Monday, January 15, 2018

My Depression, Part II

The Symptoms, Continued

Note: I have deleted 500 words that only rehashed the events culminating in the death of my father in April, 2016. We’ve been over that ground. I just went over too much of it in Part I of this epic. My, but I can talk. Especially when it’s about my favorite subject: me. Mea culpa.

My purpose here was supposed to be describing my depression symptoms in the one-year period between May, 2016 and May, 2017, as an illustration of the phenomenon that may be helpful to the non-sufferer. It is obvious to me that the un-depressed have no idea what is going on in the head of a depressed person. This can be tragic if the depressed person is their wife, or child, or their aging parent.

Note also that the covered period has been over for some time. Things are much better now, thanks.

Only one bit of information is necessary to complete the sob story at the end of Part I. My father died late in April, 2016, and for reasons that he took with him to the grave he excluded me from his will. I had thought that we were on very good terms. My father’s death put the last puzzle piece in its place, but it left one important question: was it the rejection and neglect of my parents that caused my depression in the first place? or was my depression only an outward sign of a failure of some kind in my own makeup. (Is that two questions? I think that it’s one “either/or” question.)

To get back on topic, wondering about things like this is one of the symptoms of depression.

Waking Symptoms

Do you want to know what it feels like to be depressed? Have you got someone in your life that you would like to “just get over it?” Maybe this will give you some idea of what they are going through. (Plus a couple of helpful hints for readers who may already know a lot about it.)

General Negativity: This is manifest in simple reactions to day to day events, or events in the news. All estimations are knocked towards the negative end of the scale. The tendency to worry about everything is increased. Worrying about loved ones, the future, money, the state of American democracy, health, security issues, just everything, you become more susceptible to morbid worrying about everything.

Specific negative ideation: For me, there is an increased tendency to spontaneously generate negative memories at random. At any point in the day, unless I am actively engaged in speaking with someone or reading something, specific painful memories enter my train of thought. These can be memories of events that were embarrassing to me, specific failures, missed opportunities, incidents of self-sabotage, anything in which I find fault in myself.

Not only memories, but the awareness of the current source of the depression. I would shout (silently, to myself), “why didn’t they love me?” Or, “I was a good boy!” Or, “what the hell was he thinking?” Or, “how could he hate me so?”
I spent most of the year trying to avoid these ambushes, as you may imagine. I would try to remain positive, and think happy thoughts, even forcing a smile onto my face to trick myself into lightening the mood. Quickly, though, a terrible memory would strike me. The immediate result was a full-body clench, a general tightening of all of my muscles, a brief pause in my breathing, a tight closing of the eyes. It was a moment of severe self-condemnation. I could usually calm myself down before long, and get back onto the good thoughts bandwagon, but those clenches do their harm, and such a vast number of them in a day adds up to some real damage.

This is all much worse when one’s eyes are closed, so laying down to sleep was a difficult time. Also, the time after waking but before rising.

Helpful Hints: I have two techniques for controlling my thinking during these times of special danger.

One is to go through a song in my mind. It’s not just singing the song, it’s more like performing the song and analyzing it at the same time. I’m registering the form of the song, the chords, their fingering on a guitar, their changes, their place in musical theory, and if there are harmonies, I’m trying to identify the interval between the parts, and I’m counting the song, the rhythm, the measures and the bars, and of course I’m going through all of the words to the song. This is not happening in real time, in fact it is all rather slowed down by the close examination.  This takes a lot of concentration, and it works pretty well as a block to negative thinking when your eyes are closed.

Another technique that works for me in many situations is to imagine myself flying a single-engine fighter plane from the World War II era. The piston-engine, tail-dragging variety, the Mustangs, the Hellcats, and the Thunderbolts, or for that matter the Focke-Wolfs, the Yaks, or the wonderful Japanese Franks. I am never engaged in actually firing the guns at another plane, it’s more about the focus that flying requires. Once the engine is running, and the plane is ready to take off, it all requires 100% concentration to put the plane into the flight envelope and keep it there. In the air, I focus on the sound of the engine, the vibration, and the need to adjust the trim of the aircraft, and scanning the sky for threats. Usually I imagine myself to be flying in a three-dimensional area, a cube, about five miles on a side. That tops out at about 25,000 feet. Spotting opponents off in the distance somewhere, a pilot must first maneuver the plane into firing position, preferably without alerting the other planes to his presence. The planes are at different altitudes, going in different directions, and moving at different speeds. This is a huge three-dimensional puzzle, and maintaining the illusion requires focus that borders on self-hypnosis. Both of these techniques are often successful for me.

