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Depression Pain/Madness       I suffer with major depression. It is a part of my Borderline Personality Disorder. Depression is a big black hole I cannot escape. It sucks me in and pulls me down into the depths. Thrashing me around as it goes. My brain stops functioning in a logical manner. I can only see negativity. There is no hope of a positive thought being allowed to enter. I begin to review my life and cannot find a day where I thought I might have been happy. I have become a hermit because of my illness and there is not one soul I can think of who gives a rats behind for me or my problems. I avoid people - part of the Socialphobia. I get so tired I can do little more than stay in bed. I become a prisoner of my own mind. Everything makes me cry. I feel so miserable and alone. I just sit there in the dark.       I get stuck in these depressions about once or twice a year. While I am in the depression its intensity fluctuates. Sometimes I can pull it together and get to the store for supplies and to doctors appts. and have a semi-normal few hours. Other times I close the curtains and hunker down. It is these times that I dread so much. I literally go insane. There are no words to describe the absolute despair, loneliness and depression I feel. Indecision abounds at this time. What will people think? What impact will a suicide have on them? Am I really suicidal enough to carry through? What if I goof and the job doesn't get done and I am left unable to ever do it again because I am crippled or worse?       The pain is so deep all I can do is scream in agony. People call it a big black hole. Unless you have been there you cannot understand the pure abject misery of it all. I become totally mentally and physically drained. I feel so drained I can hardly move. I only can think in the negative. I believe I have always been this depressed. I decide I can't live this way forever and begin to plan my death.       I make notes, I pick locations, I decide how I want to be found. I am supposed to go to the hospital when i get this far. But I don't. I think if I go for help they will turn me away. I think about how uncomfortable it is in there. I think of the other patients that will be there. I wonder what will I do with my animals? I know they will kepp me no longer than 2 weeks and i think - 2 weeks is not enough time to break a depression... so what is the use of going... and I talk myself out of it.       The depressions duration cannot be calculated. You know logically that you will go up the other side in a while, but there is no way of knowing when. weeks? months? longer? How much can I take? Each time i get depressed and sink into the hell i think i have always been this way. I have to hang on to the thought that it won't last forever.       During the hours that my depression is fluctuating at a lighter inesity I can hang on to that thought, but when it sinks really low all I can think of is misery and suicde. My thoughts get so dark and I think of death and dying constantly. I search out pictures of death, songs about suicide, I write dark poetry, and I cry. Mostly I cry.       The depression brings forth all my insecurites that my Socialphobia drenches me in. The Socialphobia inturn drives my Anxiety and I become an emotional wreck. I can't eat. I can't sleep. I can't concentrate. I sit on the couch all wrapped up in a ball. To change the pace I return to my bed and lay there for hours at a time, neither awake or asleep. My mind going over every excrutiating hurt I had in my life. I don't know if I'm real anymore.       I want to reach out but I can't. My life as a hermit has left me completely alienated. I have no friends or acquaintances because I don't leave my house. I have family but they are spread across the continent. I have tried in the past to tell them i am "sick" but they don't have time. They are too far away to drop in for a coffee and they get busy and forget to call. I have a son in the city, but he is having his own problems and I don't want to lay my problems on him. He is supportive when I am really needing help.       I used to take anti-depressants but I stopped. I stopped for two reasons. I was starting a new therapy and my psychiatrist wanted me drug free so my mind was clear. once i was off the drugs I realized he was right. my mind was so much clearer. I could see now how the anti-depressants had me zombie-like. I had feelings again. I could think outside the box. I made up my mind i wasn't going to take them again. I'd rather feel life than be cocooned-up in a cottony existence that comes with anti-depressants.       To relieve things medicinally I use pot now. It does not make the depression go away. it does not stop the depression from coming back, but it keeps it alleviates my mood so I am not suicidal. It calms my mind enough so I can leave my house and run errands. DSM-IV Diagnostic Criteria     DSM-IV is the fourth version of the "Diagnostic and Statistical Manual of Mental Disorders" published by the American Psychiatric Association. Although originally derived from diagnostic criteria derived for research on mental disorders, it has come to be considered to be the "Bible" of psychiatric diagnosis. There is much criticism and controversy about DSM-IV. However, in my opinion, it is the best tool we have to clarify communication and aid in diagnosis and treatment of psychiatric and psychological problems. DSM-IV is also an excellent resource for information about the rate of occurance, charactericstic features, long-term course, and outcome of many Mental Disorders. Major Depressive Episode: A.     Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning.; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood. markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others.) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. * Note: In children, consider failure to make expected weight gains. insomnia or hypersomnia nearly every day. psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down). fatigue or loss of energy nearly every day feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproachor guilt about being sick) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide B.      The symptoms do not meet criteria for a Mixed Episode (both manic and depressive symptoms at the same time) C.;    The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D.      The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism). E.      The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation. Major Depressive Disorder Single Episode: A.      Presence of a single Major Depressive Episode B.      The major Depressive Episode is not better accounted for by Schizoaffectivd Disorder and is not superimposed on Schizophrenia, Schizohreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. C.      There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode.(Exclusion does not apply to substance or treatment-induced manic, mixed, or hypomanic episodes). Major Depressive Disorder Recurrent : A. Presence of two or more Major Depressive Episodes. (Must be separated by an interval of at least 2 months). B. The major Depressive Episode is not better accounted for by Schizoaffectivd Disorder and is not superimposed on Schizophrenia, Schizohreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. C. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode.(Exclusion does not apply to substance or treatment-induced manic, mixed, or hypomanic episodes).