Wednesday, June 20, 2007

Putting a Name To It

My depression has always been a dull throb for me. It’s like a headache that you’ve carried around for a few days that ebbs and flows but never entirely goes away. Sometimes you can forget that your head hurts but when someone asks if that headache went away you realize that you’ve just been ignoring it but it’s still there.

I’ve done a good job of mostly ignoring it but recently the throb has gotten louder; thus this blog. When I posted my first couple of entries I went scurrying out into blog land to see what others were saying about depression. I found a reference to Dysthymia. One of the main reasons that I thought it sounded pretty accurate was that it is long lasting and milder although no less destructive over the long haul; specifically Wikipedia says in time it lead to things “such as high rates of suicide, work impairment, and social isolation.” Boy, does that peg me. I’ll get into those later, especially the big S. In passing I mentioned Dysthymia to James over at Finding Optimism, who has been very generous to me and my blog, in an email. He replied that it seems unlikely since I wrote in an earlier entry that I suffer from most of the physical manifestations of depression. He’s got a good point. But if I’ve had Dysthymia for a long time then I’m due for some physical consequences, right?

In that previous post I described how I self diagnosed my depression. This was later confirmed at a mental health clinic where a counselor, who I did not like, told me after less than an hour of talking that I have a mild case of depression primarily caused by social anxiety. She also promptly told me that I should go on Zoloft (I think) which apparently would help with the social anxiety. This after I explicitly told her at the outset I didn’t want medication.

I’ve been reflecting on that diagnosis over the last few days. Whether she was trying to push the meds for some self-serving reason or she genuinely believed this it would have helped me I’ll never know. I do know that I’ve become very comfortable with her diagnosis. It makes sense, really. I have always been awkward with other people. I wouldn’t call it shy; I’ve often been called that but only by people that don’t know me very well. I’m very opinionated and sometimes quick to take offense and I’m never hesitant to express this to whoever dares cross me. But I do it very awkwardly and spend the next week or more dwelling on the event and invariably beating myself up for it.

Oh yes, I was a joy for my co-workers in the corporate world! Even those I still count as friends were probably as glad to see me go as I was to do so.

The best part about all of this is that any one of these incidents may come up at anytime to torture me. Years later and for no particular reason a memory will jump out at me; refined and distilled by this point to yet another self-told tale of what a blathering oaf I was when this and that happened. I will feel my face heat up and turn red. Typically I’m alone when this happens but if I’m with others I excuse myself to take a moment to savor the bitter taste of the memory once again.

Then the talking starts. This is a new thing and the main reason I try to be alone. No one, not even my wife, has yet caught me and of this writing this is the first time that I’ve consciously dealt with it myself. It starts with a grunt as I try to stop the me in my memory from making an ass of us. Then I babble forth some of the dialogue from the event and finally wrapping it with, “I’m so stupid.” It takes me another few moments to recover then I’m able to move on, generally in a darker mood. Eventually, it fades back down to the dull thud.

My wife says that I talk a lot in my sleep though she claims that she can never understand it. For this first time now, I wonder if I’m reliving these memories in my sleep.

Wow, I really sound like a mess, don’t I? Truly, I’m a functioning adult. These incidents only happen three or four times a month although they seem to be gradually increasing in frequency. They are very swift; usually taking less time than it took to describe them.

Depression brought on by social anxiety – I don’t know if it was a spot on diagnosis or a self fulfilling prophecy but it certainly seems to describe me now.

Sunday, June 17, 2007

Dealing With an Audience

Something unexpected has happened with this little blog. It has a readership. Now of course this was the ultimate intention – it is a blog, after all – I just didn’t expect it to happen so very soon.

Blogging about my depression was really the natural choice for me. I’ve tried writing personal journals about the problem but they invariably turned into ponderous, unreadable and ultimately unwritable examinations of the minutiae of my emotional life; nobody-understands-me manifestos. Blogging and the possibility that others would find and read it, awareness of a potential audience, kept that from happening. The possible pitfall of a blog is to swing too far towards pleasing the reader. The same impulse that drives me to answer “fine” whenever asked how I am has the danger of making this exercise vapidly meaningless.

