Wednesday, June 29, 2005

On Depression

Dogpoet is always riveting to read. His experiences are uniquely his own, but he has that gift of communication that makes us look inside ourselves, and make connections to our own experiences. By sharing himself, he exposes us all.

I have battled depression and anxiety since early childhood. If I'd had a different set of parents, I might have been on anti-depressants since I was fourteen, or Ritalin since age six. I'm glad I wasn't, and I'm especially grateful for the fantastic therapist I saw when I was seventeen, who helped me to stop torturing myself for typical coming-of-age angst, and to acknowledge the more serious events in my life. I came to realize that I was far more "normal" than I gave myself credit for; I was simply surrounded by a small-minded, uneducated, judgmental and sometimes cruel community. In a lot of ways, it really wasn't me - it was them.

I am a depressive though, make no mistake. They call it "situational depression," which simply means that I have plenty of crappy things in my life for me to be depressed about. My doctors never recommended antidepressants because my brain chemistry was showing every sign of functioning normally, given the life situations I was living through. Deaths in the family, abusive boyfriends, toxic girlfriends and sadistic acting instructors all played a role. It was when I stopped going to therapy that I exhibited self-destructive behaviors, such as not eating, or drinking to excess. As long as I kept talking things out in my appointments, I was able to remain objective about my life, and feel better about the person I was growing up to be. In this fashion, I've managed to lead what many would call a successful life.

My demons haunt me when I am alone and have no one to talk to. I might be at home, or I might be walking down the street. If I'm not talking with someone else, I'm vulnerable. It doesn't happen all the time - it doesn't even happen most of the time. It has to be triggered by something. It's usually anticipation, often of a social situation - I'm going to a party alone and am afraid nobody will talk to me, or I'm going to a new jam club and I'm afraid I'll make an ass of myself when I sing. If the fear is sufficient, something rises up from deep within me, a black tide of negative thinking, threatening to overtake me. Pure and simple fear.

Most recently, the uncertainly of my job-hopping has been sending me into fits of nervousness, making my heart pound in my chest, and I madly channel-surf the television for a distraction, or the internet. If I can't find a distraction, I can still, to this day, find myself crying over the bathroom sink, splashing water on my face, staring at myself in the mirror, wondering how my life got this way. Reminding myself that it has always been this way, that I have always been a failure, spiraling downward into self-loathing, my feet stinging from pins placed in my toe shoes by mean twelve-year-olds, hearing echoes of cruel playground laughter ringing in my ears...

And then it ends. Just like that. I look at myself in the mirror and say Oh, please, you're doing it again, just stop it! I know I'll get another job, and in the meantime, there's unemployment. My expenses are low, and I'm going to be fine. I'm being ridiculous, and I can laugh about it. I look at my arms in my sleeves, remembering why I picked out what I am wearing that morning. I look at the dirt in the corners of the shower stall that needs cleaning, and trot out to the kitchen for a paper towel. I'm back to normal.

At some point I call my Mom and say "I had one of those days today."

"Oh, honey," Mom says. "You ok?"

"Yeah," I'll say, "I just really hope I get another job."

"You will," she'll invariably say. And then we talk about other things.

Often I'll take a few minutes to just stand still and say out loud the things that my therapists helped me come up with: "I'm not afraid of you anymore!" to my self-doubts, to my grade-school tormentors, to the imagined specter of death that took my grandpa from me at thirteen, to my screaming, red-faced gym teacher, to the creepy old man in my neighborhood who asked me to take my shirt off when I was ten, to the pack of dogs that chased me, snarling and barking, on my bike for several blocks when I was nine. "You can't hurt me and you never will again!"

Sometimes I'll say "I don't need you anymore!" to my self-doubts, which once kept me from trying dangerous stunts that kids used to dare me to do, eagerly anticipating the good laugh they'd have when I fell out of the tree. My feelings of fear of the unknown were once useful to me... but now, they are obstacles.

Don't get me wrong - it took until I was 30 years old to be able to do this.

At least once a day, I stop in front of my altar to the Goddess, and touch the talismans that I have made over the years, reminders of my strength, my determination, my belief in myself, and my blossoming faith in the larger world that maybe, just maybe, there aren't monsters waiting around every corner, waiting for me to slip and fall, so they can have a good laugh. Maybe there never were. Perhaps I was always stronger than I realized. I am out-growing the victim mentality. I reach for the Goddess to remind myself that there is a warrior inside me, an Amazon and a queen. My fear crumbles to dust and blows away on the gentle winds of faith.

Hope, not fear.

Two things define my pathology: I am in the habit of suppressing my emotions, and when something does touch me, I feel my emotions more strongly than most. When someone hurts me, rather than strike back, I immediately swallow the rage before it gets expressed, and withdraw in some fashion. I am not sure when I first developed this behavior pattern, but I have been unable to break it completely, and may never do so.

I have gotten better at expressing emotions as they come, but I still suppress at times. Thankfully, the times I instinctively repress are usually in either professional situations, or in situations where I don't know someone very well, such as on the subway or the highway. In these two situations my instinct becomes a benefit. I will likely never have a problem with road rage, office insubordination, or smarting off to a gunman in the East Village. I am also the perfect person to work in customer service. No matter how much a customer screams at me over the phone, I will never reveal anything but a calm demeanor and an honest desire to make things better.

And at thirty-three, if a customer screams and insults me to the point that my voice breaks with a threat of tears, they know they have gone too far... and they apologize. Granted, this doesn't happen often, but when it has, accountability is held. This isn't the playground anymore.