Suicidal Ideation: I was very lucky in this one-year period to avoid any immediate danger of committing suicide. I was spared the longing for death that often appears with a solid episode of depression. We all live lives that are controlled by a calculus that is determined by our temperaments and personalities, as filtered through conditions of which depression is only one. Suicide occurs when the sufferer decides, “not one more day, no way,” decides that there is no possible way that one more day can be faced in this condition.

That has never happened to me; luckily, I’ve never even been particularly close to that condition. I’ve been close enough, though, on only a couple of occasions, to see what the process would feel like. But I am here today to tell you that planning and committing an actual suicide is only one manifestation of the suicidal ideation that can accompany depression.

What the sufferer may carefully consider instead is the concept and utility of suicide as part of a reasonable human life. Not necessarily suicide today, but an idea that suicide may be become normalized, more acceptable. The acceptance of the idea that there might be situations or problems that may arise in the future to which suicide could be a reasonable solution.

I have engaged in this kind of thinking, and I can tell you that it can make today more bearable to know that there is a way out that may someday become feasible. I think that this kind of thinking helps to give the sufferer more of a feeling of being in control of his life, even today.

Physical Manifestations: Depression is a condition that arises from, and causes, stress. Those of us who suffer from depression know that, from time to time, in one part of our bodies or another, our stress will manifest itself as a physical pain. The every-changing cycle of the manner and the intensity of it becomes an annoying part of our lives. We are not confused about it, however, we know what is happening. But boy, if you want to make a doctor laugh, try telling him that the pain that you are experiencing in your hips is stress related sciatica. They smile and give you that look that says, “and where did you go to medical school?” School of life, pal, and it’s happened before, and it always appears in response to a specific stressor, and it always resolves when the stressor is no longer present.

In the year under examination, I experienced physical stress manifestations almost immediately upon hearing about my father’s will.

My shoulder, for instance. At first the condition was bilateral, but the right shoulder resolved quickly. The left shoulder began to hurt more or less constantly, and the mobility of my left arm was severely curtailed. It was impossible for me to lie on my left side, which unfortunately is where I’ve always spent most of my sleeping time. I tried to ride it out, exercising the shoulder gently, but finally I went to see an orthopedist. “Frozen shoulder,” was his diagnosis, and after some reading I agree with him. He suggested a few exercises for physical therapy, and wished me luck. I did more reading, and it got very interesting very quickly.

The frozen shoulder is a condition with no recommended treatment which occurs for reasons that the doctors do not understand. It has a life cycle of between two and three years, and at some point, it resolves on its own. The docs are suspicious about correlations to diabetes and heart disease, but these are only to be seen in statistics. No biological or chemical relationship has been identified. Note that a diagnosis of either diabetes or heart disease is a very stressful event for most people. So, I’m thinking that the whole frozen shoulder thing is stress related. I am happy to report that the “two to three years” prognosis could be happening, as we speak. We’re closing in on two years, and the condition is moderating week by week. I’m never sure where to direct my thanks in these situations, but in case anyone is listening, thank you!

It could be worse! But wait, it is worse. Much worse.

My blood pressure has been high for some time. Never high enough for a doctor to recommend medication, but up in the elevated region of the guidelines for “normal.”

After the bit with the will, my BP started to go up. Nothing else had changed, but by the end of the calendar year I was getting situational spikes that were alarmingly high. Finally, I sought the advice of a cardiologist, and we got me started on some medication to lower the blood pressure. I cooperated by cutting down my drinking to two ounces per day, two drinks of one ounce each. I was trying to be good. By the way, I had stopped smoking my five or six cigarettes per day about five months after my father died, which was five months before I started the BP meds. Then something happened.

The blood pressure came down, but every evening it sailed right back up above the guidelines. One night at about nine o’clock, I got chest pains, something that had never happened before in any way. I took my BP and it was very high. I seriously considered going to the hospital on the spot, but I figured that it would be better to give it twenty minutes or so and see what would happen. After about a half of an hour, it was all back in the normal range and I felt fine. That is, however, a major scare. Also, it’s the last thing that I ever expected in my life. To my knowledge, no one on either side of my family has ever died of a heart attack. I don’t know if anyone has even been treated for heart disease. Mostly cancer, it’s been, with a few strokes thrown in, and almost always in advanced old age. My father’s stroke came at the age of ninety-five. My mother, who drank like a fish and had blood pressure almost as high as FDR’s, simply died of “old age” in her bed at the age of eighty-five. I was very, very surprised by the chest pains.