But back to my small audience. I’ve been submitting my entries to social indexing sites like technorati and digg so my blog wouldn’t be allowed to retreat into comfortable, naval gazing anonymity and I knew that doing so would eventually lead to a readership. I just didn’t expect it to happen quite so quickly. And in referring to my readership don’t think that I’m getting swept up in anything here. I maintain quite a few blogs whose readerships range from two or three a day to ten thousand a day. The point about this audience is that it is huge in my mind when I write. Even though I’ve taken steps to remove the safety net, the fact of a real readership that exists now instead of in the hypothetical future substantially changes the way that I think about this project and, more importantly, how and what I write about.

Take this entry, for example.

So, where do I go from here? Initially I’d planned on a mixture of entries that more or less chronicled depressive events from life, sort of A Portrait of the Depressed Blogger as a Young Man, and entries about my current attempts at self help therapies. This would have all been foundation building. Not that my eventual readers would have cared. I really wouldn’t have expected them to find my blog six months in and go back to read all of the previous entries. But I would have had the foundation making blogging about my ongoing Portrait of a Middle Aged Man easier to maintain.

But the fact of the sudden readership makes me reconsider this plan. This isn’t a intellectual decision; it really happens at a gut level. When I sit down to write or even think about writing this current audience as already standing over my shoulder. Who really wants, I ask myself, to read about what would have been a non-event to anyone else in eighth grade algebra but turned into a festering thorn that took me fifteen years to come to terms with? As much as I’d like to be selfish and can theoretically defend selfishness in this case, now that I have readers with personalities everything’s changed.

Plus the huge amount about depression and the wide variety of therapies available (Light therapy? Really?) is staggering. So many seem to hold promise making it difficult to decide where to start. Dwelling on the past seems like a waste of time when there’s so much to deal with in the present.

What this hell is this entry about anyway? Well, I really can’t say except that I intended it to help me work out the new dynamic of the audience. (An audience for which I’m incredibly grateful, in case that wasn’t clear.) I’m really not sure if I’ve done that.

Thursday, June 14, 2007

What Does This Mean?

I had a dream two nights ago about a medical student who also happened to be a champion barbequer, or whatever the word would be. His ribs were his specialty and had never been bested in competition. People couldn’t figure out what he put in his dry rub but they knew that they liked his ribs.

Somehow, I became privy to his secret. At night he would steal the ribs from cadavers from the gross anatomy class but he was facing two problems. First, he was about to graduate and he was unsure where he could get ribs after he’d moved on from medical school. Second, his ribs were becoming more and more popular and he was having trouble keeping up with demand because removing the embalming fluids was a very delicate and labor intensive process.

So, what does this mean? What mysteries of my soul does this little dream unlock?

I doubt any other than the fact that I REALLY like ribs with dry rub (not too much salt) and if it does I’d rather not know what they are.

My approach to this depression thing is very simple. I don’t want to be depressed any more. I don’t care what started it. I don’t want to delve into my past and I certainly don’t want to participate in any rebirthing therapy sessions. I just want to feel better.

I am willing to do some self examination. It wouldn’t be possible to defeat depression without some reflection. Besides, it’s just a good thing. It’s good to know who I am and what I want. I just don’t want to become a self-absorbed naval-gazer who looks for meaning in everything.

Sometimes a cannibal is just a cannibal.

Tuesday, June 12, 2007

The Symptoms of Depression

I really hate the big pharmaceutical companies. I’m a US citizen that it’s generally known here that Big Pharm holds a huge amount of control over politicians. They use this control to squeeze more and more money out of our broken health-care system.

A few years ago Big Pharm managed to make advertising prescription drugs on TV legal. At first it might have seemed silly, advertising to consumers who would have to go supplicate to their doctors in order to get the drugs that they want. Well, Big Pharm was also working the doctor side of the equation and their TV campaigns were wildly successful.

This causes all kinds of problems. Patients taking wrong drugs or way too much for their ailment not only drives up insurance rates for the rest of us, it also creates a population more likely to produce drug resistant bacteria. And it creates a medical community that is more likely to believe in the power of drugs which leads to over prescribing. All drugs have side effects which sometimes require additional drugs if they are severe enough. The whole systems sets in motion a vicious cycle that, whether by design or luck, produces obscene profits for Big Pharm.

