Posts under ‘depression’

It’s 2am. Do you know where your insomniac is?

It’s been a few weeks since my diurnal nature has come into question. Wikipedia confirms that diurnal animals are indeed active during the day and rest during the night, and my personal experience confirms that, yes, I was once a diurnal creature myself. For the time being, at least, that seems to have changed, much to my chagrin.

So, what does a fatigued nurse do when the going gets tough at 2am? The trusty laptop is always a nice distraction, but if my mind is reluctant to be engaged, soft music or desultory attempts at meditation sometimes manage to keep my mind at bay. And then there’s always TV, every insomniac’s potential best friend, infomercials and all.

My sleeping patterns are apparently in flux, and as I navigate the beginning of my third week without pharmaceutical antidepressants, I assume that my nocturnal discombombulation is a direct result of that most apparent physiological and chemical change.

The acupuncturist/naturopath who is guiding me through my current health crises has been working diligently to cut through to the essence of my symptoms, focusing in on pain and depression as the issues most in need of immediate succor, an assessment with which I am in full agreement. Whereas no provider has been able to pinpoint a physical cause of my chronic pain, we are led to believe that the pain is indeed of psychoemotional origins, and no combination of narcotics and physical manipulations is going to assuage it.

Battling unseen demons has become somewhat of a personal habit, and these wars being raged in my body and psyche have apparently led to the taking of prisoners, and my ability to waltz with Morpheus appears to have been first on the list of casualties. My hope is that, through acupuncture, herbs and emotional inquiry, we will get to the bottom of the pain, knock the depression on its head, and (finally) help me to move beyond this current state of sleeplessness.

I understand from my recent readings that Barack Obama is a night owl, frequently burning the midnight oil at a time of day when he does his best thinking and ruminating. I’m glad to have such stellar company, although I certainly do not have the weight of the world on my tired shoulders.

Perhaps in a few weeks I’ll be able to look back on this period of disrupted sleep with equanimity, hindshight, and greater self-understanding. But for now, I’ll continue to entertain and distract myself as well as I can during these lonely wee hours of the night. There are blog posts to write, Twitter to catch up on, French to study (my newest endeavor in self-improvement), and a plethora of infomercials to avoid as I surf the channels of television purgatory. If you happen to be up, send me an email (see my Blogger profile) and we can have a late-night chat about the weather or the news of the day. Til then, enjoy your own sleep, treasure those uninterrupted hours of rest, and say a prayer for those of us whose circadian rhythms are hopelessly askew.

As was once so aptly stated, “to sleep, perhance to dream.”

Hercules, Sisyphus, and Depression
I’ve been trying to decide if living with depression is a Herculean task or a Sisyphean existence. Mythological stories and figures often offer a way to examine our lives through a different lens, and Hercules and Sisyphus are two figures who have frequently struck me as potential fodder for an examination of the vicissitudes of depression.

Hercules, as we know, was a mythological figure of extraordinary physical power, an ancient precursor to the modern Superman, with the strength to shoulder burdens far beyond the measure of ordinary humans. While I cannot remember specific challenges faced by Hercules and recounted in ancient stories that have passed down to us through the ages, I can picture said hero rescuing civilizations, conquering entire armies singlehandedly, and otherwise accomplishing that which mere mortals could only perform in their very dreams.

Sisyphus, on the other hand, was a sorrowful creature condemned (for reasons I don’t recall) to a monotonous life of endless toil in the shadowy realm of Hades, living out a life without end on the side of a cruel and unforgiving mountain. You may remember that the task faced by Sisyphus was to roll a heavy bolder to the top of that mountain each day, an arduous and thankless task without reward. Sadly, Sisyphus was eternally doomed, and the task—which he was compelled to perform for all eternity—would end in maddening disappointment as the boulder rolled back down the mountainside just as dear Sisyphus was about to reach the summit with his burden. Thus, our anti-hero would begin each day with the same daunting and impossible task ahead of him, his voiceless stone companion patiently awaiting his efforts that were assuredly going to end in utter demoralization.

This examination of the Herculean and Sisyphean myths offers us two disparate notions of how the depressed human being faces the challenge of setting his or her feet on the floor with each earthly sunrise. Does the day seem like a heroic task which the modern depressive hero faces, assuredly daunted, yet ever willing to tackle? Or does the day appear as an insurmountable burden, a boulder of enormous proportions that the sufferer is doomed to roll up that forbidding hill, despite the knowledge that his or her efforts will always lead back to the same damning place of burdensome failure?

