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Woman Standing on Dock
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Six Months

Six months ago on February 18th, I started taking Ritalin (in addition to the rest of the cocktail that manages my condition).

It has changed my life.

I want to go into some detail, but as it always is, my mental energy level is unpredictable and it’s just not up to it at the moment.

But just briefly, I recently posted about my Mental Health Scaleand I will use that to illustrate how things have changed.

I didn’t really see this clearly at the time, but prior to starting Ritalin, my score on the MHS ranged pretty consistently from -7 to -9.  I would say at the time that it got up to 0 but never got into the positive range.  It’s true that it never got into the positive range, but in retrospect, I can see that it never really got to 0 either.  The best I did was maybe -5 and that took immense and unsustainable effort.

I had resigned myself to this.  I didn’t expect it to improve much and I believed it was unsustainable.  I was committed to holding out as long as I could and doing everything I could to stick around but I did not expect to last forever.  I believed that suicide was inevitable unless things changed.

Now things are different.

I think there’s a good chance that I can avoid suicide.

I think there’s even a chance for stability and semi-normal mental health.

I would say that my MHS ranges typically now between -8 and +3.

NOT ideal, but that’s a huge improvement.

I still have spikes to -9 and occasionally -10.  But I also have occasional periods where I’m at maybe +5 or +6.

At first this happened only in the first couple of hours after taking the Ritalin.  It would kick in after 20 to 30 minutes and then a couple of hours later, I’d suddenly start to plunge back deep into the negative.  A second dose would not seem to do anything.

But, I’ve experimented with dosage and timing and stuck it out.

Often it has been VERY difficult.  It’s often seemed more painful to experience what it’s like to be almost normal and then return to the depressed state than to just stay depressed.  The contrast just makes it more clear how horrible the depressed state is.

It’s like I had a certain equilibrium in the state I was in.  It was horrible and unsustainable and I almost certainly wouldn’t have survived it long-term, but it was familiar and I had ways to deal with it.

Ritalin disrupted that equilibrium.  For months, I wasn’t sure if I could find a new equilibrium.  EVERY morning is still a monumental challenge.  It doesn’t matter how good I felt the day before, I always wake up in a -8 or even -9 state.  Anyone who has experience Depression with the big D probably understands it when I say that it is almost impossible to get yourself to do even the things that you know will make you feel better.  So, every morning, I have to absolutely force myself to take this medication that I know will pull me out of this horrible state.

But, it’s gradually getting easier because several things are happening.

It used to be that the effect of the medication came on suddenly and then stopped suddenly after a couple of hours and then it was back to blackness.  Having the lights go out was worse than not having them going on in the first place.  Now, the effect comes on more or less as fast, but it lasts longer and tapers off gradually over a period of hours.

It used to be that a second dose had no effect.  Now, sometimes, a second dose does help, but not as much as the first dose.  So, through further experimenting, it may be possible to further optimize it.

Over this period, despite the ups and downs, there has been long-term improvement in both emotional and mental function.  I thrive on improvement.  As long as I see improvement, however small, I can keep going.  That’s why the resignation to my state prior to Ritalin was so dangerous.  But, I’m learning to recognize and deal with a pattern of punctuated improvement, plateauing and then punctuated improvement again.

My confidence that this is for real and that I will continue to improve is increasing.

So, I can feel good and optimistic, at least part of the time now.  For at least short periods of time, I can see how to solve the huge backlog of problems I have to deal with after many years of illness.  For short periods of time, I can actually enjoy things.

And, at least for short periods of time, for the first time in my life, I feel happiness.

I guess that’s worth something.

 
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