Tag: mental health

Depression – The Masks We Wear and How to Remove Recognize Them

Depression – The Masks We Wear and How to Remove Recognize Them

depression
ARTIST: Lance Johnson
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Depression is often characterized as a deep sense of hopelessness. It typically arises after a devastating rejection, disappointment or loss. I described a little of my experience with depression in my recent posts,  Living Under the Cloud and  A Crack in the Night Sky. Depression, however, set down its roots within me in childhood when I was doing my best to cope with a world that was far more complex than I was equipped to handle.

What I am beginning to understand and wish to share with you, is that while depression can be an insidious state of mind that sets up housekeeping within us, it is useful to also see it as a mask. It is not who we are, but rather a lens through which we live and view our lives.  I believe, that if the mask went on, it can be taken off. It just may take a broader approach and a little more work than we heretofore have understood.

One of the dangers of modern medicine is the conviction that medication is the best and most expedient solution to a majority of ailments.  While it may be expedient, and provide some sort of relief, it may not always be a cure. Modern medicine has done wonders for many illnesses. It has also sidelined solutions for many others. We’ve become a quick fix society that doesn’t understand the need to dig deeper for healing.  Science and medicine continue to narrow their focus, to specialize and fine tune. Drug companies continue to come up with medications to treat the most popular illnesses. Depression is one of those popular illnesses.  What I believe is needed in spades is a broader approach. Specializations can’t see the forest for the tress.  Medication for depression is too often a band-aid approach.

In order to effectively treat and heal depression, particularly chronic depression, it is absolutely necessary to listen to and treat the whole body. Depression is classified by clinicians as a “mood disorder.” This “mood disorder” is the mask. Getting to what lies beneath is more of a challenge. It is my conviction that those who suffer must be shown how to step back from themselves and the labels  to learn to see themselves differently. Stepping back creates the space that can allow in new ideas, new treatments, new methodologies, new understandings of what it means to heal, what it means not only to survive, but to thrive.

Depression was not well understood when I sought help in the 1970’s. It took a decade or more for science to hand me antidepressants and therapy as a solution. It was a God send for me at the time, but it was not a permanent solution. A decade later I was not rid of depression, as my physicians and therapists told me I would be.  At that time psychiatrists were the only medical professionals authorized to prescribe  psychotropic drugs and from whom I received my first explanation as to how they worked.  My doctor told me that antidepressants would “ jump start the synapses in my brain and once mine would eventually begin to work again without help.”  I understood enough about jumping cars to understand the concept and it sounded plausible. What I didn’t think about, nor did he seem to be concerned with, was why was the battery draining and what would keep it from becoming depleted again.

After several relapses and futile attempts to go off antidepressants I was then told by therapists and physicians to just accept that my body was not going to do what it needed to do. They encouraged me to look at my condition as one similar to diabetes, a condition that could be managed with medication.  I had no choice but to accept the sentence I was given, but I never liked it.

I wasn’t convinced that it was quite that simple, although I had not yet found an alternative answer, nor did I even understand the nature of the problem.  Medication and therapy were the only options I was given and I relied on them to get me through the child rearing years.  It was not easy. In fact, while I functioned, and even well at times I felt almost “normal”, I lived under a cloud that threatened to pour at any moment.  Therapy was more of a crutch than a cure and I tried a wide variety of therapies and therapists over the years.

I have functioned, more or less, throughout my life with one hand tied behind my back, and I am fairly certain that there are plenty of people just like me who are doing the same thing. Whether the rope that keeps us bound is depression, anxiety, fear, narcissism, PTSD, or any other mental or emotional condition, I do not now believe that it is always in our best interest to ride the waves in a boat designed by drug manufacturers and over specialized physicians.  Their perspective is far too narrow and has become far too complacent.

Those of us who are riding the waves owe it to ourselves and other sufferers to push the edges of our condition, to challenge the status quo, to do more than just survive. We owe it to ourselves to dig deeper, to try new avenues, to ask hard questions and to accept and love ourselves through it all.

Mental and emotional illness, is more accepted now than it was fifty years ago. If I had been born just twenty-five years earlier I might have spent a good portion of my life in a mental institution undergoing shock treatment. Before that I might have been sequestered behind bars. I am grateful for what was available to me and the relief it did offer. However, I think we can do better. I believe we can work toward acceptance and understanding in a way that doesn’t simply pat the suffering individual on the head and send them home with a pill and a therapist. Mental health issues are more accepted, but they still make us uncomfortable.  We don’t understand them and they frightened us. We fear what we don’t understand. We marginalize what we fear.

All you have to do is look at the state of mental health treatment in this country to see our fear and disregard for the suffering.  Public institutions are underfunded and understaffed. Research is funded more often by drug companies than independent research.  The mentally ill too often end up wandering the streets or end up behind bars.  For those who manage to function more or less normally, current treatments are not often healing treatments.

