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 start keeping a depression diary on November 13, 2024, following his example. Entries before November 10, 2024, will be recorded here, in chronological order, while subsequent entries will be recorded under the headings below, in reverse chronological order. You can see the right sidebar for clarity.
My Depression Experience#
Feeling in the brain: heavy, tight, painful, chaotic
- Note that it is the brain, not the entire head. The sensation is internal, not external.
- Heavy, equivalent to weight.
- Tight, feeling like the brain is a sphere, under continuous compression, 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. Moreover, it is a continuous and mild pain, sometimes lasting three to four hours, and at most an entire day.
My Previous Depression Experience#
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 fall asleep, it was pure torment. Over time, I became afraid of sleeping; hearing phrases like "good night" or "go to bed early" would terrify me, causing my body to 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 I was in a half-asleep state, very sensitive to sounds, able to accurately judge what was happening around me, even the slightest noise could be captured; this cannot be considered rest. In the evenings, I often felt exhausted, and in severe cases, I could hardly lift my limbs, only able to lie in bed. There was a strong sense of defeat in my heart; at that time, I was still insisting on exercising every day. The strong and healthy me from not long ago could now not even lift my limbs; even elderly people who have 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, I couldn't say a single thing, yet these were all 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 terrible, 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 that affected fertility, so I stopped taking it 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 town, and if it weren't for the sign at the entrance, one would think it was a rural yard.
After that, I took a break from school for more than half a year, staying at home, feeling the pity and sympathy from my family, but they were truly of no help; they didn't know 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 ordinary people. The city doctors have some understanding but not much; many only 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, which only treats the symptoms but not the root cause. At least it has a positive effect starting from the provincial level, right? Most families of depression patients only take them to the county for a check-up, which may lead to misdiagnosis, and if the effect is not good, they give up treatment; they may not even consider it an illness, thinking it is just self-abandonment, laziness, unwillingness to strive, or being a spendthrift, and then they declare a death sentence. Over time, my family was filled with accusations, believing that a young man should not only not study but also do nothing. The most severe was when my father began to resort to violence, frustrated that I was not waking up, pulling me up from bed, saying that I should be doing 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 quiet countryside where no one knew me, eating at a villager's house every day; this would relieve a lot of pressure, and I wouldn't have to care about my family's gaze, and I would gradually get better, but I never told my family because I knew they would definitely not agree.
Later, my condition improved slightly, but the symptoms remained, 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, with a strong sense of loss. Nighttime again became difficult to sleep, falling into 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 period, I forgot which of these two medications to take in the morning and which at night, so I took them in reverse order. Later, during a follow-up visit, the doctor asked if I felt sleepy after taking mirtazapine in the morning, and that’s when I remembered why I had been so sleepy around nine or ten o'clock these past few days; I had to sneak in 20 minutes to sleep somewhere else.
Sometimes, even when I wasn't injured, if my hair moved, that part of my head would start to hurt, and sometimes it would be in my forearm, hurting at the slightest touch. Later, the doctor prescribed pregabalin, which worked very well when I took one tablet for 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. In the meantime, I traveled to Tibet for more than half a month and had some insights. The scenery was indeed beautiful, but the scenery is not as impactful as people; the differences in scenery are far less significant than the gaps 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, which 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 the same as 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 rank among the top hospitals in the country for depression. I registered with a chief physician, whose appointment was hard to get; I had to try several times to secure one. However, that day he had just tested positive for COVID-19 for the second time, 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 thought I would just 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 of wanting to do something big?" In fact, sometimes I do have insights on certain topics and talk to myself, like debating, but I never had the thought of doing something big. For some reason, I said "yes," and the doctor suspected I had bipolar disorder, noting it in my medical record. I asked the doctor for a prescription. I had also seen a neurologist at the First People's Hospital in the county, but the doctor's understanding of depression was about the same as that of an ordinary person, not much different, just using the previous doctor's prescription. The cost of going to a big city for a follow-up 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 in 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 my family woke me up, I could hardly open my eyes and would continue to sleep.
In September, I decided to visit a friend in Hefei and coincidentally went for a follow-up at the First Affiliated Hospital of Anhui Medical University. After explaining my condition (I forgot to mention the hypersomnia), the doctor harshly criticized me, saying that flupentixol and melitracen tablets should only be taken temporarily, and after three or four months, it was already too much; how could you take it for a year? This is reckless. He told me to stop taking flupentixol and melitracen tablets immediately, while continuing with escitalopram and mirtazapine as usual. He refused my request for a prescription and provided me with two months' worth of medication, instructing 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 Western Mental Health Clinic of Cangzhou People's Hospital. The doctor did not express any opinions; I was the one who voluntarily shared my medical history and medication, and the doctor merely continued with the previous prescription, as if it were a mathematical formula: I described my condition, and he wrote the prescription. I did not feel treated like a person.
From November 4 to November 9, I became forgetful and often misplaced things.
