Depression and Stimulus

Ok so this post has nothing to do with macroeconomics, though it borrows its concepts from there. As the more perceptive of you might have figured out by now (ha, i love that line!) I was diagnosed with clinical depression about a year back. Actually that was the second time I had been diagnosed with that diagnosis, the first being a full six months earlier, when I had suddenly stopped medication after I had lost trust in that psychiatrist.

For over a year now, I have been on anti-depressants. It started with 37.5 mg per day of Venlafaxine (brand name Veniz), which got slowly bumped up until at 187.5 mg per day I started going crazy and having crazy mood swings and had to be scaled back to 150 mg. I was at that level for over six months when I realized that I had plateaued – that there was no real improvement in my mental situation thanks to continuous intake of the drug and perhaps I should consider getting off.

I proposed this idea to the psychiatrist when I met her last month and amazingly she agreed without any hesitation and quickly drew up a plan on how I need to get off the drug (you need to decrease dosage slowly else you’ll have withdrawal symptoms which are pretty bad). I found it a little disconcerting that she so readily agreed to take me off the drug, given that she had herself not given any indication of wanting to take me off the drug. I was disconcerted that I had been taking the drug for much longer than necessary, perhaps.

The doctor, however, paired the paring of my anti-depressant with doubling the dosage of the stimulant that I have been taking for my ADHD for the last six months. As it happened, though, I went through a major bout of NED that evening, and didn’t muster the enthu to go to the one pharmacy that legally sells Methylphenidate (the ADHD drug, ¬†supposed to have similar chemical composition as cocaine) in Bangalore. That I managed to function pretty well the following one week, including the three days spent at my client’s office, meant that I probably didn’t need teh ADHD drug also. So as I write this I’m off all mind-altering substances (apart from my several-times-a-day doses of caffeine and occasional ingestion of ethanol).

Recently I met a friend who told me that I had been too generous in my praise of psychiatric drugs in my blog, and that I hadn’t taken into consideration their various side effects and addictive symptoms. I’ve heard this from other people also – that I probably wasn’t doing the right thing by taking anti-depressants. So do I now regret taking them, given that I’ve chosen to go off them? Probably not.

This is where the analogy of economic depression and clinical depression comes in. In an economic depression, there is a halt in economic activity thanks to which there isn’t much circulation of money. When people start earning less, they start spending less, which further depresses their income and the whole economy goes into a tailspin. Going by Keynes’s theory, letting the economy slowly repair itself would take an extraordinarily long time (in the course of which we will all be dead, as the joke goes), so it is recommended that the government steps in and spends heavily in order to “stimulate” the economy and break the vicious circle it was getting itself into.

When you suffer from clinical depression, there is a shortage of flow of this chemical compound called Seretonin in your brain. Thanks to that, your mental energy is at a much lower level and you get tired and stressed out easily. Moreover, depression also leads to a significant drop in your confidence levels. You start believing that you are useless and not capable of anything. But then, your lowered mental energy levels mean that it is tough for you to be good at work, and do things that are likely to give your confidence a boost. And this in turn leads to further lowering of confidence and there is no way out for you to break out of this vicious circle.

A number of people believe that depression can be conquered with “willpower”, but this is applicable only if you’ve recognized it in its early stages. In most cases though, you realize it only when it’s deep into the vicious circle, and your “willpower”, much like “normal economics” during an economic depression, will take way too long to break you out of the vicious circle, and by then half your productive life will be gone.

Hence, to draw the Keynesian analogy, you need a stimulus. You need some sort of an artificial stimulus that breaks you out of your vicious cycle of low self-esteem and low performance. Sometimes, there can be a fortuitous life event which by matter of chance gives you a sudden sense of achievement and helps you break out of the cycle (for example, I was quite depressed (most likely clinically) through most of my life at IIT, but success in CAT proved to be a good stimulant in helping me break out of that cycle). But then, most of the time, life is structured such that there are few opportunities for such positive black swans, especially when you are older and especially when your mental energy levels are in general quite low.