I could go on but I won’t. I just want you to get a feel for why I hate Big Pharm and the ads that they have all over TV.

Seven or eight years ago I was watching TV with my wife and one of these Big Pharm ads came on. Sometimes when I see one I delight in picking apart their wording to get to the heart of their deception. In this case the ad was for an antidepressant. The narrator, a silky voiced woman, said with great sympathy, “Do you suffer from…” and she listed around ten different symptoms while images of various sad people flashed on the screen. The deception here was so obvious that I had to laugh aloud.

“Of course we do,” I blurted, “That’s the human condition.”

My wife didn’t say anything. She just kept watching.

“I mean, these are daily things, right?”

Now she looked at me. “You think about suicide?”

“Well, yeah, doesn’t everyone?”

“Promise me you won’t do anything stupid.”

I laughed, “I’m to much of a wuss to actually do it. I just think about it.”

She let it drop then but a few days later she brought up again. She was obviously thinking about it.

I was too. The next time I saw the ad I wrote down the symptoms that they listed. I regularly experienced almost ever one of them to one degree or another. I decided to look them up and found them listed virtual verbatim on the National Institute of Health’s website under Symptoms of Depression. This was the first time that I began to think that I actually had depression.

Those symptoms are:

  • Persistent sad, anxious, or "empty" mood
  • Feelings of hopelessness, pessimism
  • Feelings of guilt, worthlessness, helplessness
  • Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
  • Decreased energy, fatigue, being "slowed down"
  • Difficulty concentrating, remembering, making decisions
  • Insomnia, early-morning awakening, or oversleeping
  • Appetite and/or weight loss or overeating and weight gain
  • Thoughts of death or suicide; suicide attempts
  • Restlessness, irritability
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

This is still a strange list for me. Except for those symptoms that become evident as changes from regular behavior, I’ve had all of these since as long as I can remember. There’s never been a catalyst; this is just how I live.

I don’t know if it will ever change. If I ever make enough money for it, I will seek a professional therapist, one with a holistic approach that won’t say “drugs” in our first session.

For now, though, this is all I have.

Sunday, June 10, 2007

Herbal Remedies

I really haven’t tried too many herbal remedies for depression. St. John’s Wort seems to be a popular one. I might even have heard once that it’s recognized in Germany as a “proper” drug and covered under whatever sort of health insurance system that they have.

I tried it once a couple of years ago – back when I was still toiling away in the corporate world – and found that all it seems to do was put me on edge. No, that’s not right because it sounds like I had coffee-like jitters. It made my emotions tenderer, like a new wound. And the effect was only on the negative emotions. I didn’t benefit from any super highs, no fits of uncontrollable happiness; only rage, sadness, and self pity. It was like it worsened the depression. I thought that perhaps my body just needed to adjust so I went ahead and stuck with it. But it was always temporary and negative. For the hours after my dosage I was always just on the edge of a meltdown and just about the time that that feeling would wear off it would be time for another dosage. I never experienced and overall lightening of spirit like I hoped I would. I finally stopped taking it after I got in a huge fight with a co-worker. I had indeed been inconvenienced by her but I completely overreacted. Luckily we didn’t work in the same department because I really never could look at her again.

So, what’s it all mean? Don’t take this to mean that I think that St. John’s Wort. With most things I’m a majority opinion kind of guy. If so many people find relief with it then there most be something to it. It just didn’t work for me. There’s another, somewhat conspiratorial possibility: Since the FDA doesn’t see fit to regulate herbal remedies it could be that I had a bad batch. It could be that it wasn’t St. John’s Wort at all. Maybe I was taking lawn clippings and my depression produced a predictably negative placebo effect.

I keep an herbal garden and thought I’d try growing the stuff but friends and family like to come over, point at different plants, and ask What is that? Remember, my diagnosis was depression caused by social anxiety. Think I’m willing to just grow my remedy where everyone can see? My wife knows that I’m depressed; I told her when I went to that clinic. But we never talk about it. She bought me a book once but that’s been it. Other than that I just don’t talk to anyone about it. I didn’t even tell her when I tried the St. John’s Wort. There’s not a chance that I’m going to try to grow the stuff.

