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. Everything before November 10, 2024, is recorded here, in chronological order, and afterwards in reverse order under the headings below. You can see the directory on the right for clarity.
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 hurting. Hurting is like being pricked by a needle; pain feels like someone is squeezing your head with both hands. And it’s a continuous and mild pain, sometimes lasting three to four hours, at most an entire 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. I often dozed off during the day, but it was in a half-asleep state, very sensitive to sounds, accurately judging 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 frustration; at that time, I was still insisting on exercising every day, but the strong and healthy me from not long ago could now not even lift my limbs; even an elderly person who had been bedridden for years could do 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 at the intersection was red or green, whether there were pedestrians coming out of the alley on the right, what the street vendors were selling, not being able to say a single thing, even though these were matters from 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 uncomfortable and chaotic, 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 know a bit more, but not much; many just use the medications prescribed by the big hospital doctors, having never heard their opinions or treatment plans. Some provincial hospitals have some effect, but mostly just prescribe medications, proposing treatment plans; even if the medication cures it, depression can still recur, treating only the symptoms and not the root cause, but at least it started to have a positive effect on the condition from the provincial level. Most families of depression patients only take them to the county for a check-up, which is likely to lead to misdiagnosis; if the effect is not good, they give up treatment. They may not even consider it an illness, thinking it’s just self-abandonment, laziness, unwillingness to strive, or being a prodigal son, and then they declare a death sentence. Over time, my family was filled with accusations, thinking that a young man not only didn’t study but also did nothing. The most severe was when my father began to resort to violence, frustrated that I wasn’t waking up, pulling me up from bed, saying that I couldn’t do anything, and insisting that I must 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 quiet 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 told my family because I knew they would definitely not agree.
Later, my condition improved slightly, but the 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 unable to sleep at night, falling into a vicious cycle. At the First Affiliated Hospital of Anhui Medical University, I was diagnosed with depression through conversations and psychological questionnaires, and a prescription was given.
- Escitalopram oxalate, 1 tablet in the morning, 1 additional tablet at noon if severe.
- Mirtazapine tablets, 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 sleepy 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 20 minutes to sleep elsewhere.
Sometimes, even though I wasn’t injured, if my hair moved, that part of my head would start to hurt; sometimes it would be in my forearm, and it would hurt just by touching it. Later, the doctor prescribed pregabalin, to be taken when in pain, and it worked very well. I had a head MRI done, and after seeing two neurologists, they both said it was normal.
Later, the condition worsened, and the doctor prescribed flupentixol and melitracen tablets, 1 tablet every morning, and 2 tablets if severe. I resigned in May 2023, wanting to prepare for the civil service exam at home, and during that time, I traveled to Tibet for more than half a month, gaining some insights. The scenery was indeed beautiful, but the scenery is not as impactful as people; the difference in scenery is far less than the gap between people, and people can touch me more deeply. In the future, I want to focus more on humanities and less on scenery.
I continued taking medication until August 2023, during which I had follow-up visits every two to three months. I felt the doctor’s role was minimal; during follow-up visits, they only inquired 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 after thinking about it, I realized 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 be among the top few in the country for depression. 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 for the second time, and a student of his, an associate chief physician, came instead. Although the department said I could switch to the next week for free, guaranteeing an appointment, how could I go back and come again? The cost was too high, so I thought I’d just see him this time, and my depression wasn’t too severe anyway. 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 have insights on certain topics and talk to myself, rambling on like a debate, but I don’t have the idea of doing something big. At that moment, for some reason, 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 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, knowing very little, just using the previous doctor’s prescription. The cost of going to a big city for a follow-up visit was too high, so I privately bought the medications online, and during this time, I continued taking the following medications:
- Escitalopram oxalate, 1 tablet in the morning, 1 additional tablet at noon if severe.
- Mirtazapine tablets, 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.
Around July, I started experiencing 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 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 severely criticized me, saying that flupentixol and melitracen tablets should only be taken temporarily, and it was already outrageous to take them for three to four months; I had taken them for a year, which was 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, 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 Western Mental Health Clinic of Cangzhou People's Hospital. 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 explained my condition, and he wrote the prescription, without treating me like a person.
