Description#
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 diary for depression 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 following primary headings in reverse order to make it easier for you to see the latest updates, with the right sidebar providing reference.
My Feelings About Depression#
Feeling in the brain: heavy, tight, painful, chaotic
- Note that it is the brain, not the entire head. I can feel it inside, not outside.
- Heavy, equivalent to weight.
- Tight, feeling like the brain is a sphere, being 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. Moreover, it is 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 a complete torment. Over time, I became afraid of sleeping; hearing phrases like "good night" or "go to bed early" would terrify me, and my body would even tremble. Every night, I would exhaust myself to the point of fatigue, not knowing when I fell asleep, waking up with deep guilt and self-blame. I often dozed off during the day, but it was always in a half-asleep state, very sensitive to sounds, able to accurately judge what was happening around me, even the slightest noise could be detected, which really couldn't 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 barely lift my limbs, even an elderly person 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 events 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 told me I truly existed. I was diagnosed with neurasthenia at a mental hospital in the county, and the medication prescribed had side effects that could affect fertility, so I stopped taking it after just a few doses. This mental hospital couldn't even be called a hospital; although it was the only mental 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.
After that, I took a break from school for over half a year, staying at home, feeling my family’s pity and sympathy, 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 an ordinary person. 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 medication, proposing treatment plans, and 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 province. Most families of depression patients only take them to the county for a check-up, which may lead to misdiagnosis; if the treatment doesn't work well, they give up. They may not even consider it a disease, thinking it’s just self-abandonment, laziness, unwillingness to strive, or being a prodigal, and then they declare a death sentence. Over time, my family was filled with accusations, believing that a young man not only wasn't studying but also wasn't doing anything. The worst was when my father began to resort to violence, frustrated that I wasn’t waking up; he would forcibly pull me out of bed, saying that I had to do something. Others were relatively milder, often implying ridicule 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, going to a villager's house for meals every day; that way, the pressure would be much less, and I wouldn't have to care about my family's gaze, and I would slowly 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 struggling to fall asleep at night, falling into a vicious cycle. I was diagnosed with depression through conversations and psychological questionnaires at the Neurology Department of the First Affiliated Hospital of Anhui Medical University, and a prescription was given.
- Escitalopram oxalate, 1 tablet in the morning, add 1 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 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 around nine or ten o'clock these past few days; I had to sneak in 20 minutes to sleep elsewhere.
Sometimes, even though I hadn’t been injured, when my hair moved, that area of my head would start to hurt; 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 I took one tablet 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 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, so I should watch more cultural content and less scenery in the future.
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-up visits, 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#
I thought that continuously taking medication wasn't a solution, and 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, and the appointment was hard to get; I had to grab it several times before succeeding. But coincidentally, that day he had a second COVID infection, and a student of his, an associate chief physician, came instead. Although the department said I could switch to the next week for free, ensuring I would get an appointment, how could I go back and come again? The cost was too high, so I just decided to see him, and my depression wasn't too severe. The doctor only talked with me and didn't do a psychological questionnaire. I proactively shared my medical history, and in the middle, the doctor suddenly asked, "Sometimes do you have impulsive thoughts to do something big?" Actually, 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 down in my medical record. I asked the doctor for a prescription. I had also seen a neurologist at the county's First People's Hospital, 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 medication online, and during this period, I continued taking the following medications:
- Escitalopram oxalate, 1 tablet in the morning, add 1 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 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, and it was already serious after three to four months; how could I have taken it for a year? 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 and provided medication for two months, 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 did not express any opinions; I was the one who proactively 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, without treating me like a person.
From November 4 to November 9, I became increasingly forgetful.
2025#
January 2021#
January 12, 2024#
At 5 PM, I experienced 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 also felt a bit nauseous this morning.
January 5, 2024#
This morning, even before brushing my teeth, I felt a very strong urge to vomit, and it was the same after brushing.
January 4, 2024#
Nausea and dry heaving, no bile.
2024#
December 2024#
December 25, 2024#
Yesterday, I felt a bit more disoriented, and today I felt very serious as soon as I got up. But I clearly took my medication on time and in the right dosage; there shouldn't be withdrawal symptoms. I just remembered that I ran out of escitalopram while organizing my medications, and I hadn't taken it for the 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's and his friend's gazes, and the feeling of uselessness reappeared.
