Explanation#
What to Record#
Sleep, interests, physical reactions, psychological feelings, medication situation.
This article will be updated frequently.
After reading Zhang Jin's “Crossing Over: Notes on Curing Depression”, I decided to follow his example and start keeping a depression diary from November 13, 2024. Entries before November 10, 2024, are recorded here, arranged in chronological order for readers to get a general understanding; subsequent entries will be recorded under the headings below, in reverse chronological order, to make it easier for you to see the latest updates. The directory on the right can provide reference.
My Feelings About Depression#
Feeling in the brain: heavy, tight, painful, chaotic
- It’s the brain, not the whole head. I can feel it inside, not outside.
- Heavy, equivalent to weight.
- Tight, feeling like the brain is a sphere, continuously compressed, as if an invisible force is squeezing it inward from all directions, becoming tighter and tighter, as if the internal space is being compressed smaller and smaller.
- Pain, not sharp pain. Sharp pain is like a needle prick, while this pain feels like someone is squeezing your head with both hands. It’s a continuous and mild pain, sometimes lasting three to four hours, at most a whole day.
My Previous Experiences with Depression#
2014#
My condition was most severe when I was in high school (around 2014), suffering from insomnia all night, wanting to sleep but unable to, it was pure torment. Over time, I became afraid of sleeping; hearing “good night” or “go to bed early” would terrify me, and my body would even tremble. Every night I would exhaust myself, not knowing when I fell asleep, waking up with deep guilt and self-blame. During the day, I often dozed off, but it was a half-dreaming state, very sensitive to sounds, accurately judging what was happening around me, even the slightest noise could be captured; this could hardly be considered rest. In the evenings, I often felt utterly exhausted, and at its worst, I could hardly lift my limbs, only able to lie in bed. There was a strong sense of frustration; at that time, I was still insisting on exercising every day, but the strong and healthy me from not long ago could now barely lift my limbs—surely even an elderly person who has been bedridden for years could manage that! If I fell out of bed, could I get back up?
I spent day after day in a daze, often arriving at a place without remembering how I got there, having no impression of everything along the way, whether the traffic light was red or green, whether there were pedestrians coming out of the alley on the right, what the street vendors were selling—couldn’t say a single thing, even though these were matters from just four or five minutes ago. During this time, I was truly a walking corpse, just a shell, without a soul.
I once engaged in self-harm, punching the wall; my brain felt awful, filled with chaos, but the pain in my hand was incredibly real, only the pain and blood reminded me that I truly existed. I was diagnosed with neurasthenia at a mental illness hospital in the county, and the medication prescribed had side effects affecting fertility, which I stopped taking after just a few doses. This mental illness hospital couldn’t even be called a hospital; although it was the only mental illness hospital in the county, it was located far from the county seat, and if it weren’t for the sign at the entrance, one would think it was a rural yard.
I then took a break from school for over half a year, staying at home, sensing my family’s pity and sympathy, but they were truly of no help; they didn’t understand how to help, and they didn’t even take me to a big hospital for a check-up. But what is a big hospital? The county doctors’ understanding of depression is about the same as that of an ordinary person. The city doctors have some understanding but not much; many just use the medications prescribed by big hospital doctors, having never heard their opinions or treatment plans. Some provincial hospitals have some effect, but mostly just prescribe medication, proposing treatment plans; even if the medication cures it, depression can still recur, treating only the symptoms but not the root cause. At least it started to have a positive effect on the condition from the provincial level, right? Most families of depression patients only take them to the county for a check-up, likely misdiagnosing them; if the effect is poor, they give up treatment. They may not even consider it a disease; it’s just self-abandonment, laziness, unwillingness to strive, being a prodigal son, and then they announce a death sentence. Over time, my family was filled with accusations, believing that a young man not only didn’t study but also did nothing. The worst was when my father began to resort to violence, frustrated that I wouldn’t wake up, pulling me out of bed, saying I couldn’t do anything, and insisting I had to do something. Others were relatively milder, often implying sarcasm in their attitudes and words. During this time, my father wanted me to work at a supermarket, but I refused. I always thought about renting a room in a secluded countryside where no one knew me, eating at a villager’s house every day; this would relieve a lot of pressure, not having to care about my family’s gaze, and I would gradually get better, but I never mentioned it to my family because I knew they would definitely not agree.
Later, my condition improved slightly, but symptoms still persisted, occurring infrequently.
September 2021#
The condition worsened again; every evening I felt exhausted, my limbs weak, sometimes even unable to lift them. If I fell asleep at this time, I usually could only sleep for about 40 minutes, waking up to find it was already dark outside, feeling a strong sense of loss, and once again struggling to fall asleep at night, trapped in a vicious cycle. At the First Affiliated Hospital of Anhui Medical University, I was diagnosed with depression through conversation and psychological questionnaires, and a prescription was given.