Hercules and Sisyphus—those mythic figures of old—live inside me (and potentially every sufferer of depression), jostling for position within the psyche like morning commuters on a crowded urban subway car.

Hercules, girdled with a wide leather belt, silver buckle, gold shield, loincloth and sandals, flexes his muscles and readies himself for the fray, prepared for battle, be it of the emotional, psychological or the physical realm. Steady on his feet despite the rolling of the psychic subway car, this eternal hero can survive anything the Universe sends his way, even against a foe as insidiously powerful as the demons of depression. Were depression itself a river, Hercules would himself be a stalwart dam of self-reflective power and emotional control. He would prevail despite the odds, immediately ready for the subsequent onslaught, tireless in his defense of self-righteous emotional equanimity.

Sisyphus, on the other hand, greets the day in a tattered cloth tunic, barefoot, his blistered feet bleeding from the toils of the previous day. Unlike Hercules, who can ride the emotional subway car like a California surfer riding the edge of the Pacific, Sisyphus is thrown hither and thither as the car lurches around corners and arrives shrieking to yet another stop along its torturous track. Emerging from the car into the hew day, Sisyphus shoulders his burdens with the full knowledge that, no matter how determined he may be, the day will end as it began: unforgiving and damning, the next day sure to be as painful as this one, any progress made only to be disappointingly reversed once again.

As those of living with depression face our days, saddled with the emotional yoke that many of us wear throughout our lives, which of these mythic figures do we emulate as we plant our feet on the floor and face the new day? That, my friends, is an important question that we each must answer for ourselves.

According to the website of the National Institute of Mental Health, depression is the leading cause of disability among Americans between the ages of 15 and 44. Further statistics show that 6.7 % of the U.S. population (14.8 million adults) are affected by Major Depression in any particular calendar year. And at least in the U.S., more women are diagnosed with depression than men, with the median age of onset being 32 for both genders.

When reading these numbers, please bear in mind that this reflects only the statistics vis-a-vis Major Depression, and does not include significant data concerning Dysthymic Disorder and Bipolar Disorder, as well as the myriad anxiety and personality disorders, phobias, PTSD, and other mental illnesses.

Extrapolating the data to include all mental disorders, the numbers of astounding. It is estimated that 26.2 % of all Americans 18 and older (more than 57 million adults) suffer from a diagnosable mental disorder, however only 6-7 % have a serious mental illness.

Here on Digital Doorway, I have disclosed a number of times that I have lived with Major Depression for many years, dating back at least to adolescence, but most likely into early childhood. Having suffered Post-Traumatic Stress Disorder (PTSD) in late 2001 following the murder (by police) of a close friend, my struggles with my mood disorder have been even more challenging. With chronic pain also on board, my life has certainly become significantly challenging in my 40’s, the aches and pains of middle age supplanted by the daily punishment of pain that is (so far) untreatable, often occurring in concert with stultifying depression.

We are all statistics in one way or another. We can all be catalogued, categorized, compartmentalized, boxed, packaged, and graphed. Be it our gender, race, income level, tax bracket, profession, educational level, marital status, gender identity, or any other label-ready identifier, we can all be lumped into a veritable mosh-pit of humanity and stirred into the statistical melting pot.

So, yes, I do indeed identify as being a person who lives with chronic pain and depression. At times, I actually identify as being a person living with a mental illness, and I have occasionally played with actually saying that I am mentally ill. These labels that we give ourselves or allow others to give us have power, and I am often admittedly ambivalent about them. It’s always easy to say that someone else is mentally ill, or that someone else has this or that disorder. But when we look at our ourselves, placing that very same stamp on our own forehead can be another issue altogether.

Many public figures have come out of the mental illness closet to talk publicly about their lives. Legislators, actors, musicians, writers—they cut through the stigma by normalizing depression and mental illness, serving as beacons to those who fear betrayal, judgment and real discrimination.

As a person with multiple chronic illnesses and disabilities, I am seeing more and more clearly that I need to be increasingly outspoken about my own experiences, to use my writing and communication skills to help to normalize this very universal experience. I hope that my writing about my own life can serve even one person in making sense of their own struggles. Whether I am ever aware of that effect is beside the point. As a blogger and writer, I am indeed a public figure, and I want to use this soap box for more than my own aggrandizement.