December 10, 2024#
Woke up at 11:30 AM, vomited after brushing my teeth, and ended up vomiting bile. I planned to spend a few days finishing reading articles tagged with depression by the white bear Amaru, and I also planned to play "Sky: Children of the Light."
December 9, 2024#
Woke up at 11:30 AM today. My mood hadn'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 wrong, go back and get under the covers." I had been studying philosophy, computer science, and economics, but he thought I was just playing games, and I didn't want to argue. I began to feel that if I didn't get married, home wouldn't feel like home; it would feel like hell, filled with ridicule, deceit, and blame. Today, I wanted to find someone to chat with and messaged 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. When watching somewhat profound videos or slightly longer professional articles, I would lose patience within minutes. I chatted with Song Yinye for a while, and he said my thinking was 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 is just lazy." My mood was terrible. After getting drunk, I called my uncle to talk about deception, and later we discussed politics, discovering he was a selfish person who harshly criticized me. He always compared the present with the past; I wanted to guide him to compare China with other countries, but he said I always compared China's shortcomings with other countries' strengths. I mentioned China's major infrastructure repairs, saying that the roads built hardly had anyone walking on them, but he replied, "If you are from the mountainous areas, even if few people walk on them, would you be willing to build roads?" You are standing here talking without feeling the pain because you are not from the mountainous areas. It was really hard to continue the conversation. In the end, he even started to differentiate between high and low status, saying that my current achievements were not as good as his, so I was wrong. I couldn't bear the pressure of a family.
November 2024#
November 21, 2024#
Woke up at 11:30 AM.
November 20, 2024#
I didn't write on the 20th, so I'm making up for it on the 21st. Woke up at 7 AM because of a full bladder, went to the bathroom and continued sleeping 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 at noon as usual. Fell asleep around 2 AM the next day.
November 19, 2024#
Woke up at 11:30 AM.
Reflecting on how I have always failed to prioritize, busying myself with low-priority interests while high-priority tasks are pushed to the back.
Reflecting on whether I really forgot to take my medication at noon? I clearly set up a reminder on my to-do list, which should alert me at the right time, yet I always take it lightly. Maybe I should change the reminder sound and reorganize it; I shouldn't force reminders, as I currently feel very resistant to them.
It seems like I'm transitioning into a depressive state, often experiencing a lack of focus and absent-mindedness lately.
November 18, 2024#
I didn't write on the 18th, but I remembered it, so I'm making up for it on the 19th. I also woke up at 11:30 AM. I forgot to take my medication at noon. Fell asleep around 2 AM the next day.
November 17, 2024#
Today I woke up at 11:30 AM, but I had some awareness beforehand, thinking whether I should set the alarm earlier. I planned to look for 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 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 and can continuously engage in one thing, seemingly tireless. My current interests include politics, economics, philosophy, and computer science; I used to be into rooting devices. This includes when I was cycling on the road; I initially had a high interest and could 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.
I forgot to take my medication at noon.
November 16, 2024#
I forgot to write on the 16th, so I'm making up for it on the 17th. I woke up at 11:30 AM on the 16th and watched quite a few driving tutorial videos. I 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 more awake; the alarm didn't ring, so I continued to sleep until 11:30 AM. I 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 pick up a car; I asked him which car, and he vaguely mentioned it, then suddenly started to insult me, and then he abruptly hung up. I was still sleepy and, feeling rebellious, continued to sleep. At 10:29 AM, he called again, scolding me again; 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 hadn't really slept well, thinking about why I was resisting in this way; I wasn't that sleepy anymore, and if it weren't for his insults, would I have gotten up? I struggled for a while and finally got up.
In the afternoon, while hauling 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 cutting factory (there were some items on my left, making it inconvenient for him to back up), so I intended to park to his left, firstly not blocking his way out, and secondly, so that I could immediately park at the entrance once he left. However, 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 else's yard, only opening half the door, scraping the wall and damaging the car. 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 definitely 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 some 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 severely this time, but he didn't; perhaps it was because he didn't pay for this one.
I fell asleep at 2 AM the next day.
November 13, 2024#
Woke up at 11:30 AM after being awakened by the alarm clock, wanting to continue sleeping, so I set the alarm for 15 minutes later. After waking up at 11:45 AM and washing up, I 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 just before lunch. I felt a bit guilty, but I knew that guilt would only delay things and wouldn't change the situation. I 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 serious sense of chaos that lasted until the evening. I went to bed 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 at all 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.