It is September 25th, and the winter depression is already beginning. Joy.

I have had to go off St. John's Wort, because I have started taking the Pill, and St. John's Wort can lower the efficacy of the Pill by as much as 50%. Double joy.

Also, the anitbiotics I am on seem to have done nothing so far for whatever is causing this immense pain in my head, and then, there's the insomnia. Triple and quadruple joy. Yippee.

This is what I do, though, every fall ever since I can remember being aware of the progression of the seasons. I am like one of those mantle clocks with the extra rotating dial with pictures of the seasons on it, only instead of falling leaves painted on my dial to signify autumn, I've got a half-empty glass of water and a snot-filled kleenex on mine.

Every year, I take my time weighing the options (drugs? acupuncture? cleansing fast? therapy?) until the insomnia that accompanies my depression has me dangling dangerously above a pit of my own paranoid delusions. Then, I take St. John's Wort, which doesn't do everything I wish it would but does enough to yank me back off the ledge and stop writing tragic poetry about death. I don't have that option to fall back on this year, and it makes this whole impending winter propostion seem more than a little dodgy.

I am thinking that I may end up leaning toward pharmaceutical anti-depressants, which makes me uncomfortable. I don't have a good track record with the pharmaceuticals. The first time I tried brain drugs, my psychiatrist had diagnosed me a paranoid schizophrenic, and the carbamazepine he prescribed me put me into a nearly catatonic state. My boyfriend at the time was a wonderful man who was willing to make sure I ate, got dressed in the morning, and went to the bathroom regularly. I am not kidding you when I say that I drooled a couple of times. The second time, my third psychiatrist diagnosed me a schizoid affective, and the perphenazine she prescribed made me dizzy, turned my urine green, dried out my mouth, made my heart race, and made me feel as though I had something perpetually stuck in my throat. My third go at pharmaceutical therapy was at my own insistence about six years ago, and I ended up taking paroxetine, which made me pack on thirty pounds of extra weight before my wedding, and weaning myself off it made everything taste weird, gave me visual disturbances, produced random thoughts of offing myself, had me prematurely orgasming thirty seconds into sex, and made me too paranoid to socialize properly for months. Granted, that second-to-last side effect wasn't the worst thing I've ever experienced, but it put a new spin on the quickie.

It has been six years since I've taken a prescribed medication for whatever my condition happened to be depending on which psychiatrist happened to do the diagnosing. I have been leary of trusting psychiatry since I was diagnosed a paranoid schizophrenic, a manic depressive, and a schizoid affective within a three-year time period back in the mid-1990s. Still, it has been six years, and new drugs have come out that may be kinder to me than the ones I have taken before. I do hold out hope.

But... What if I have to suffer all those side effects again? What if I don't take medication and my depression takes hold? What if I do take medication, and it doesn't work? Of course, I could play the What-If game all day long and be no closer to doing anything about this krazy karpet ride I am currently taking downhill into despair right now. Although, it might be better to hit a tree halfway down the hill than ride it out all the way to the bottom, by which I mean: it might be better to suffer the dry mouth and headaches if I have to rather than purposely go headlong into my own emotional doom.

Also, you might be saved from such truly painful metaphors as the ones I've been employing in this entry. There would be far fewer my-brain-is-a-mantle-clock or krazy-karpet-ride-of-emotional-doom references. We would all win.

For those of you out there who have issues with mental illness, how do you deal with it? Is your method of dealing with it pharmaceutical, otherwise, or a mixture of different methods? Is it effective? Is there any particular method of treatment that you would suggest I stay away from as a general rule? How do you feel about psychiatry? Is the pharmaceutical industry your chemical boy/girl/otherfriend, or did you have to break up? Is a lye bath for my brain a bad idea?

Wow. I just had to give my head a shake. Did I just ask you internets for something that could be construed as advice? Yikes. It's not that many of you are not full to the brim with personal experience and good ideas, but there is always the chance that I am going to get comments and/or e-mails telling me to get a sex change operation already or to get into yogic flying or to remove all the lucite from my home before my brain turns permanently squirrelly. But then, who am I to say that they're wrong? Perhaps if I removed all the lucite from our home, had a hysterectomy, and floated around the apartment a few times a day in a state of bubbling bliss, all would be well. I do know that eating potato chips, hiding in the bath, and four hours of sleep a night haven't been doing it for me, so I shouldn't discount any options out of hand.

Just so's you know, I have been taking a high potency multi-vitamin, having extra naps when necessary, eating my vegetables, and not subjecting myself to too many stressful situations. And yes, I do have a full spectrum lamp at my work desk that I leave on every day. I am green with the bloody chlorophyll already. I assure you that I am not just wallowing in my own filth waiting for the magic cure.

Without the Wort to fall back on, I've got options to weigh, people, so have at it in the comments. Tell me about your trials and tribulations, your game plans and victories. Chop chop.