Travelling has always been a passion of mine. Since I got sick, travelling with depression means my illness gets its hands dirty interfering in my travel plans and hopping along for the ride.
So much for trip cancellation insurance
In 2007, I had planned to do an organized tour across China, Mongolia, and Russia with a couple of friends. Around two months before our planned departure, I ended up in hospital with psychotic depression following a suicide attempt. So much for that trip. It was the one time I had ever purchased trip cancellation insurance, so I went ahead and made a claim, but the insurance company came up with an excuse to deny it. I’ve never bothered purchasing cancellation insurance again.
Travelling while unwell
In 2012, I was feeling quite a bit better after a 2-month hospitalization in late 2011, so I booked a 2-week trip to Russia for that summer. As the trip neared, it was taking more and more effort to hold myself together. Then the day before I left, things just fell apart. I went ahead with the trip, thinking it would at least be a distraction, but my mood remained low, and I found myself just going through the motions and not enjoying anything.
In 2014, I had planned a trip to Central Asia (Uzbekistan, Kazakstan, and Kyrgyzstan). A few weeks before I left, a stressful event brought on a relapse of my depression. I was very slowed down, both in movement and in thinking. An increase in lithium helped, but I still wasn’t feeling great when I left for my trip. I found myself having to schedule at least one or two nap breaks into each day, and sometimes I would just run out of gas and have to sit myself down wherever I could, even if that meant the floor or the sidewalk.
I think teleportation is the invention that I would most like to see happen in the near future; it would make travelling with depression significantly easier. I’ve never been all that keen on the actual in transit part of travelling; it’s uncomfortable and often a real pain in the ass. But when I’m not feeling well, uncomfortable is definitely not a strong enough word to capture how yucky it is. As I was at the airport waiting to leave on my recent vacation, I felt totally overwhelmed by external stimuli, which made me feel so dizzy I thought I was going to pass out. I was desperate to drown out the onslaught of noises, so I blasted my music on my headphones as loud as my ears could tolerate.
Being on the plane was also difficult. I’m a fairly hippy girl and the girl next to me was even more endowed in that department, which meant that it was very hard to prevent our legs from touching. Normally this would be no big deal, but as sensitive as I was feeling, this was just not working for me. This translated into me trying as hard as I could to pour myself out of the seat and into the aisle. Luckily on the flight home I had an empty seat between me and the next person over, but she was very antsy, and that in turn triggered me.
I am quite prone to motion sickness, and having barfed more than once before on planes, I always take drugs for this. Normally I take Gravol (dimenhydrinate), and it has the side benefit of sedating me at least a little bit. But on this particular occasion, I had run out of Gravol, so instead I took some promethazine that I’d picked up in India a couple years ago. That’s not actually as dodgy as it sounds; it does prevent me from barfing, but doesn’t sedate me at all. Damn it, should’ve brought Ativan!
I have to recognize that my early 20’s, a time when my body and mind were functioning optimally mental illness hadn’t yet reared its ugly head, and I could sleep almost anytime, anywhere… well, those days are far, far behind me. I need to drill it into my brain that I can’t function that way anymore now that I’m travelling with depression, and it’s important to prepare myself better for experiences that used to come much more easily. If nothing else, I’ve learned that Ativan needs to be a basic part of my sizeable travelling pharmacy (which I’ve written about before in How do you say antidepressant in Uzbek?).
Dealing with medication
Lithium is definitely the hardest medication for me to travel with. I have to be very mindful of my hydration, and sun, heat, and alcohol all can have a major impact. Particularly in countries where tap water isn’t necessarily the best idea, water intake requires effort and planning. When it’s hot, I can’t be sure if I’m losing much lithium or mostly just water through sweating. When I was in India, I had diarrhea most of the trip, and again, I knew I was losing fluids but wasn’t sure how much salt I was losing as well. When my lithium level gets too high I get a bad tremor, headaches, and nausea. With no handy way of doing a quick lithium level check (besides a teleporter machine, I need a blood sugar-type monitor for lithium to be invented), I just have to guess.
When I was in India and again when I was in Mexico, I made the assumption based on my symptoms that my level was high and lowered my dose accordingly, which did seem to help. I was able to find a few research studies that suggest there can be climate-based variations in lithium levels, but it doesn’t appear to be something that’s been studied very much. It bugs me having to think about this. It’s not that I have a problem with lithium per se; I just hate having to blindly approach the situation without the benefit of a lab or a doctor to problem-solve with. At least my recent 1-week trip was short enough to be fairly manageable, but still, the frustration persists that I have to think about it at all.
Adding to my fluid balancing woes is that my body seems to have learned to automatically kick into travel mode, with my kidneys presumably trying to make life easier for me. This has served me well when I’ve been on long train or bus rides with icky toilet options, as I can sometimes go up to 24 hours without urinating. On the day I returned from my recent vacation, I went 12 hours without urinating despite drinking around 2L of water during that time. I don’t know if this is something that happens to other travellers, or perhaps I’m just a random oddity.
Speaking of oddities, it would be nice if solo travellers weren’t seen as going against social norms/expectations. I’ll leave most of this rant for another post, but for now I’ll just say that when I’m not feeling very well and I’m treated like a weirdo because I’m on my own, it just plain sucks. I wish I could bring my pet guinea pigs along to display as my companions, but they are non-stop poop factories, so it just wouldn’t be practical.
I’ve accumulated enough credit card points for a free flight to Europe, and I think I’m going to aim to do a trip this fall. It would be the first time I’ve booked an international trip (other than a short beach getaway) knowing that I’m not feeling so great. Given that I’m just working casual I don’t have to worry about booking off vacation time advance, so I can leave it until relatively last minute to make a decision. I’ve seen from past experience that I can get manage travelling with depression even when I’m pretty unwell, so it may be a good idea to push myself to do something that I might actually end up enjoying Stay tuned.