Depression and anxiety have plagued me most of my life.  Pain is a powerful motivator and it has been the  impetus behind my never-ending quest for understanding. It has driven me to question, research, study, contemplate and experiment, not only to find relief for myself, but to find true healing for all who suffer from this painful, life altering condition. In the process I have amassed an enormous amount of experience and knowledge on the subject. I have seen the commonalities between myself and those I’ve tried to help. The threads that weave us together are the threads that can set us free.  As we untangle these threads we loosen the mask  and the painful pressure beneath is relieved.

As I continue this backward glance at my own struggle with depression and the effect its had on my life, I hope to reach into my knowledge and experience and pull out the most important threads required for healing.  One by one, I hope to offer what insights I am able to offer, not only on the healing process but on mental health treatment in the twenty-first century.

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Sandy – A Crack in the Night Sky

Sandy – A Crack in the Night Sky

touch the painLIFE UNDER THE CLOUD (Previous Post)

SANDY – A Crack in the Night Sky

Sometimes it just happens. The black sky cracks open and a beam of light shines in. It’s always when and where we least expect it.

Sandy was that light for me then. She reached inside of me and took hold of the essence of who I am and yanked it out just a bit – enough for me to take several bold and courageous steps forward into myself.

I remember the day I met her like it were yesterday.

The day began when my sister came by Mom & Dad’s house where I was staying and pried me loose from the chair I had been sitting for days, hands holding the fabric covered arms in a death grip, eyes swollen and red, my body slumped and frail. Each day I felt a little more of the life go out of me, so weary of fighting the pain that nothing would stop. I stood for her, not myself. She handed me my coat and I followed her to the car. My oldest sister, she was the only family member who saw a glimpse of hope in me; or cared enough to look for an answer for me, a way out at a time when I could not find it for myself.

The sun was trying to shine through the heavy winter clouds but the cold, damp air cut through me like a knife. The sudden shock of it felt like relief from the heat of emotional pain that held me like a vice. I sucked in the fresh air like a lifeline and climbed into the passenger seat.

When we drove into the parking lot of the County Mental Health Clinic and parked I discovered I could not move. I felt like the disheveled mess that I was. I didn’t belong here. I was educated. I held a degree equal to those who would be treating me. I was riddled with shame and an overwhelming sense of failure. My thoughts sent me right back into the darkness and I shrunk inside the pain. Tears began to flow. My sister persisted.

The walls of the waiting room were institutional blue. The rows of plastic seats around the perimeter were dirty white, bent and scuffed and overused. Light streamed through the film that coated the window, and played across the dust and grime that layered the gray linoleum floor. I fell into one of the plastic chairs as a woman handed Sue a clipboard through a round opening in a window littered with smudges and dust. She handed it to be and then sat down beside me. I willed myself to pick up the pen but remained frozen in place.

“Just write your name,” Sue said. “If they want to know more they can ask you.” I always loved her rebellious spirit. It gave me courage to summon my own. I began to write. She let me off my own hook. When it came to the reason for the visit, I stopped and put down the pen. She took the clipboard and handed back through the hole in the glass. Then, we waited.

A round back man dressed in baggy, worn pants and a moth-eaten sweater shuffled into the waiting room and sat down across the way. He had a face that looked as old as Methuselah but without the wrinkles.   “Hey, Henry,” came the woman’s voice from behind the glass. “How are you this morning.”  Empty eyes stared at her for a moment and then disappeared as his head fell forward. His need frightened me. It was so glaring and intense.

I didn’t belong here. I was not him. Or was I?

The double doors beside him opened up and a slender forty something woman in high heels,  fitted skirt and black sweater appeared holding a clip board. Her chin length black hair was the perfect foil for the golden nuggets that dangled from her ears, matching the gold chain that fell from her neck. Stylish and elegant, she was not at all what I had expected. Loafers and jeans were what I expected. Work clothes for a dirty job.

“Dorothy”, she said looking right at me and smiling. I was both attracted and repelled by the woman. I hated her for her “togetherness”. I revered her for her courage and confidence.  I felt so small by comparison. So broken. So beyond repair.

“Follow me”, she said and I did, because the only thing I knew how to do was what someone told me to do. I followed her down a dark hall, around a corner and into an office with a plaque on the door that read SANDRA KAHN, M.S.W.

We sat face to face. She crossed her legs and leaned in toward me peering right at me through the horned rimmed glasses that only magnified her eyes bearing down on me. It was too much. I looked down. I did not want to be seen. So fallen. So off my game.  Her raspy smoker’s voice lifted me brought be back for a moment. She, like my sister, would not let me off the hook. She, like my sister, saw something in me worth saving.

