Mood: Low

Intrusive thoughts: High

Suicidal thinking: Almost daily

Concentration: Very poor

This has been my state of mind more often than not in recent weeks (months, years). I had a few better days in November and December, but I keep sliding back into the pit. It’s wearing me down. I’m discouraged and have trouble believing that it won’t always be this way. And the idea that it will always be this way is unbearable.

E asked me a few days ago to think about a medication change. “I see you trying really hard. You’ve built your skills, and you do a little better, and yet you keep sliding back. It’s hard to see you suffering like this. I’m concerned. I can’t help thinking there is a chemical component to this.”

This reminded me that the last time I saw Sharon, the psychiatric nurse, back in October, we’d had a similar conversation. I was about to leave for China, and we knew that travel often acted as a mood lifter for me.

“Go on your trip, have a good time,” Sharon told me. “And then see how you are doing a couple of weeks after you come back. If you are still feeling low a lot of the time, fill this prescription for lithium, and let’s see if this helps.”

Lithium is well known as one treatment for bipolar depression, but it can also be used to augment depression medication. I’d forgotten I had the prescription until E mentioned changing medications.

I’ve become very skeptical about psychiatric meds, since I’ve taken so many of them and never had more than partial relief. But if I’m not going to end my life, then I need to try to improve it. That’s why I started taking lithium four days ago. It supposedly takes two to three weeks to work (assuming it works at all), so I wait.

I text E this morning about how miserable I feel. “I know you can’t do anything about it,” I tell her. “I suppose I’m just telling you so I will feel less alone with it all.”

She calls me (guilt, it’s Sunday, I’m disrupting her time off). She is warm. She has a nice voice anyway, but her voice on the phone is especially warm. She’s concerned, she’s sorry to see me struggling. These words feel good to me. I thank her. She encourages me to talk more to my husband. Ah, but I can’t. I’ve told him before, but if I just do it over and over, what a drag that is for him! And he can’t do anything anyway.

“You can tell him what you need, what might distract you,” she suggests. “You could tell him to sit by you or hold your hand…”

“I don’t know what I want,” I tell her. I honestly don’t. It’s 11:30 in the morning, and I’m still in bed.”

She tries to give me words I could use with my husband, but it’s too much work. Finally, I say, “Could you just tell him for me?”

“You want me to talk to him?” she sounds happy about it. “Sure, I’ll talk to him.”

I take him the phone and crawl back in bed, curled up tight. After a few minutes he brings the phone back to me so E can say goodbye. Then he crawls back into bed with me. He holds me and strokes my hair. He says he did not realize how bad it was. Why don’t I tell him? He says he loves me and just wants me to feel better. It’s comforting to have him next to me. After a while, I fall back to sleep.