That was my cue to jump all of the way onto the deprivation bandwagon, so I gave up drinking altogether, and coffee too, for good measure. I never went back on BP meds, and my pressure now is always low-normal, all by itself. By now, I’ve had the entire battery of tests up to and including the CT scan. The news is neither alarming, nor completely threat free. I’ll just say that I do not now require an operation, and the odds are very good that I will not be requiring one any time soon. (Note that I may require a mere procedure. Ah! The precision of the trained lawyer!)

I’m blaming this one on the stress and depression as well, and let the docs get as snarky as they want to. There are numerous studies by now that have found correlations between stress, depression, and many diseases, including heart disease. I’ll probably be fine, at least the evidence of the many tests seems to indicate that result. But it will be a continuing worry, and a considerable expense from time to time.

Sleep Symptoms

Here, two problems present themselves. Sleeplessness, and nightmares. Wait, there is also the possibility of the sufferer sleeping too much. It frequently happens that depressed people find it hard to get out of bed at all. I have avoided that symptom, and I am grateful. Those first two, I’ve had those over the years, and they were very noticeable during the year under examination.

Sleeplessness: Mine came in the middle of the sleep period. At one or more points during the overnight, I would find myself unable to return to sleep. When this happened, I would employ one of the above-mentioned two techniques for settling the mind, to avoid an onrush of negative thoughts or general worrying. It wasn’t so hard to deal with.

Helpful Hint: The secret of dealing with sleeplessness is to pretend that you are asleep. Get as comfortable as possible and then do not move. Not even to scratch your nose! You must mimic the sleep-paralysis. Never look to see what time it is. When you do this, you will probably be in first stage sleep without even realizing it. I know that this is true, because many times I would hear a bird outside and feel myself “waking up,” whereas I had been sure that I was not asleep. The mistake that people make is moving. A certain person that I had many opportunities to observe compounded this by not only moving almost constantly, but also getting angry about being awake. Only do that if you wish to stay awake all night.

Nightmares: Regarding nightmares, I am something of an expert. I have suffered them, more or less, all of my life. Some of my earliest memories are of nightmares. This could turn into a long story in a hurry, so let’s stay focused on this specific year. My depression and anger about my father’s rejection resulted in a bumper crop of nightmares with a very particular character. They were vivid and naturalistic, in color and with great detail regarding surroundings and clothing. They were long dreams that could start and stop over the course of many hours of sleep. They featured real people from my family, speaking very realistic dialog in their own voices, in fully lit rooms. There was almost none of either Freudian substitution or Jungian symbolism. It was people from my own life, giving me shit about my shortcomings, and often blaming everything on me. Often, my father would be there, hurling recriminations with his usual sarcasm; other times he would be a dead presence, and we, his family, dead and alive, would be discussing one thing or another. Waking up from some of those dreams, I would be in a bad mood for a day or two, recalling only too clearly something spoken in the dream, or some dirty look.

This depression thing is no party.


There are many lesser symptoms. There is the inability to comfort oneself; the sufferer takes less pleasure, or no pleasure, in the things that they usually enjoy. Depressed people tend to blame themselves for any negative events around them. I never give up trying to figure out how I could be responsible for every bad thing that has ever happened to me. Sufferers, when the depression is in flood tide, are less inclined to do anything at all that is remotely social. There’ll be more reading and less interaction in general. There will be an avoidance of all things that can possibly be put off until a future day. Sometimes all that I can manage is to do the things that are absolutely necessary, like my job, and paying bills, and the dishes. Dishes don’t wash themselves.

We, the people who suffer from depression, hate what we put our families through. We hate what we are putting ourselves through. We hate being depressed. It is, however, a disturbing fact of life that the only cards that you can play are the cards that you have been dealt. I know, I used this same metaphor very recently, but it’s mine, so I’m using it again. You cannot wish that you had gotten that last club in the draw. You cannot bet a wish. It’s too late. It’s time to bluff or fold. “Bluff” may be an apt metaphor for the mask that we all wear in our public lives, and “fold,” please excuse me for leaving this part in. “Fold” may take on a particularly dark meaning in this context. The entire metaphor is apt for depression sufferers.

So please, dear readers, do what you can to try to understand why your depressed family member is acting in that strange, annoying way. We certainly do not do it intentionally, and we would change in a second if we could. Maybe after reading this you can begin to understand that as annoying as their behavior may be for you to deal with, depression is a much bigger burden for those who must bear it. 

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