For the next six weeks, we embarked upon “crisis counseling” as she described it.  The state didn’t allow us anymore time than that so we had to work hard and fast. I don’t recall all that we talked about. I do recall that she saw the real me. She knew that I could not see what she saw. She knew that it was her job to help me find myself.

In addition to our bi-weekly sessions she wanted me to join a group, to speed the process she said.  She and her co-worker Joe moderated them and she assured me she would be right there supporting me.

I did what I was told and showed up for the group. I thought I was willing. Something inside of me was not. I could not speak. Listening to everyone’s pain sent me reeling. I couldn’t help them. All I could do was hurt for them. Hurt for myself. The tears just flowed and no words came. I knew they were supposed to, but they refused. Only tears and suffocating pain. I had failed again.

After the next group session she pulled me back to her office. “I want you to see Dr. Chinigo and she handed me a business card. “Joe agrees. I think you need to go on medication.  I believe you are chemically depressed, that’s why you can’t work in the group.” I was perplexed. Chemically depressed? What did that mean?

IT’S A WHOLE NEW WORLD – Or, is it? – Coming Soon.

I STILL Honor You Robin Williams – July 21, 1951 to August 11, 2014

I STILL Honor You Robin Williams – July 21, 1951 to August 11, 2014

Robin WilliamsToo little has been said about Robin Wiliams’ suicide. Too little has been done to honor his life. I sense a world uncertain and confused about how to respond to his suicide, or how they “should” feel, and so they remain silent. Still caught in the archaic notion that depression and suicide are choices we make, sympathy, compassion and understanding are lacking. We are too often a heartless society, unable to rise above our baser instincts, our judgments, our egos.

Robin William’s death could have been a launch pad for vitally important and valuable conversations about mental health, depression, suicide, medically induced suicide, the emotional and mental aspects of illnesses such as  Parkinson’s and Dementia, how we allow advertising and drug companies to determine what is best for us, how doctor’s too often do the same. His death could have been an addition to his legacy, not an embarrassing post-script.

I was stunned by the lack of honor paid to this talented man and his incredible body of work at this year’s awards ceremonies.  When it came to the segment honoring those lost during the year, his picture seemed to be thrown in at the end, like an afterthought,  as if they were debating right up to show time whether or not to include him.  The fact that he died at his own hand seemed to somehow tarnish his legacy.

Wouldn’t it be nice if the reasons behind his suicide were thrashed about as hotly on the internet as Donald Trump’s current insult to our collective intelligence are now? I didn’t see it, and I’m present here every day more than I often would like to be.  A few spoke up at the time of his death, like Dean Burnett’s article in The Guardian, Robin Williams’s death: a reminder that suicide and depression are not selfish, otherwise the topic was dropped quickly; a lack of consensus perhaps, or a lack of understanding.

Robin Williams’ death was ruled a suicide. That is the black and white of medical science. It’s not the whole story. It never is. News reporting didn’t seem to want to go the distance. US Today reported:

The official cause of Williams death, released Friday by the Marin County coroner, was ruled a suicide by hanging, with no evidence of alcohol or illegal drugs in his system and only therapeutic concentrations of prescribed medications.

 

Williams had long battled alcoholism, drug addiction and depression, but in November 2013 he was diagnosed with Parkinson’s disease, according to his widow, after noticing a tremor in his left arm and difficulty moving on his left side as early as 2011.

 

Now a redacted pathology report from the autopsy on Williams’ body has been made public and it mentions Lewy body disease, a newly recognized disorder similar to Parkinson’s.

My mother-in-law who died a little over two years ago, and who was born on August 11th, the  same day on which Robin Williams life ended, was also diagnosed with Parkinson’s. She was given powerful doses of medication that created a vast array of difficult side affects, including anxiety, depression, and hallucinations. Several years into treatment the doctor said, “Oh, sorry, my mistake. You don’t have Parkinson’s.”

We need to question our medical practitioners with increasing frequency and regularity about the drugs they are prescribing, too often without respect for the consequences.  We must continue to be pro-active in our health care, questioning, reading, researching and evaluating in addition to seeking the advice of a professional. We need to stop being so agreeable and willing to accept whatever the multi-billion dollar drug industry prescribes for us, because the drug companies, more often than not, are dictating what doctor’s are prescribing and/or inducing us to ask for them.  They convince us with their expensive advertising that we need their product, much like McDonald’s, and the ill effects may be just as inauspicious.

DoubtfireIn addition, we need to continue to look harder at the underlying causes of mental illness. It is not always a difficult childhood, a trauma, a confused identity alone that leads to depression and suicide. These things may only be the precipitating factor behind a biological imbalance, or vice versa; a biological imbalance that may be corrected by diet, supplements, or remedies other than the chemicals prescribed by drug companies.

