Depressed Woman COPYRIGHT DEPOSIT PHOTOS Used With PermissionI don’t talk much about depression. Most of the time, my depression is one of the least important things in my life. I have it fairly well managed due to a combination of meds (thank you modern medicine). I rarely go to talk therapy any more, though it (literally) saved my life when I was in my twenties.

But every once in a while, depression comes back so strong and fresh it’s as if it somehow knew I’d stopped thinking about it. I have to stop, recoup, remember that the desire to cut my brain out of my head (and yes, that’s literal, not figurative) is not the first symptom. That I’ve been ignoring my own mental health. And that I’ve felt like this before, and managed to get through it. In fact, since the first time I locked myself into my own closet at age 13, I’ve gotten through it many many times. I will get through it again.

Depression is not monolithic. Mine, mixed with anxiety and OCD, will manifest differently—or at least partially differently—than other people’s. You may hear me on social media discussing depression and think “well, that doesn’t sound anything like this horrible shit show I am going through…so mine must not be depression.”

Let me tell you something right here and now: if you have a healthy mind, self-talk is great. If you are suffering from depression, or a host of other mental illnesses, self-talk can be the very worst thing. Check those impressions with an outside voice. Self-talk telling your you’re lazy? You’re useless? You’re bad at whatever it is you’ve been working really hard to be good at? Yeah…my guess is that the little voice in your head could use an argument.

I’m a little disgusted with myself, to be honest, for letting this go on as long as it has. Partially, I’ve been waiting for my new insurance to okay my meds. Why do I wait with my depression meds when I won’t wait with my epilepsy meds? It’s the same fight. The same insurance company merry-go-round. $300 a month for my epilepsy drug. $300 for my depression drug. I know how to handle the change of insurance companies. I know that I have to wait until my doctor can get the approvals through. I know that I can buy ten pills of each at the beginning of the year and I will get the money back once the insurance company approves me. But I got careless.

For me, here are some of the symptoms of depression I should have noticed before the “can I please stick a knife through my temple and be done now?”

  • Not meeting goals.
    If you know me at all, you know I am incredibly goal-oriented. I love to plan and to tick things off my To Do list. When I don’t even come close to meeting my goals for a day for no good reason, there’s a problem.
  • Negative muttering.
    I’m pretty straightforward. Piss me off, and you’re apt to hear about it. That means most of the time I don’t walk around muttering.
  • Chronic insomnia combined with not wanting to get out of bed.
    Now, even when I am in a good mood, I love sleep. Love it. And even when my meds are on track, I have stretches of insomnia. But when depression and OCD take over, the lack of sleep and the exhaustion have a very particular quality. Depression/OCD insomnia is an odd combination of a constant loop of things you’ve done wrong in your life (since you were a kid, if you’re like me) and things you need to do but cannot possibly do anything about at night. When I have regular insomnia, I can get up, go downstairs, write, clean the kitchen…do stuff. When I have depressed insomnia, I’m paralyzed. I can’t get up. Can’t do much of anything but lie there and worry and berate myself.
  • Noise in my head.
    Not voices. (I’m an author. I always have voices up there.) This is like static, white noise. The stuff that gets so dense sometimes I realize I have missed a good chunk of conversation around me, or what’s on TV, or the book I am reading because the noise won’t let me focus.
  • Random bouts of tears.
    I cry easily at the best of times, but not usually just driving down the street.
  • Strange physical sensations.
    For example yesterday half my face went numb. That’s really when it clicked in for me what had been going on.

If any of those things sound familiar to you, if you’re experiencing any of them now, do something for yourself: find someone to talk to, get on meds, get out of your rut. Don’t judge yourself, don’t judge others, don’t pass go. You won’t collect $200, but you’ll end up in a better location.