After a few months of trying slowly increasing dosages of an anti-depressant, I might have finally found one that works. “Might,” being the operative word. I’m only a week and a half into this new dosage as I’m writing this, but I actually have had bursts of adequate executive function in the past few days and while the biggest bursts of it could be attributed to the common early side-effect of “manic energy,” I find myself wanting to feel cautiously optimistic about it. Well, cautiously willing to consider that this might be the medication working. I’m not sure I can call myself optimistic if I’m essentially trying to prove to myself that something other than the medication might be responsible for my buoyed mood. I mean, there’s been all kinds of studies in recent years about how eating a reasonable amount of ice cream every day can have positive effects on your health, so maybe my recent little treats of just a little ice cream every couple of days is responsible. Maybe it’s my improved sleep. Maybe it’s the fact that absolutely nothing horrible happened last week and all I have to deal with was the normal stress of a very busy work week. There’s a lot of things it could be. But its still probably the medication taking effect, even if I’m nervous about whether this feeling will last, grow, disappear, or whatever else could happen. As a teen, I had a really bad experience with mental health focused medications and my experiences so far this year have done little to resolve the general trepidation I feel at the thought of altering my mental state with outside chemicals. A trepidation I’m willing to forcefully overcome since that effort is so much less than the effort it takes to not look and feel miserable constantly that I’m spending just about every single day.

I’ve been thinking a lot about masks lately. Both “masks” as in the thing you wear on your face to protect yourself and others from the spread of airborne pathogens and “masks” as in the behaviors and personas we wear to fit in or hide our neurodivergence. One of the things I’m expected to do at work is hide my depression, burnout, and anxiety. Any time those things start to leak through, I get comments from people about the quality of my work dropping, about how I should take a rest, how I need to stop worrying so much, and so on, regardless of wether there’s been any change in my behavior other than no longer putting in the effort to hide how I feel. I’m not allowed to be sad or moody or even sleepy. I have to be active, engaged, attentive, and constantly on the lookout for people in the lab who might need my help (since none of them will ever ask for anything, apparently, and my biggest plus in all of my recent reviews has been how I’m ready, willing, and very good at stepping in to help people when they need it). It’s an exhausting way to live my life, to have to be this person I absolutely am not (I’m a bit of a myopic sad sack in real life, if you can’t tell, but not without my glimmers of hope and steel-cored resolve), but it’s all I’ve got these days.

Which, if this current feeling of slightly increased capability (and slightly decreased friction when it comes to masking) stays, it’ll be worth it. I might try for more still, if this doesn’t change enough, since I’m only on antidepressant two of dozens of options, but even a little bit of help goes a long way. If it’s saving me energy when it comes to what I’m spending ten hours a day on, making it easier to be at work five days a week, that’ll be huge even if it’s only by a tiny amount. And if it increases, as the new dosage builds up in my system or whatever it is antidepressants do that makes them take three to eight weeks to take full effect (based on the specific medication of course), then maybe that’s all I need. A bit less misery. Less of a climb to get out of the doldrums every day. A fraction less effort spent on not feeling miserable all the time. All of that would be good. And if this medication and dosage actually has a significant impact? If it actually forces my depression into submission so the only thing holding me back is my OCD, anxiety, and burnout (all of which, excluding burnout, it is prescribed to help deal with, so it’s unlikely that they’re remain at their current… tier of difficulty)? I honestly can’t even imagine what that would be like. I’ve been managing my mental health on my own, unaided, my entire life, aside from those miserable couple of months in high school. I’ve dealt with all the rises and falls of the past two decades with no chemical intervention save caffeine and abstinance from alcohol (which, honestly, was such a good idea), so having something take that burden off my metaphorical shoulders? To be able to go through my life without needing to spend most of my effort and energy on managing myself, masking, and fitting in? What a wonder that would be.

Which is why I’m trying to convince myself that my recent mood alteration isn’t entirely the medication. I don’t know that I could recover from feeling like I was getting that full effect only to have it vanish if I don’t eat ice cream regularly or get past the “manic energy” stage of changing my dosage. Better to stay cautious, to step carefully, than to stride out confidently only to have the floor collapse beneath me. I don’t like living this way, of course. It’s just another method of managing myself to deal with my mental health issues and burnout. But I can’t really afford to not act like this. I need to be cautious, I need to be careful, I need to make sure that any changes I’m seeing are genuine and not just coincidence. The placebo effect will fail pretty quickly, as I’ve learned in the past, so I can’t let it become a part of the structure I build to support myself. At the same time, I can see how constantly tamping down my spirits and forcibly lowering my expectations could have a negative impact on me that might undo some part of the benefits I’m seeing if I push too hard. It’s very easy for me to make myself miserable, after all–no one else is as good at it as I am. Caution is my watch-word, no matter what direction I’m going, and all I can do is hope that I’ll be cautious enough to avoid pitfalls but not so cautious that I can’t recognize a good thing when it happens. Another couple weeks should give me my answers. About this antidepressant, anyway. It’ll probably be a while longer before I get answers about the rest of it, though.