Friday, February 29, 2008

No Change; Despair in Ascendancy

Today is leap day, and if I calculate my treatment correctly it corresponds to my tenth ECT treatment. I went in in tears and I was in tears before they put me out and put the electrodes to my head. I told my doctor that I wasn't getting better, that I was getting worse. He seemed to hear me because afterwards he loaded me down with some new prescriptions and increased some of the old. You want to see my menu? I won't go into all the dosages, I'll just name the medicines: Prozac, Wellbutrin, Trazodone, lithium, Klonopin, Invega, plus aspirin and my blood pressure pill. Some of the dosages are really high; Wellbutrin, for instance, is now 600 mg. day, which puts me at risk for having seizures from it. (Since I am paying to have seizures induced I expect that's not a bad bargain.) My Prozac is at 80 mg./day, four times the usual dose. Invega is new, an antipsychotic that differs from Abilify, the one to which I briefly responded. The addition of lithium, 1200 mg./day and Trazodone 150 mg. for sleep are both new. The doctor would prefer I take Trazodone if I can't sleep rather than Klonopin, as Klonopin is a mild anticonvulsant and we are trying to elicit seizures. I know, I know, that's a lot of medication and a lot of electricity. It is only evidence of how desperate I am after nearly two years. Come April 1 I'll have my two-year anniversary of the onset of this depression, and during that time I may have had three months remission, total--spread out over different times-each time thinking I might have made it through the eye of the proverbial needle only to have the meds quit working after a brief time. This length of depression sets a new record for my 53 years; I have never been depressed so long. I want to weep as I write this but by force of will I won't allow myself to do so or I wouldn't be able to type.
People tend to wonder what this depth of depression feels like. All I can say is that what makes me saddest is the notion that someone loves me, because I feel so utterly unworthy to be loved, and the certain intellectual knowledge that my dear wife, Kathleen, loves me, consistently brings tears to my eyes. "Why is she wasting her time with me?" I think to myself. "How could she possibly love me if she knew what an awful person I am? Why doesn't she cut her losses and find a life partner not afflicted with manic-depression, someone more emotionally reliable?" But her love and loyalty are beyond question; to me they are absolutely supernatural. Underneath the darkness in which I travel, I know I am in love with her as well. For all time. Forever. And it is true that I have nursed her through some serious depressions for my part, and she came through and found the light. But she's never had a depression this long and this bad in our nearly nine years together, and I don't know how she holds up under the strain of my continued illness.
Little things can break me. "Can you make some coffee?" Yes, but in beginning such a simple task I feel overwhelmed and I suffer severe doubts as to whether I will, indeed, be able to make coffee, and the spectre of failure is always on my shoulder, whispering, telling me I can't do an effin' thing. I am so sad that I think if my sadness were parcelled out to every man, woman and child in this country the entire nation would be clinically depressed. And what am I sad about? I don't know. My daughter's death occurs to me, but that happened July 29 and I felt that my grief for her, though painful, was healthy and healing, I welcomed it as a relief from depression--not that I welcomed losing my daughter, naturally, but that the experience of having an appropriate emotion for a change felt good and right and human. Whether that was just a phase and the grief subsequently piggy-backed on top of the depression, I don't know. Because when I cry now, I cry for crying. I cry for the emptiness, the hopelessness, the devastation I feel inside the hollow of my chest. I feel as if I'm made of wicker or papier mache'--there is just this hollow inside containing nothing but an infinite sponge of grief, just squeeze my arm and it will leak. And fear? Fear attends everything. I'm afraid to rise up and afraid to sit down; I wish with all my heart that I were confronted by a real danger, a man wielding a knife, for instance, so I could lay it on the line and do my damndest, but life doesn't work like that.