2024#
December 2024#
December 11, 2024#
Woke up at 11:30 AM, experienced vomiting again, throwing up sour liquid. My attention was still scattered; often after finishing a sentence, I would realize I had missed a sentence or didn't understand it, and would go back to read it a second time, or 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's and his friends' gazes, and once again felt a sense of uselessness.
December 10, 2024#
Woke up at 11:30 AM, vomited after brushing my teeth, eventually throwing up sour liquid. I planned to spend a few days reading articles tagged with depression by the white bear Amaru, and also intended to play "Sky: Children of the Light."
December 9, 2024#
Woke up at 11:30 AM today. My mood has not 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 have been studying philosophy, computer science, and economics, but he thinks I'm just playing games, and I don't want to argue. I began to feel that if I don't get married, home is not home; home is hell, filled with sarcasm, deceit, and blame. Today I wanted to find someone to chat with, sent messages to a few people, but none of them 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. From the evening, I found it hard to concentrate; my thoughts were very scattered. Watching somewhat profound videos or slightly lengthy professional articles, I would lose patience within minutes. I chatted with Song Yinye, and he said my thinking was very scattered. Fell asleep at 1 AM.
December 8, 2024#
Tonight, my dad began to pressure me, even starting 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 is just lazy." My mood was terrible. After getting drunk, I called my uncle, talked about deception, and later discussed politics, discovering he is an egoist, harshly criticizing me. 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 repairs, saying that the roads built hardly have anyone walking on them, but he replied, "If you are from the mountainous area, even if not many people walk, would you be willing to build the road?" You are standing and speaking without pain because you are not from the mountainous area. It became really hard to continue the conversation. In the end, he even began to differentiate between high and low status, saying, "Your current achievements are not as good as mine, so you are wrong. You haven't shouldered the pressure of a family."
November 2024#
November 21, 2024#
Woke up at 11:30 AM.
November 20, 2024#
Did not write on the 20th, catching up on the 21st. Woke up at 7 AM due to a full bladder, got up to use the bathroom, and continued to sleep afterward. Woke up at 7:30 AM, took my brother to school, and went back to sleep, 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 my tendency to not prioritize, always busy with low-priority things that interest me, while high-priority tasks get pushed to the back.
Reflected on whether I really forgot to take my medication at noon. I clearly set reminders on my to-do list, which should alert me, yet I always take it lightly. Maybe I should change the reminder sound and reorganize; I shouldn't force reminders, as I currently feel very resistant to them.
It seems I am transitioning into a depressive state; recently, I often experience neglecting one thing while focusing on another, becoming absent-minded.
November 18, 2024#
Did not write on the 18th, but remembered to catch 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 planned to find an online doctor in the afternoon to ask whether I should 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 that I might indeed have bipolar disorder; I didn't think so before. Although I sometimes become very excited, talking to myself for an hour, this happens rarely, maybe once every few months, or even once every six months. Most of the time, I have deep interests and can continuously engage in one thing, seemingly tireless. My current interests include politics, economics, philosophy, and computer science; I used to enjoy rooting devices. Including when I used to ride road bikes, I initially had a 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 gliding along.
Perhaps the doctor from Nanjing Brain Hospital judged correctly.
Forgot to take 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 go off, so I continued to sleep 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 a car; I asked him which car, and he vaguely mentioned it, then suddenly started to insult me, and abruptly hung up. I was still tired, feeling rebellious, and continued to sleep. At 10:29 AM, he called again, angrily continuing to scold me. At this point, I wasn't that tired anymore, but I just didn't want to do as he said and continued to sleep. I slept for a minute or two; actually, I didn't sleep well, thinking about why I was resisting in this way. I wasn't that tired anymore; if he hadn't insulted me, would I have gotten up? I struggled for a moment and finally got up.
In the afternoon, while transporting goods, I reached a narrow alley (a dead end, barely allowing two cars to pass side by side), where a car was parked in front of a cutting factory (I had some clutter on my left, making it inconvenient for him to reverse), so I intended to park on his left side; this way, I wouldn't block his exit, and once he left, I could immediately park at the entrance. However, I didn't pay attention to the rear of my car and scraped another vehicle, 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 else'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 tear. When I discovered 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 a rural intersection, there were some stones blocking the road at the corner, and although I went around, the rear wheel still went over the stones, making a loud noise when sliding down.
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, disturbed by the alarm clock, wanting to continue sleeping, so I set the alarm for 15 minutes later. Woke up at 11:45 AM, 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 me further and wouldn't change the situation. Fell asleep around 1 AM the next day.
All day, my brain had a slight feeling of chaos.
November 12, 2024#
Woke up at 11:30 AM. In the evening at 7 PM, I felt exhausted, dozing off in a half-asleep state for a while. When I woke up, 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, I discovered that I had run out of mirtazapine tablets, so I didn't take any that night. I experienced some insomnia that night; I usually feel sleepy around 1 AM, but I wasn't sleepy until 4 AM on the 12th. I forced myself to turn off my phone, closed my eyes, and lay there for a while before finally falling asleep.