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I once read a story where everything changed and nothing stayed the same. What I mean is, that every day, when the protagonist awoke, things would be different from the day before. Some days he would have a wife, but never the same one. Some days he would have children, but they were never the same children. His house was different; the route to his work was different. Nothing was ever the same. Then one day, that all changed; everything did stay the same and he found he couldn't cope.

It used to be a bit like that for me, but in reverse. The world stayed the same, but I was different every day. Whether in a manic phase or in deepest depression, the days were never the same. I was never the same.

With this new medication, I wake up every morning feeling – about the same: fairly cheerful; moderately energetic and enthusiastic; reasonably alert. Not exactly the same – hey – human here, but – pretty much. After six months, I am just about getting used to it.

So, a little while ago, when, at a friend's house just before lunch, I was suddenly and for no reason, overwhelmed with a desire to weep, to crawl away into a dark place and hide; I was horrified. Was this the depression coming back?

The world retreated behind a thick plate-glass window and sound became dim. My thoughts started that cockroach skittering, that rat scrabbling, in the corners of my mind. The tide of foul darkness engulfed like floodwater, icily cold.

Depression.

Please, no!

Panic!

Then a lance of bright pain pierced behind my left eye and I remembered. Ah yes – migraine.

Some people get visual "auras" with migraine. Things blur, or zig-zig; one side of their sight might disappear. I get what's called a "neurological aura"; it affects my emotions. Oddly enough, the moment the pain hits, the aura disappears. It's almost a relief. I know that I must take painkillers and lie down for a couple of hours (sometimes more) and it will be over – all bar that floaty, head stuffed with cotton wool feeling, that is.

I hadn't had a migraine for years; I thought they had disappeared for good once I left my highly stressful job, but now they have reappeared as a side effect of the medication. I'll happily take that swap.

But it made me think. How many of the symptoms of our depression are the depression itself? How many may be attributed to physiological reasons?

If we are exhausted, if we have not eaten or drunk enough, if we are in pain; the mind will reflect this.

We know that some of the symptoms of depression are the overwhelming desire to sleep and a craving for carbohydrates. This is the brain decoding the symptoms of depression and effecting the "cure" it knows has worked for similar symptoms before.

But it's always worth thinking about the physical causes of depression.

Before you panic.

Mary

A Moodscope member.