- Escitalopram oxalate, 1 tablet in the morning, 1 additional tablet at noon if severe.
- Mirtazapine, 1 tablet of 30mg before bed at night.
At that time, due to work, I needed to regularly switch to night shifts. During this time, I forgot which of these two medications to take in the morning and which to take at night, so I took them in reverse. Later, during a follow-up visit, the doctor asked if I felt drowsy after taking mirtazapine in the morning, and that’s when I remembered why I had been so sleepy at nine or ten o'clock these past few days; I had to sneak in an extra 20 minutes of sleep elsewhere.
Sometimes, even when I wasn’t injured, just moving my hair would cause pain in that area of my head; sometimes it would be in my forearm, and it would hurt just from a touch. Later, the doctor prescribed pregabalin, which worked very well when taken during pain. I had a head MRI done, and two neurologists said everything was normal.
Later, the condition worsened, and the doctor prescribed flupentixol and melitracen tablets, 1 tablet every morning, 2 tablets if severe. I resigned from my job in May 2023, wanting to prepare for the civil service exam at home. During this time, I traveled to Tibet for over half a month, which gave me some insights. The scenery was indeed beautiful, but the scenery is not as impactful as people; the difference in scenery is far less significant than the differences between people; people can touch me more deeply, and I need to focus more on humanities and less on scenery.
I continued taking medication until August 2023, with follow-up visits every two to three months. I felt the doctor’s role was minimal; during follow-ups, they would just ask about my condition, and it was still the same few medications, just with dosage changes that I could manage myself.
At first, I was conflicted about whether to tell my family, but I thought that telling them would only increase their worry; could they provide help? Clearly, it would be just like before, not at all, and it might even bring discrimination and blame.
August 2023#
Thinking that continuously taking medication wasn’t a solution, I heard that seeing a psychiatrist for depression is better, so I specifically went to Nanjing Brain Hospital, which is said to be among the top hospitals for depression in the country. I registered with a chief physician, whose appointment was hard to get; I tried several times before finally securing one. But coincidentally, that day he tested positive for COVID-19 again, and a student of his, an associate chief physician, came in his place. Although the department said I could switch to the next week for free, ensuring I would have an appointment, how could I go back and come again? The cost was too high, so I just went to see him, and besides, my depression wasn’t too severe. The doctor only talked with me and didn’t do a psychological questionnaire. I voluntarily shared my medical history, and in the middle, the doctor suddenly asked, “Sometimes do you have impulsive thoughts to do something big?” In fact, sometimes I get inspired on certain topics and talk to myself, like debating, but I don’t have the idea of doing something big. At that moment, I don’t know why I said “yes,” and the doctor suspected I had bipolar disorder, writing it in my medical record. I asked the doctor for a prescription. I had also been to the First People’s Hospital in the county’s neurology department, but the doctor’s understanding of depression was about the same as that of an ordinary person, not knowing much, just using the previous doctor’s prescription. The cost of going to a big city for follow-ups was too high, so I privately bought medication online, and the medications I continued to take were as follows:
- Escitalopram oxalate, 1 tablet in the morning, 1 additional tablet at noon if severe.
- Mirtazapine, 1 tablet of 30mg before bed at night.
- Flupentixol and melitracen tablets, 1 tablet every morning, 2 tablets if severe.
September 2024#
After the New Year of 2024, I decided to stop preparing for the civil service exam and went with my father to Cangzhou, Hebei, to do e-commerce.
Starting around July, I began to experience severe hypersomnia, sleeping up to 10 hours a day. Even when the alarm clock and family woke me up, I couldn’t open my eyes and continued to sleep.
In September, I decided to visit a friend in Hefei and also go for a follow-up at the First Affiliated Hospital of Anhui Medical University. After describing my condition (I forgot to mention the hypersomnia), the doctor severely criticized me, saying that flupentixol and melitracen tablets should only be taken temporarily; it was already outrageous to take them for three to four months, and I had taken them for a year—wasn’t that reckless? He told me to stop taking flupentixol and melitracen tablets immediately, while continuing with escitalopram oxalate and mirtazapine as usual. He refused my request for a prescription, giving me two months’ worth of medication and asking me to return for regular follow-ups.
November 2024#
Still experiencing severe hypersomnia.