From November 4 to November 9, I became increasingly forgetful.
2024#
December 2024#
December 11, 2024#
Woke up at 11:30 AM, experienced vomiting again, throwing up acid. My attention was still scattered; often after reading a passage, I would find I missed a sentence or didn’t understand it, and I 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 and his friend's gaze, feeling useless again.
December 10, 2024#
Woke up at 11:30 AM, vomited after brushing my teeth, eventually throwing up acid. I planned to spend a few days reading articles tagged with depression by Bai Xiong A Wan, and I also intended 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 and turned on the air conditioning; my dad saw this and said, “If there’s nothing to do, 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, sent messages to 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. Since the evening, I’ve found it hard to concentrate, and my thoughts are very scattered; when watching somewhat profound videos or slightly lengthy professional articles, I lose patience within minutes. I chatted with Song Yinye for a while; he said my thinking is very scattered. 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 is just lazy.” My mood is terrible. After getting drunk, I called my uncle, talked about scams, and later discussed politics, discovering he is a selfish person who harshly criticized 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 don’t even have many people walking on them, but he replied, “If you are from a mountainous area, even if not many people walk on them, would you be willing to build roads?” You are standing here speaking without pain because you are not from a mountainous area. It’s really hard to continue this conversation. In the end, he even started to differentiate between high and low status, saying that my current achievements are not as good as his, so I am wrong. I 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, went to the bathroom, and continued sleeping. 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 are pushed to the back.
Reflected on whether I really forgot to take my medication at noon. I clearly set up a reminder on my TickTick list, which should alert me at the right time, but I always treat it casually. I should change the reminder sound and reorganize things; don’t force reminders, as I currently feel very resistant to them.
It seems I am transitioning into a depressive state, often experiencing neglect and distraction recently.
November 18, 2024#
Didn’t write on the 18th, but I remembered it, catching up on the 19th. Woke up at 11:30 AM. Forgot to take my 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 if I should reduce the dosage of mirtazapine. The doctor also 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, which I didn’t think before. Although sometimes I can be very excited, 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 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. Even when I was cycling on the road, I initially had high interest, able to ride over a hundred kilometers, increasing speed. 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.
Forgot to take my medication at noon.
November 16, 2024#
Forgot to write on the 16th; this is a catch-up on the 17th. Woke up at 11:30 AM on the 16th, watched several driving tutorial videos. Forgot to take my medication at noon. Fell asleep at 1 AM the next day.
November 15, 2024#
Although I was still sleeping this morning, I felt much clearer; the alarm didn’t ring, so I continued sleeping until 11:30 AM. Forgot to take my 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 he abruptly hung up. I was still sleepy, feeling rebellious, and continued to sleep. At 10:29 AM, he called again, continuing to scold me; at this point, I wasn’t that sleepy anymore, but I just didn’t want to do as he said and continued to sleep. After a minute or two, I didn’t really sleep well, thinking about why I was resisting in this way. I wasn’t that sleepy anymore; if it weren’t for his insults, would I have gotten up? I struggled for a while in my mind 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), and a car was parked in front of a factory (there were some items on my left, making it inconvenient for him to back out), so I thought of parking to his left; this way, I wouldn’t block him from backing out, and it would be convenient for him to leave, and I could immediately park at the entrance. But I didn’t notice the rear of the car and scraped someone else's 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’s yard, only opened half the door, and scraped 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 a rural intersection, there were several stones blocking the road at the corner; although I went around, 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 severely this time, but he didn’t; perhaps it wasn’t his money this time.
Fell asleep at 2 AM the next day.
November 13, 2024#
Woke up at 11:30 AM after being woken 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. I was mocked by workers for brushing my teeth right before lunch. I felt a bit guilty, but I knew that feeling guilty 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 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, which lasted until the evening. Fell asleep at 1 AM on the 13th.
November 11, 2024#
When I returned home to take my medication, I found that I had run out of mirtazapine tablets, so I didn’t take any that night. I experienced some insomnia that night; usually, I feel sleepy around 1 AM, but I wasn’t sleepy until 4 AM on the 12th, forcing myself to turn off my phone, closed my eyes, and lay down for a while before entering dreamland.