I was encouraged recently by my psychologist to make a list of early symptoms of the descent into depression so I can look out for them as we head into winter here in Australia. I have a very strong history of winter depressions so although I’m going in armed with different medications this year and a lot of therapy under my belt, I still have to be vigilant of these early signs so I can act quickly and hopefully prevent a full-blown episode.
My earliest symptoms of an oncoming depression are feeling tired and irritable. Sometimes there’s a change in my sleeping pattern that causes the tiredness – I might start being restless at night or dreaming vividly and disturbingly. Other times the lack of energy seems to come from nowhere.
Irritability is present for me in both depression and mania. I snap at people for the smallest things – sometimes I don’t even have a real reason but the very presence of other people is infuriating. They start tip-toeing around me.
Old obsessive-compulsive symptoms flare up – things I haven’t noticed or cared about for months suddenly are sources of uncleanliness. I can’t eat a lot of foods because I feel they’re contaminated. The amount of rinsing, wiping, scrubbing and stressing I do is exhausting and I quickly start getting overwhelmed by it all.
Next is the increased volume in my head. I become hyper-aware of my thoughts and getting caught up in them. With every passing day on the downward road they get louder and more vicious. It starts off with self-doubt or a few negative thoughts about myself. Next thing I know there’s two or three voices at once talking over one another while short movies play in circles in my head along the themes of humiliation, self-harm and suicide. Yes, for me suicidal thoughts arise fairly early on and are frequent and persistent. I can no longer concentrate on daily tasks because my mind is too busy fantasising about making myself suffer.
Social withdrawal begins. In a group setting there is too much stimulation for me to follow anymore. It’s difficult to keep up with the conversation when there’s three other louder voices talking at me in my head. As it gets worse even one on one conversations become difficult. I can do it, it’s just exhausting and it’s hard to keep up the facade of being ok because I really don’t have the energy to talk about it now.
I want to be alone – always. Sometimes it’s because people annoy me. Most of the time it’s because I feel so inferior near other people I can’t bear it. I can’t meet people’s eyes. Suddenly I feel disconnected from everything – people, hobbies, values… nothing holds meaning anymore and I can’t enjoy anything. Happiness becomes a distant memory and the only thing I feel around the clock is absolute crushing despair. My body becomes heavy and it’s difficult to move. I feel like I’m in a dream state and I can see life going on around me but I can’t participate in it. People talk to me and I can see their mouths moving but I can’t grasp any meaning. I have to ask them to repeat themselves sometimes two or three times. This is obviously annoying so people stop trying.
In my worst states I can’t eat. My self-disgust swells my tongue and I can’t swallow any food even when I try. I rapidly lose weight even though I’m already quite thin and I become skeletal. I sleep 12-14 hours a day but I still have no energy.
And at some point I might start making plans for suicide. It’s not unusual for me to take steps in the direction of carrying it out also.
That is a pretty typical sequence of accumulating symptoms for me. Now that I’m more aware of the pattern I can try to intervene when I start feeling tired a lot with no reasonable explanation or I snap at several people and it’s not because of hormones.
Are there any very early warning signs you show before a depressive episode? Something that might allow you to intervene before the episode is in full swing? Please comment!