On November 4, I discovered that I had run out of mirtazapine tablets, and on the 5th, I went to the Cangzhou People’s Hospital’s western mental health clinic. The doctor didn’t express any opinions; I was the one who shared my medical history and medication, and the doctor just continued with the previous prescription, as if it were a mathematical formula: I described my condition, and he wrote the prescription; I didn’t feel treated like a person.
From November 4 to November 9, I became increasingly forgetful.
2025#
January 2021#
January 12, 2024#
At 5 PM, I felt weakness in my limbs and drowsiness, so I closed my eyes to rest for a while (but didn’t fall asleep).
January 11, 2024#
In the afternoon, I felt weakness in my limbs and drowsiness, slept for a while, and felt very uncomfortable upon waking.
January 9, 2024#
This morning while brushing my teeth, I felt nauseous and vomited bile.
January 6, 2024#
I felt a bit nauseous this morning when I got up.
January 5, 2024#
This morning, I hadn’t brushed my teeth yet, but the urge to vomit was very strong, even after brushing my teeth.
January 4, 2024#
Nausea and dry heaving, no bile.
2024#
December 2024#
December 25, 2024#
Yesterday, I felt a bit more frequent disorientation, and today I felt very severe upon waking. But I clearly took my medication on time and in the right amount; there shouldn’t be withdrawal symptoms. I just remembered that I ran out of escitalopram while organizing my medication, and I hadn’t taken it these past few days.
Today while brushing my teeth, I dry heaved and vomited bile.
December 11, 2024#
Woke up at 11:30 AM, experienced vomiting again, vomiting bile. My attention was still scattered; often after reading a paragraph, I would realize I missed a sentence or didn’t understand it, and I would go back to read it a second time, sometimes even a third time (which is rare). At 9:50 PM, while watching “One Flew Over the Cuckoo's Nest,” I suddenly thought of my father and his friends’ gazes, feeling useless again.
December 10, 2024#
Woke up at 11:30 AM, vomited after brushing my teeth, and finally vomited bile. I planned to spend a few days finishing the articles labeled with depression by the white bear Amaru and also planned to play “Sky: Children of the Light.”
December 9, 2024#
Woke up at 11:30 AM today. My mood hasn’t improved all day, still trapped in yesterday’s gloom. After dinner, I felt cold, turned on the air conditioning, and my dad saw it and said, “If there’s nothing going on, go back and get under the covers.” I’ve been studying philosophy, computer science, and economics, but he thinks I’m just playing games, and I don’t want to argue. I started to feel that if I don’t get married, home isn’t home; home is hell, filled with sarcasm, deceit, and blame. Today I wanted to find someone to chat with, messaged a few people, but none replied, which made me very sad. Maybe I’m starting to turn around! I don’t know how deep this depression is or how long it will take to turn around. Starting from the evening, I found it hard to concentrate, my thoughts were very scattered; when watching somewhat in-depth videos or slightly longer professional articles, I would lose patience within minutes. I chatted with Song Yinye for a while; he said my thoughts were very scattered. I fell asleep at 1 AM.
December 8, 2024#
Tonight, my dad started to pressure me, even began to deceive me, telling me to take the civil service exam after the New Year and to go on blind dates during the New Year. My stepmother repeatedly expressed her disdain to others, saying, “He’s just lazy.” My mood was terrible. After getting drunk, I called my uncle, talked about deception, and later about politics, discovering he is a selfish person who criticized me harshly. He always compares the present with the past; I wanted to guide him to compare China with other countries, but he said I always compare China’s shortcomings with other countries’ strengths. I mentioned China’s major infrastructure projects, saying that the roads built don’t even have many people using them, and he replied, “If you’re from the mountains, even if not many people use it, would you want to build a road?” You’re standing here talking without feeling the pain because you’re not from the mountains. It’s really hard to continue this conversation. In the end, he even started to differentiate between high and low status, saying, “Your current achievements are not as good as mine, so you’re wrong. You haven’t shouldered the pressure of a family.”
November 2024#
November 21, 2024#
Woke up at 11:30 AM.
November 20, 2024#
Didn’t write on the 20th, catching up on the 21st. Woke up at 7 AM due to a full bladder, got up to go to the bathroom, and continued sleeping afterward. Woke up at 7:30 AM, took my brother to school, and continued sleeping after returning, waking up at 11:30 AM. Took medication normally at noon. Fell asleep around 2 AM the next day.
November 19, 2024#
Woke up at 11:30 AM.
Reflected on how I’ve always failed to prioritize, busy with low-priority things I’m interested in, while high-priority matters are pushed to the back.
Reflected on whether I truly forgot to take my medication at noon. I clearly set reminders on my to-do list, which would alert me at the right time, yet I always take it lightly. Maybe I should change the reminder sound and reorganize it; don’t force reminders, as I’m really averse to them now.