Antidepressants and anti-anxiety medications have served their purpose and continue to do so for many, during a time in history when they were the best option available to us. Now, however, research is reaching further every day into the body/mind connection. Let’s start listening to their findings and following common sense at least as often as we follow big business and advertising.

Lewy Body Dementia, the disease Robin Williams actually had, causes hhallucinations, visuospatial abnormalities, and other psychiatric disturbances. As mentioned above, Parkinson’s medications can cause these types of problems as well. Should he not have been monitored more carefully?

Robin Williams’ life was a gift. I hope one day I will be able to watch Mrs. Doubtfire without a deep sadness lurking behind each laugh; or Hook without wishing this vibrant life was still dancing across the screen. I don’t think I will ever force myself to decide which of his movies I love the best. Each expressed a piece of him.  How rich a life he lived; how very much of himself he gave in the process. We should all live so boldly. In light of such a life,  does the end really matter? I honor you Robin Williams.

 

Depression – Fighting the Battle

Depression – Fighting the Battle

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There is no way to measure the pain of depression. There are no blood tests, x-rays, or questionnaires to determine beyond a shadow of a doubt whether or not an individual is suffering from depression. There are educated guesses. There are circumstances suggesting the possibility and likelihood of its presence. How much suffering can be endured is relative to the individual in all illnesses, but depression has a way of going unnoticed, of being looked upon as a behavioral or character flaw, not only by outsiders looking in but by the sufferer as well.

Depression is a nebulous disease. It creeps on us going undetected and managed through force of will and determination. Those with long-term depression often have not known anything other than a dark state of mind. They don’t know they’re suffering unless, or until, it becomes too hard to handle or their lives are turned upside down by poor decisions made by a depressed mind. It’s a tragic disease. It’s a disease that significantly alters the course of an individual’s life. And yet, there is no effective diagnosis and no guaranteed treatment or prevention.

Depression is widely treated with medication and therapy.  Almost anyone can walk into their doctor’s office, tell their physician they’re feeling blue and can’t seem to snap out of it, and be given a prescription for antidepressants — especially women — especially those over fifty. I have a problem with this. We’re a quick fix society that loves a fast, easy solution to problems. I’m pretty sure there is no such thing when it comes to treating depression. There are too many variables. There are too many physical, emotional and experiential dynamics at play.

Popping a pill doesn’t address unresolved issues. Therapy doesn’t address diet and exercise. Like most things, I’m a fan of addressing the whole person when it comes to most things. We’re way too complex creatures to toss a pill at a problem and call it a day.

TREATMENTS FOR DEPRESSION

  • Prescription Drugs – use is on the rise and prices are getting cheaper. Effectiveness is always up for discussion. They work great for some, not so much for others and not at all for a few.
  • Therapy – a valuable addition to the arsenal. Finding the right therapist is crucial. I always recommend interviewing potential therapists and choosing one with whom you feel comfortable and understood; someone who speaks the same language. This takes work, but it’s worth the effort and saves time and money in the long run. Researching types of therapy can be an added plus. More on that later.
  • Exercise – Research has shown repeatedly that exercise boosts endorphins and energy and effectively fights depression. It also combats stress which also can be a factor in depression.
  • Diet – Food allergies and sensitivities can create a physiological environment for depression or worsen an existing depression. Working with someone who understands and knows how the body reacts to a variety foods and circumstances can be very beneficial, a Naturopath for instance. Research has begun to show the ill effects sugar has on our bodies in general and it may in fact, exacerbate depression.
  • Body Work – Everything and anything we do to improve our health and well-being can help counteract depression. Massage therapy, chiropractic treatments, sauna, etc.
  • Spiritual Practices – Meditation, guided imagery meditation, prayer, mindfulness, reflective reading, etc.
  • Education – Learning something new opens the mind to new ways of thinking and re-directs our thoughts along more constructive pathways. Habits of thought are insidious and take a concerted effort to change. Therapy is one avenue, but reading and studying can also be helpful.
  • New Experiences – Depression tends to cause us to shut down and close the doors to our lives. A new experience  may be like a breath of fresh air that lifts the spirits. This, of course, would depend on the depth and nature of the depression.

SEEK HELP AND SUPPORT FOR DEPRESSION

The bottom line is that if you suffer from depression, chances are good that your quality of life suffers. Seeking treatment and support is absolutely a must. It is not something one can manage on ones’ own. It just isn’t. The sooner this is accepted, the sooner relief can be found. That being said, trusting your instincts and being your own advocate is important. If something feels right or works, do it. If it doesn’t, leave it alone and go on to another option. Do consider a variety of simultaneous treatments. We are, after all, very complex creatures!

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HOW TO RECOGNIZE DEPRESSION IN THE ELDERLY