Under these circumstances, I believe, there is no way out but chemical stimulants to help you get out of your depressive state. Clinical researchers and psychiatrists over the years have found the answer to be this molecule called “SSRI” which slows down the rate of seretonin uptake into the brain, with the result that there is greater flow of seretonin in your nervous system (continuing our economic analogy this is like the government cutting taxes as a form of stimulus). Greater seretonin in the system means greater mental energy, and sometimes the difference in energy levels is itself enough to push up your self-esteem levels, and the new energy levels means you have given yourself a chance to perform, and the cycle breaks.

Keynes said, as part of his theory, that it is important that a stimulus is short and targeted, and that in good times a government needs to be fiscally conservative so that, if not anything else, it has the necessary firepower to deliver a stimulus when necessary. Similarly, it is important that you don’t get yourself addicted on these anti-depressants and that you don’t become immune to them. Which is why psychiatrists typically wean you off your anti-depressants six months to a year after you started on it. By then, they expect, and in my case it did, that the stimulus would have been delivered.

Project Thirty – Closure

Today is the last day of my twenties. Which means Project Thirty has come to an end. I had a long list of things to do, and as the more perceptive of you would have expected from me, most of them are undone. Nevertheless, it has been a mostly positive year, and I’m glad I gave myself the year off in an attempt to find what I want to do.

The biggest positive of the last one year was that my mental illnesses (anxiety, depression, ADHD) got diagnosed and started getting treated. Yes I’m on drugs, and face severe withdrawal symptoms if I don’t take my antidepressant for a few days, but the difference these drugs have made to my life is astounding. I feel young again. I feel intelligent again. I have more purpose in life, and am back at the cocky confidence levels I last saw in 2005. I suddenly feel there’s so much for me to do, and for the first time ever, have started enjoying what I’m doing for money.

Which brings me to professional life. I decided to give myself a year to become a freelancer. I must admit I got one lucky break (one long-term reader of this blog was looking for a data science consultant for his company and I grabbed the opportunity), but I grabbed it. My improved mental state meant that I was motivated enough to do a good job of the pilot project I did for that company, and I have managed to extract what I think is a reasonable compensation for my consulting services.

There are other exciting opportunities on the horizon on the professional front, too. I’ve started teaching at Takshashila and am quite liking it (I hope my students are, too). There is so much opportunity staring at me right now that the biggest problem for me is one of prioritization rather than looking for opportunity.

There has been both progression and regression on the “extra curricular activities” front. Thanks to demands of my consulting assignment, I haven’t been getting time to practice the violin and abruptly discontinued classes two months ago. I did one awesome and rejuvenating bike trip across Rajasthan back in February but wasn’t able to follow that up even with weekend trips. I wanted to start on adventure sports but that remained a non-starter. I started preparing for a half-marathon and gave up in a month. I took a sports club membership, tried to teach myself swimming again, but have been irregular.

Personal life again has been mixed. Increasing excitement about work means less time for the family, and have been finding it hard to balance the time requirements. I seem to be putting on weight again, and now look closer to the monstrosity I was four years ago rather than the fit guy I was two years ago at the time of my wedding. I blame my expanding waistline and neckline on my travel, but that is not an excuse and I need to find an exciting way to get fit soon.

For perhaps the first time in several years my car didn’t take a knock that year, but I had two motorcycling accidents (one major and one minor) this year. The former led to the first ever broken bone in my body (the fifth metacarpal) thanks to which I don’t have a prominent fourth knuckle on my right hand. The latter led to major damages to my laptop.

My “studs and fighters” book still remains unwritten, and not a word has been added to its manuscript in the last one year. I was hoping to capstone my Project Thirty by organizing the first ever “NED Talks” but I seem to have bitten off much more than I can chew in terms of work, so that has again been postponed.

So let me take this opportunity to define my Project Thirty One. I want at least two published books by the end of the year. I want to do at least one major motorcycling trip. I need to find partners/employees and expand my consulting business. I want to travel a lot more – at least five weekend trips over the next 12 months. I want to become fit, to the size I was at the time of my wedding. Hopefully I can get weaned off anti-depressants. And I hope to resume music lessons, and start jamming. Ok let me not promise myself too much.

And I have a five-year plan too. By the time I’m thirty five, I want to have written a book on the economic history of India. Ambitious, I know. Especially for an NED Fellow like me.