Wednesday, September 15, 2010

The Long and Winding Road

I warn you. This is going to be a long post. I am also nervous about this. This will be the first time discussing my depression in public. Not even some members of my family know that I've been battling this on and off most of my life and none of them know the gory details.

Why is this? I am old enough (almost 50) to remember when dealing with mental illness wasn't cool. You were frowned down upon, less than, defective, irreparable. Of course this was prior to the politically correct age and the plethora of antidepressants that are available now. Back then depression was seen as a personal defect that you should be able to pull out of if you just put some effort into it.  If you couldn't you should be locked up. They didn't yet know that it was due to a chemical imbalance in the brain.

My lack of forthcoming is also a result of being English. My Mum was raised by a Victorian era grandma. You don't talk about it: keep a stiff upper lip: get on with it, kind of people. This was passed on to me. Unfortunately there seems to be a genetic predisposition to depression that runs in my family. I've seen evidence of it in my Mom (sorry to out you), me, my sister and even my son. I don't know about my other sibling. We aren't close enough with each other to discuss such things. It's just not the done thing.

So when did this family secret first raise its ugly head? I was actually a very happy kid. I even adjusted well when my family emigrated to the US from England in 1968. However, when puberty hit so did the depression. It was like a switch being thrown. Apparently when my brain got rewired it had a few bad spots woven in. (MRIs show that the adolescent brain is physically rewired during puberty. The prefrontal cortex catching the brunt of this reconstruction. It also explains why teenagers do the weirdest stuff.) I had my first bout with clinical depression somewhere around the age of 14. I really should have seen someone since I was borderline suicidal at the time but back then depression was kept hidden. I managed to pull out of this myself by deciding one day that I didn't want to live like that anymore. I started to do things just to get me out of the house. Stupid things like going to the grocery store; being English we used to shop every day. But it worked to a degree. I became functional again and was no longer suicidal.

Since that first bout of depression I was what used to be called melancholy, a low grade depression. I was angry all the time. I had obsessive thought patterns. I was sullen and quiet. I made few friends and kept to myself. My bouts with full blown clinical depression seem to occur at major changes in my life, getting married, moving across state,going away to college, coming home from college, becoming a mom, etc.

The bouts I had around college were mostly ignored. I did try several different talk groups on campus none of which were helpful. I healed more by leaving behind my dysfunctional group of "friends" and joining a new group of highly functional friends in a new dorm. These are people I am still friends with today. I haven't heard anything from anyone in the dysfunctional group.

The bout of depression I had after I got married was the first successful professional treatment and the most successful drug treatment I had. I did a round of talk therapy with an excellent councilor who put me on Prozac which I did very well on.

The next bout I had occurred after I moved across the state. That one wasn't dealt with very well. I had a different therapist who wasn't very good at talk therapy and they never gave me Prozac. Again I pulled myself out of it enough to function normally again and the HMO I was in declared I was "cured".

The bout I had after my son was born had to be dealt with through talk therapy since I was nursing at the time. I didn't make the adjustment to motherhood easily and I still get pangs of jealousy when I hear about parents swooning over their new baby. I hated being a new mother. This time I had a very good therapist and we decided together not to pursue drugs.

Then, in 2001, my world fell apart. I had a HUGE problem with my marriage, I became the target of sex discrimination at work, there was a major fall out in my husband's family and a minor rift formed in my own family. If I had to deal with any single event I might have been okay but this was the perfect storm. Every support system that I had failed within months of each other and I fell to pieces. I still had my great therapist but she couldn't prescribe drugs so she sent me to a psychiatrist and the medication nightmare began. He must have been on the receiving end of kickbacks from the drug companies. I told him I did well on Prozac but he insisted on trying me on the new meds first. I was too messed up at the time to refuse. I cycled though each new drug having one adverse reaction after another; thoughts of suicide, loosing time, no muscle strength, staring off into space for hours, hearing voices, thoughts of killing others. After a half dozen different drugs I said enough. I was done. I didn't care if I was depressed it was better than being parked on my deck wrapped in a blanket for hours on end while I drifted off to nowhere. I spent the next several years in talk therapy. My husband and I patched things up. My work situation changed and I slowly became functional again.