It seems I’m transitioning into a depressive phase, often experiencing neglect and distraction recently.
November 18, 2024#
Didn’t write on the 18th, thought about it, catching up on the 19th. Also woke up at 11:30 AM. Forgot to take medication at noon. Fell asleep around 2 AM the next day.
November 17, 2024#
Woke up at 11:30 AM today, but I had some awareness beforehand, thinking whether I should set the alarm earlier. I plan to consult an online doctor in the afternoon about whether to reduce the dosage of mirtazapine. The doctor similarly suggested I first reduce it to 15mg and observe; if it worsens, I can increase it back.
Today I read Zhang Jin’s "Crossing Over" and realized I might actually have bipolar disorder; I didn’t think so before. Although I sometimes feel very euphoric, talking to myself for an hour, this situation is rare, occurring once every few months or even half a year. Most of the time, I have deep interests, able to continuously engage in one thing, seemingly tireless. I previously thought this was the motivation of interest; my current interests include politics, economics, philosophy, and computer science, and I used to enjoy rooting devices. Even when I was cycling on the road, I initially had high interest, able to ride over a hundred kilometers, getting faster and faster. Later, I often found myself suddenly not wanting to ride after just halfway, feeling completely drained, just coasting along.
Perhaps the doctor from Nanjing Brain Hospital judged correctly.
I forgot to take my medication at noon.
November 16, 2024#
Forgot to write on the 16th; this is being caught up on the 17th. Woke up at 11:30 AM on the 16th and watched several driving tutorial videos. Forgot to take medication at noon. Fell asleep at 1 AM the next day.
November 15, 2024#
Although I was still sleeping this morning, I felt much more awake; the alarm didn’t ring, so I continued sleeping until 11:30 AM. Forgot to take medication at noon.
November 14, 2024#
At 10:16 AM, my father called to wake me up to drive him to retrieve his car; I asked him which car, and he vaguely mentioned it, then started to insult me, and suddenly hung up. I was still tired, feeling rebellious, and continued to sleep. At 10:29 AM, he called again, continuing to scold me; at this point, I wasn’t that tired anymore, but I just didn’t want to do as he said, so I continued sleeping. I slept for a minute or two; actually, I didn’t sleep well, thinking about why I should resist in this way. I wasn’t that tired anymore; if he hadn’t insulted me, would I have gotten up? I struggled for a while in my mind and finally got up.
In the afternoon, while transporting goods, I arrived at a narrow alley (a dead end, barely allowing two cars to pass side by side), and a car was parked in front of a cutting factory (there were some items on my left, making it inconvenient for him to reverse). I intended to park to his left, so as not to block him from reversing out, and to allow him to leave quickly after I parked at the entrance. But I didn’t pay attention to the rear of my car and scraped another car, costing me 200 yuan.
I was filled with self-blame; this was the third time I had an accident while driving. The first time, I entered someone’s yard, only opening half the door, scraping the wall. The second time, I don’t know how it happened, but the right rear tire had a cut. When I noticed the tire pressure was low, although there was some bumpiness, it shouldn’t have been this bad; my father said I must have been riding the curb and kept blaming me. Looking back, it should have been my fault; once, while passing through a rural intersection, there were several stones blocking the road at the corner. Although I went around them, the rear wheel still went over the stones, and when sliding down, it made a loud noise.
I thought my father would scold me more harshly this time, but he didn’t; perhaps this time it wasn’t his money.
Fell asleep at 2 AM the next day.
November 13, 2024#
Woke up at 11:30 AM after the alarm rang, wanting to continue sleeping, so I set the alarm for 15 minutes later. After waking at 11:45 AM, I washed up and found that the water in the entire building had stopped, so I went to the neighboring yard to brush my teeth. The workers mocked me for brushing my teeth right before lunch. I felt a bit guilty, but I knew that guilt would only delay things and wouldn’t change the situation. Fell asleep around 1 AM the next day.
All day, my brain felt slightly chaotic.
November 12, 2024#
Woke up at 11:30 AM. In the evening at 7 PM, I felt exhausted, dozing off between half-sleep and wakefulness for a while. Upon waking, I didn’t feel abandoned by the world, but I had a very severe sense of chaos that lasted until the evening. Fell asleep at 1 AM on the 13th.
November 11, 2024#
When I returned home to take my medication in the evening, I found that I had run out of mirtazapine tablets, so I didn’t take any that night. I experienced some insomnia; usually, I would feel sleepy around 1 AM, but I wasn’t sleepy until 4 AM on the 12th, forcing myself to turn off my phone, close my eyes, and lie down for a while before finally falling asleep.