Monday, June 05, 2006

Sine Wave #24: "To My Psychiatrist": Mood Update

Poem redacted.

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I like working in form, and this poem, is, of course, a mangled villanelle. It is self-explanatory and almost whimsical when compared with some of the earlier pieces. The speaker's honesty with himself, while not entirely trusting himself to psychiatric intervention, shows good boundaries and perspective. He is a survivor, not a true believer. And he shows little shame for his habits; they mark the difference between psychiatric theory and what it's like for the patient.

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I fell back into a depression about May 20, which I ascribe to resuming the analgesic therapy prescribed by my pain specialist, namely hydrocodone and acetaminophen. Along with Celebrex, these tablets work really well for my back pain. But, paradoxically, when I first take them they can render me hypomanic; at other times, continued use pushes me into melancholy. Withdrawal is certainly dangerous and may precipitate a depression, so withdrawal must be managed very incrementally.

The problem is change: my pain specialist is 600 miles away in San Diego, and will only give me enough medicine for two months, so unless I manage to get down there I have to withdraw. It is probably better that I don't take narcotics at all, but they are very seductive: Imagine a vacation from pain. And when one's mood is normal, the twin dangers of hypomania and depression don't appear so bad, one of the terrible things about a mood disorder: after a period of euthymia, or normal mood, we sometimes have trouble imagining the horrors of depression or the dangers of mania. As Heraclitus showed, you can't put your hand in the same stream twice, thus humans only notice change for the most part, and past lessons are hard to employ in present temptation.

Though I felt worthless yesterday, I did one good deed. Kathleen and I went to the local fair in Mendocino, a charming one-horse affair to raise money for local schools. Afterwards we strolled down in the village, and before I could turn my head, Kenyon and a larger, younger dog with the chest of a pit bull were locked in a mortal embrace; it took three of us to separate them, and afterwards Kenyon was bleeding; Kathleen came running out of the grocery store in tears, and I, of course, felt responsible.

Kenyon's wounds were not serious. A nice local lady offered to go bother her vet a few blocks over on his behalf; I explained I was a physician and could sew him up. Due to my dress and appearance no one ever believes me when I tell them this; so we finally left after her protestations. We drove home and I numbed Kenyon up and sewed up his two wounds with Kathleen restraining his head. He's a great patient, but it's hell on my back to kneel on the floor to do surgery; we don't have a table yet.

This incident didn't shock me out of depression; it only distracted me briefly. The dog is doing fine. Kathleen slept with him downstairs overnight. (The only thing better than being Kathleen's husband is to be her pet.)
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I still want to get back to the theme of the unknown artist, though to be fair, at least on the net, I am not entirely unknown. "Jealousy is the essence of narcissism," I wrote long ago, and the primitive emotion I often experience vis a vis recognized performers stems from the fact that I know I'm better; I know, for instance, that I can play blues and rock guitar better than most people who perform; I write poetry better than most featured readers (I used to be one, as I noted yesterday.) So I wonder if the emotion is not so much jealousy as a mistaken sense of fairness; Why should they be up there instead of me? Or better, why should they be up there at all when I know personally know better talents who go neglected? And then I remind myself: they wanted it more, they worked for it harder, their recognition may have even been harder to achieve with mediocre talent. Then I relax somewhat and tell myself: It is fair. They were willing to pay the price and you weren't, Dr. Chaffin. Still I can't seem to cure myself of this curious process.

Also, one measure of depression is that nothing could make you feel better. If they gave me the Nobel Prize tomorrow I would be nonplussed and assume they had made a mistake. My being given the award would naturally devalue the award--the defeatist logic of depression.

One other thing: I'm going to take a break from these daily postings on Thursday, when the first section of Sine Wave is complete. It also happens to be the first day of the NBA finals, and I am a huge fan, even if the Lakers aren't in it.

All for today,

Dr. Chaffin

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