The only other herbal remedy that I tried was indeed from my garden. I cracked my copy of Rodale’s Illustrated Encyclopedia to Herbs and read up on everything that I was already growing. It turned out that quite a few of my culinary herbs were also traditional remedies for depression or melancholy. I went to the local health food store and bought a couple of cups of bulk green tea then harvested large amounts of the alleged happy herbs – I can’t remember all of the herbs that I used but I know that rosemary and lavender were among them. (I know lavender isn’t culinary. It’s my only none culinary herb. I just love the look and smell of it.) I mixed them with the green tea leaves and started drinking the tea.

It tasted absolutely horrible. I’m making a face as I write this at the memory. Nothing I did to it could make it taste better. In the end I drank it with lots of honey. The honey didn’t take the taste away – with enough honey it just made the tea taste like honey and something horrible - though it did manage to make it a bit more drinkable. But here’s the thing: I really made me feel happier - content, really. For a couple of hours after choking down a pot of the stuff I really did feel better. I actually still have quite a lot of the stuff and I’ve almost thrown it out a few times but can’t bring myself to because it really does help. Unfortunately I also can’t bring myself to drinking it, either.

So, I started writing this post with the idea that I would announce a decision to try St. John’s Wort again – the thinking being that now I work at home I’ll give it another try. But why turn my back on the tea? I think that I’ll try to start drinking it again. I’m pretty sure that the green tea is a big part of what I don’t like about it. I will go to the store and find a different base like plain black tea and mix up some more of the stuff. Or maybe I will try it with just the herbs and no tea leaves. Some rose hips, dried apple or cranberries might just give it the lift that it needs. (I will also do a better job this time of cleaning the herbs. Part of the problem is that there is a bit on dirt on some of the leaves where I didn’t clean them very well. There’s nothing worse than getting dirt in your teeth when you drink a cup of tea.)

The only problem with this is that it is a temporary fix. One day of me not feeling like having my tea or being out of town could spin me right down into the depths again. If my problem is a chemical imbalance as Big Pharm would have us all believe then whatever remedy I find needs to be maintained. But if it’s all in my mind, as opposed to the physical brain, then using the temporary fix of a chemical high from herbs on most days could be enough to bring about the right kind of change in my overall disposition.

Tea it is, then. For now I’ll choke down the nasty stuff until I have a chance to go to the store and mix up some more. I’ll let you know how it goes.

Saturday, June 9, 2007

The Pursuit of Happiness

This is the inaugural post of a project that I've been thinking of for a while now.

Here's my story: I'm fighting depression.

*Right, see? I'm already rolling my eyes at myself. I'm embarrassed and a bit disgusted about all of this - the blog, my condition (ugh), that I have to write publicly about it, everything. But let's get back to it.*

I'm fighting depression. I've always known that I wasn't as happy as others or, more importantly, as I should be. Then, in a story that I'll tell later, I got diagnosed with depression brought on by social anxiety. Foolishly I said thank you very much and never again darkened the otherwise sunny doorway of that particular clinic.

Since then I started a home business and had to go out and find insurance for myself. In order to get a package I could afford I had to take one with no mental health benefits. Besides, I suppose when it comes down to it, this is a preexisting condition so it wouldn't have been covered.

Predictably, if I have to take the cheaper insurance package then I can't afford to go looking for professional help to be paid out of my own pocket.

I've been working at home for almost three years. At first it was heaven, given the social anxious aspect of my psyche. The depression was still there but a wonderfully supportive wife and a fulfilling job kept me above water.

But now I'm starting to drown. Circumstances that will be fully explored in later posts are conspiring to to pull me under completely. I really need help. I've been self medicating with bourbon and Comedy Central but these are only temporary fixes and they're starting to have their own detrimental effects on me.

So, I can't afford the professional help that I know I desperately need. What to do? I'm trying an anonymous blog. I'll blather on here about whatever is bothering me, the memories that haunt me, and how successful my self help remedies are. This blog is my therapist.

Its anonymous because I work in a pretty happy industry and I don't want to advertise this depression. Also, I'm terribly embarrassed by this and were I reading an in kind blog written by someone else I would lose all respect for them. Finally, I want to confess without worry and bitch about whomever and whatever I want. I feel restricted from that when I do these things under my own name.

This blog isn't going to be my only therapy. I'm also going to try some herbal remedies. I'll be reviewing these in futures posts.