If you are one of those people who suffer in silence, know that your suffering—while apparently solitary—is shared by many, and I encourage you to reach out in any way that feels comfortable to you, breaking the isolation that can feel so crushingly impervious. If there are indeed so many of us, then we are certainly not alone, and it’s up to us to be more than a statistic on a graph. We are individuals with lives of importance and meaning, and no diagnosis or label can take that away.

Is mindfulness possible during periods of depression? Is it possible to be mindfully depressed? Can you experience depression but still remain aware that that state is only a transitory one akin to a veil draped over one’s mind and heart?

I do believe that this is possible, and I believe that this is what I have experienced during the past week. After decades of suffering from depression, I am hyper-aware of its effects on my life, and with my condition in relative remission at this time, it’s power over me is significantly diminished and I find that I can actually observe it with some level of detachment.

If I can observe my states of depression with detachment, then one would have to assume that there is also some modicum of attachment to depression as well. When the pall of depression makes itself known, I’ve been aware for decades that despite the discomfort that is part and parcel of depression, there is also a level of comfort that’s experienced while one is depressed. Depression gives one permission to withdraw, creating a mask or a veil behind which one can hide and rest. And without knowing it’s happening, the depressed person can begin to identify so strongly with that state of mind, that it becomes more and more difficult to detach from its grip. Sadly, some people consequently stay in that place for years.

This past week, I’ve been recovering from the flu, withdrawn from the world and mostly enclosed in the house. Having just visited family, my mind has been flooded with memories and feelings which have necessitated a great deal of emotional processing. Due to my acute illness, my chronic pain has been significantly flared, I’ve had trouble exercising, and my concentration has been poor. Watching movies during the day, my tears have fallen with little warning, and my floodgates seem to have opened, allowing some cleansing to occur.

Now, as my flu symptoms subside and I prepare to reenter the world tomorrow, I also find that the veil is lifting, and I am seeing more clearly. I have been mindful of how I have been feeling all week, and in this mild state of depression, I have felt no panic that it would become a protracted experience. I have remained aware that this state is transitory in nature, and I have felt assured that, just as the buds of Spring will make themselves known any day now, the buds of my self-awareness and clear, non-depressed mind would also manifest without much effort.

Living personally with chronic pain and chronic depression, I am seeing manifest in my own life how these two conditions so frequently feed off of one another. These insidious parasites will, if not paid a fair amount of attention, bleed the joy from one’s life without a second glance, and anyone who suffers from either knows how, from one moment to the next, life can indeed be turned on its head.

As far as research goes, the jury is in: depression actually can cause pain, and chronic pain can lead to chronic depression. According to some studies, up to two thirds of patients with depression who are interviewed will report moderate to severe pain, with the back, the joints, the head and the abdomen as the most common areas of complaint.

For me, the depression has been life-long, as far back as I can detect—even to childhood. As far as pain is concerned, what used to be periodic back pain requiring intermittent chiropractic and massage has now mushroomed into chronic pain (which is often between 6 and 8 on a severity scale of 1 to 10) and which has begun to limit my ability to do the things I love. A year or so ago, when the pain was really beginning to ramp up in intensity, I made a promise to myself that I would not allow myself to begin that inexorable slide down the slippery slope of loss that pain can instigate. But as I have communicated here on Digital Doorway before, those losses have begun to take place, and I pray that some of those losses will eventually be reversed.

The scary thing about pain which has neurological symptoms is the potential for an underlying neurological disorder such as Multiple Sclerosis. I have seen enough patients with neurological illnesses to know that it is not a fun place to spend one’s days, and I am clearly hoping that my forthcoming evaluations over the next few months will reveal a true lack of chronic neurological illness. Still, I realize that this is a potential outcome, and I really should be prepared for anything.

As for depression, it certainly does not make pain any better, and on days when my pain is at its worst—like yesterday, for instance—depression will often deepen. For several decades now, antidepressants, psychotherapy, diet, exercise and a loving and supportive wife have been the cornerstones of my armamentarium against depression. Now, I need similar success in my battle against pain, although up until now, the pain has been winning out.

Stay tuned for news from my own personal medical front line, as I seek a referral to a neurologist in order to delve deeper into the potential roots of my pain. And perhaps, with any luck, I can manifest further healing in my own life, and be of even greater service to others as I greatly wish to be.