Now, between my terrific husband and wonderful therapist I managed to get out of my chronic melancholy and perpetual anger but I still suffered from obsessive thoughts. My real breakthrough came when I started practicing Buddhism with a nun. I learned meditation. I learned Buddhist philosophy. I attended weekly classes and special seminars. I participated in a healing ceremony and became part of the tiny Buddhist community in my town. All in all I did a steady practice for about three years. During this time my thought patterns changed. My obsessive thoughts stopped. The melancholy went away completely and I was happy most of the time. During this period my therapist and I decided that I no longer needed her services and I haven't gone back since. There is now MRI evidence that the brain gets rewired in a person that practices meditation. There are several studies that have been done on Buddhist monks specifically. Luckily the Dali Lama is very curious about science and has volunteered his monks for all sorts of brain studies. I don't know if the results are the same with people who practice other forms of meditation or prayer but I suspect that there are detectable changes in brain wiring.

Now I am facing another major change in my life and I am on the lookout for the symptoms of depression. Both my husband and I know that it often shows up in chronically ill people. It makes sense. Your life has totally changed. You can't be the person you were. You have to reinvent yourself. At least now I know what to look for and I know enough to call my cool therapist as soon as I start to get into trouble. But so far I doing fine considering. I'm five months into my illness and I'm generally still pretty happy. I get cranky on bad days but I figure hey I'm allowed. I've been reading about treating serious illness as the "dark night of the soul" and using the illness as a soul journey. I enjoy putting a philosophical framework around my illness. I have been toying with various definitions of success and happiness. I have been thinking about the cultural norms that are imposed on us and the roles society imposes on us that we willingly take on. What will I become as a result of this illness? Who will I be? Instead of dreading this trip into the abyss I see it as an adventure. But I still have my spyglass in hand scanning the horizon for any warning signs of that ugly monster. So far so good. Maybe I should put my therapist's number on speed dial just in case.

Some older musings on the chronic life:
My Labels Have All Fallen Off
Why Am I Not Angry?
Secret Worlds


  1. Wonderfully honest and open post! Thank you for sharing! I feel so bad for everyone who has suffered with depression or any mental illness years and years ago when the stigma was much worse than it is today. Atleast we can talk about it now...some easier than others of course. Thank God for support systems, whether its family, friends or medications! Thank you for opening up on such a difficult topic. I have found since my illness, I tend to be an open book...not ashamed of anything really..not shy about telling anyone all about me and my problems. I feel by talking about our own issues, we may somehow help someone else who has the same problems find a way to deal...just like you just did! xoxo

  2. Thx for sharing your experiences with depression! I know it's not easy to be open about such things, given that I'm a little older and know all too well the stigmas attached to folks who weren't "quite right in the head."
    My chronic depression began in childhood, long before my chronic pain/chronic illness issues became a daily struggle.
    Like you, it runs in my family: my mother (who spent the last 18 years of her life miserable as she would not admit, even to her family, that she was depressed so she received no treatment for it.), my father's family has a few folks who probably suffered from clinical/chronic depression.
    Somehow, knowing/acknowleding that I inherited the likelihood that I'd be depressed made it easier to accept.
    I didn't start taking meds on a regular basis until a few years ago. The anti-depressants work for a time (only to stablizer my depression, not relieve it), but then stop working, so I try another one (I'm transitioning right now between a newer one to an older one).
    I've had bad luck with counselling: most of the one's I've seen thought my depression was just situtional, and that I could change the triggers. What they didn't get was the fact I couldn't change my triggers (my family, my illnesses, my pain) or just make my depression go away. And that was the attitude of consellors! One even told me that if I joined a competitive sports team (I'm not that athletic), my depression would go away!
    I'm glad to hear that there are GOOD counsellors out there! That restores my faith in talk therapy as a means to an end!
    Thx again -- my comment ended up being longer than I intended.
    I'm glad I discovered your blog through the blog carnival!

  3. There are excellent talk therapists out there and even a lot of good ones. It does take some hunting to get a good match. I think I've seen about eight different coucelors over the years and had two good ones and one excellent one. The best way to start the hunt is to find someone with a PhD. The worst coucilors I've had were social workers. I was never totally cured by talk therapy but with a good coucilor it helps a LOT. It gives you better tools to help with life situations.

    BTW, my doc did the same thing to me when I went to him for a referal: "if you just exercise you would feel better." I was already lap swimming three times a week and I knew enough by that point to know I was clinically depressed and needed some help. I fired his ass about a year later after he claimed my weight was to blame for some medical problems which turned out to have nothing to do with being chubby.

  4. I love this idea and I am going to look into Buddhism in my area. Thankyou, I really really need something new to try.