have plenty of cope left. But I can feel the ropes of my nerve endings fraying.

I have been noticing irritability--driving, parking, responses to the stress of city living--as a symptom, creeping up. It's not like me to be irritable--irritability is a warning sign, a marker. Next step down the ladder is this fatigue and the feelings of lightness and heaviness in the head, as if there were an energetic elevator randomly stopping off at different floors. It gets harder for me to stay present.

My doctor, whom I love, has talked to me a lot about learning to recognize and log these markers, so that I can catch myself before the elevator plunges into the sub-basement. That's why I'm outing myself here on this blog, My aim is to stay out of the sub-basement--it's an arduous road back up.

As luck would have it, my copy of Elle Magazine arrived today, with an interesting article by Lauren Slater, a memoirist (Lying,) and recovering mental patient as well as a mental health professional (and damn good writer) about when anti-depressants poop out and the differences and similarities between prescribed pharmaceuticals and narcotics. Opiates, in tiny doses, worked well for her in interrupting the cycle. Fascinating. I've never used narcotics, for anything, knock wood--never had surgery or needed major pain killers. But all substances have their uses and their limitations. I'm just grateful I live in a time when this stuff is talked about openly and without the kind of prejudice that characterized the debate even a few years ago.

If there is one thing I that makes me really mad, (oops, irritability, warning sign!) it's people who haven't experienced serious depression themselves inveighing against the widespread use of anti-depressants. Sure, SSRIs are prescribed a lot these days, and maybe too much, but as someone who had years of ineffective talk therapy while I felt like my head was going to detach from my body and my body was going to fall off the chair, after years of being too tired to live, drugs have been a miracle to me.

I know they are no panacea, and self-care is a long and winding road. My body's changing now, in my late forties; menopause is right around the corner and I'll probably have to be more vigilant and continually adjust my self-care in the years to come. If there's one thing I've learned in the past twenty or thirty years of dealing with all this stuff, it's how physical my emotional and spiritual life is. It's humbling; I am not in total control--I cannot rigidly will myself to be healthy with the proper attitude, sad to say. There is a component--a large component--that is affected by hormones, bio-chemistry, and physiology. The best I can do is respect that and ride it.

When my mother died, Ruth stayed by my side for the next thirty-six hours as I felt as if I were riding an energetic roller coaster. I mean that literally--I had sensations of rising and falling waves of energy going up and down my body. I kept saying to her, "Grief is so physical!"

At moments I needed to work and so I crawled outside into the sunshine and cleared weeds and moss from her steps. I just needed to get my hands in the dirt. At other times I sacked out and napped. At night I only slept in little bursts. I was on a train, strapped to a locomotive called grief and trauma release. I couldn't get off it--my body just had to do what it needed to do.

She hung with me as long as she could, about a day and a half, and then a couple of other friends baby-sat me for the rest of the week, and then the obvious symptoms subsided. It's possible that the six years since then have been characterized by deeper and deeper releases from trauma, mostly informal, without any practitioner to monitor them, since I had quit talk-therapy the month before, convinced that it was a waste of time.

C and I have been talking about seeing a couples counselor to see us through the delicate process of joining two highly individuated lives, lives full of creative projects, musical equipment, unfinished dreams, and important outside relationships. We want to see how we can fit it all under one roof--thankfully, one big roof--without damage. That's good, and/but I know I should do some individual work now too, preferably with a therapist trained in somatics and depression.

One of my oldest dearest friends who has a healthy thirty-year marriage, attributes the happiness of her union to the fact that she and her husband both have done their own work all the way through--that is, each of them went into individual therapy as needed, instead of blaming their problems on each other. Frankly, I have found most of the individual talk therapy I've done prior to going on meds to be pretty useless--I believe I have all the communication skills and sorting out skills--or have access to friends who have them--that I need, but I'm willing to try again with someone who has a deep understanding of the way the brain and the body work together.

My checklist for a therapist these days includes: someone who understands and speaks the language of neuro-transmitters and physiology, the yoga of trauma recovery, muscle memory and all the rest of it--a tall order, and one that can't be satisfied by just a nice person who's available for supportive conversations, which is what I had with my last therapist.

Date with G now, to either walk around the lake or play some hoops or some tennis. And later--meat! Viva recovery!