Recently, I read an article about Cyclothymia, which is a very mild form of Bipolar Disorder. You still experience mood swings, but not to the point of suicide. The article's author suggests that too much situational depression can cause the brain to adapt to the stressed state, and be unable to stop functioning in this manner even when things brighten up. In other words, there is the possibility that situational depression can lead to endogenous, clinical depression if it goes on too long.

After twenty-one years of ups and downs, I admit this could be a possibility in my case, but I'm not ready to go there just yet. I did a trial of Paxil in May of 2003 when my company forced me to commute from Manhattan to White Plains, and I had an immediate need to get over my fear of inter-city trains. (Post-traumatic stress - that's another essay.) I was fascinated by the blunting of my fear instinct, but disgusted by the peripheral nerve side-effects. However, the meds did a great job at teaching me how to better handle fear and uncertainty. In the past, if I had found myself on the wrong train, speeding off to God knows where, I would have stayed in my seat, too embarrassed to admit I'd made a mistake, paralyzed, heart pounding, until I hyperventilated and someone called 911. On the Paxil, however, because my fear was dulled, my logic took over, and I was able to seek out a conductor when I realized I was on the wrong train, who calmly showed me where and how to transfer, and I completed my journey as though nothing had gone wrong, only 15 minutes late for work. Nobody noticed.

This experience and the realization of my power over my fear changed my life. I have treated virtually every new situation in my life different since then. Once I connected my shame of being seen as a screw-up with my inability to ask for directions, I wiped it out of my mind. There were no demons waiting to humiliate me when my inadequacies were revealed. This was a simple mistake that any adult could make. Indeed, I was not the only lost passenger on that train. I connected this with many other "mistakes" I had made in my life, and opportunities I had passed by for fear of screwing things up. There are a lot of assholes in the world who enjoy seeing others in pain, and I'd known plenty of them. Suddenly, they lost their power. One demon effectively slain.

Eventually I stepped off the meds, but since that time I have ridden not just the Metro North but the Long Island Railroad, New Jersey Transit, and an Amtrak. I haven't had a single "attack." And I actually enjoy telling the story of getting on the wrong train. It's pretty funny, in retrospect.

My father's work as a clinical neuropsychologist spurred him to develop the terms "Realistic Despair" and "Unrealistic Despair." As I understand these terms, Realistic Despair involves tangible, real-world things that anyone would realistically be depressed about. The death of a loved one. The loss of a pet. The contraction of serious illness that you may have to live with for the rest of your life. It is perfectly normal and natural to experience despair in these situations. It could be something like the dissolution of your company, or the loss of a beloved home. A person doesn't just "get over" these things - they will be experiencing periods of grief for a long time. In some instances, for the rest of their life, these feelings will resurface from time to time, and they may have to deal with it all over again. This is situational depression.

Unrealistic Despair, however, involves extreme statements such as "Nobody will ever love me" or "No matter what I try, I will fail at everything." Even these types of thoughts are experienced by normal people at one time or another - who at 15 hasn't looked at their braces-filled, acne-covered face and felt that they would never be loved? Who hasn't screamed in frustration that any further effort toward achieving anything is hopeless? Many of us feel these things from time to time - but the feelings fade. Pathological, unrealistic despair is when a person feels this way all the time, every day of their lives. This is endogenous depression.

I believe that it is possible for some people to choose to be happy, as Dogpoet mentions, but I am also of the firm belief that not everyone can, and that even those of us who can will never be able to sustain it indefinitely. Life is both beautiful and horrible. Life is unpredictable. Fear will immobilize us from time to time. Sadness will result from the loss of loved ones, and may stay with us for years. Human life is a roller-coaster, and despair comes and goes. How we deal with it, and how effective our support systems are, makes the difference between anxiety and mania, between sadness and suicide, between a person who says they'd like to kill someone and a person who commits murder. Medication is essential for some, and medicating is never an easy choice. I applaud those who have the courage to get the help that they need. But many others of us are simply dealing as best we can, and failing often, at working through the nightmares of life.

Dogpoet's post is a reminder to me that I have to remain aware of myself, and continue to seek help, like he did, when I catch myself sliding down that slope again. It is also a reminder that I have a right to be sad about the losses in my life, and that fear of the unknown is natural, as long as I don't let it control me. Of course, his situation is not mine, but I am moved to look inside myself, acknowledge myself, and start taking better care of myself in the same way he has. Thank you, Dogpoet.

Right now, a lot of things are going well for me. I am not out of the woods yet. I can see the edge, but I'd better not run for it. I've gotten as far as I have by stepping slowly, carefully and bravely forward, day by day. I have to remember to continue this slow, steady pace to my future, whatever it may hold. Last week, while meeting with my women's spirituality group, I stated my ongoing prayer request for "temperance and compassionate restraint." I'll know when the time is right to party. Not just yet.

Postcript: I just want to be clear: Tom Cruise is a moron.


Frank said...

There are so many great things in this post. It had bells ringing for me all over the place. Thanks from someone who has been a stranger in a strange land.

goblinbox said...

Ditto what Frank said.

I was recently telling my well-woman care provider about all my tools (for dealing with panic disorder) and she said, "Wow, you've really got a lot of great insights!"

Reading your post made me realize that a girl *must* have a lot of great insights to live with conditions like these.

At the end, it might turn out to have been one of those blessings, given not with malice but with love, to force us to mature into what we could not otherwise have been.

Knottyboy said...

LOL you were reading my mind on the Cruise issue.

You sound damn good sweetheart for the ups and downs you've had. Fear will immobilize all of us if we let it, sounds like you've gotten the tools to get and stay well.
Cheers on the work you've done and what you'll accomplish in the future.