I was reading a clinical treatise on ECT last night and although it was twenty years old, it was clear that they didn't know how or why it worked, and nothing I've heard since elucidates the mystery. I conceptualize it as a re-set button on a computer, a wiping of the disk that has become frozen in one repeating affect. But who knows? And there are side effects. My memory for this period is very poor, I have trouble with directions; the internal architecture of my geographic perception is much reduced, I feel as if I have entered Flatland, because normally when I think of directions I see the actual places and turns, for the most part, and I can trace the pattern with my finger in the air. Now directions seem more like words without the maps attached.
Whatever I am, I am not me. I'm a shell of myself with all the filling sucked out. Craig has sprung out of the box of his body and we don't know how to get him back in again. What you meet, what you see, is a construct of Craig, a golem that looks like Craig but really ought not to cast a shadow. My essential Craigness is gone, my way of looking at the universe, my take on literature, humor, my daffy take on so much, it is not there. I cannot laugh except out of politeness. I shudder to give any advice, fearful it may lead to trouble. I crave the simplest tasks, tasks I can do like sweeping or washing the dishes. In short, I don't know who I am. I've lost myself. I don't recognize myself in the mirror; what looks back at me resembles me (with extremely puffy eyes), but it does not feel like me. To touch myself is to touch a golem, a doppelganger, a very weak approximation of who I am as a human being. That I have lost such normal sensations of the self argues that perhaps my sense of self was always very tenuous, but I can assure you that in my manic phases I was more self than anyone wanted to put up with. I was simply too much, knew too much, did too much, slept too little.
For those joining this story late, the onset of symptoms of my depression coincided exactly with when Kathleen and I moved into our quite little house in the redwoods, and all the trouble and sturm and drang and torture of Mexico was behind us. I couldn't believe how quiet everything had become; where was the pressure, where was my next struggle, my next date in a Mexican court or jail, how would I keep up the spirits of my dear wife, there was always purpose and work, both of a nature I didn't want, but I was busy. Busy combatting evil. It was like I held my breath all the way from Mexico until I had us and our dog in a safe dwelling in the beauty of Northern California before I could collapse altogether. And then I did collapse altogether. Sure, I've tended a garden, written much, played music, cooked, hiked, fished, and all the other activities I might have usually done, but the savor is gone from those activities. I walk through them like a ghost. I don't feel present. Like I said to the anesthesiologist this morning, "I hope I don't wake up." I don't. I hope a boulder would fall on me to put me out of my misery. But I won't consider suicide because I know how awful that is for your loved ones, as my father burdened our family with that event when he was 62. I keep telling myself I'll get better someday, but all I have is the terrible now, the feeling of devastation, as if Napoleon and all his armies had marched through my chest and where a heart was is now a vista of burnt and blackened fields. It's a sadness that won't abate, won't relent, can't be forgotten for one iota of a second. The pain my my solar plexus focuses everything inward, like a black hole bending light to its center. If I touch you I'm afraid I'll steal something from you, some life force or animation that inhabits normal people, good or bad. I can't own who I am in this condition because I am not who I am. It's more alien than being another gender or a different animal. If I were a horse and could experience horsness I would count myself blessed. But as a depressed horse, I couldn't experience horseness for that matter; there is just this acre of sadness and tears inside the field of my soul, a graveyard if you will with no redeeming virtues, where no one is mourned because there's nothing to mourn although it feels like an absence of something.
They say 10 to 15 courses of ECT are the usual limit, and already I wonder what's to become of me after I've had 15, which shall be in less than two weeks. Then what therapy is available? Is there a halfway house for the superdepressed, a place where manual labor can be enforced to make our bodies feel as if they were our bodies? I think of some wilderness journey, some extreme physical trial as a possible antidote, something so physically dangerous that I have to pay attention to my body until I begin to inhabit it once again else die trying. You'd think with all the advances in biological psychiatry that someone somewhere would have an answer for me. I'm open to anything. I would try religion but religion just makes me feel more damned, I feel so unworthy of God's love and forgiveness. And it does not escape me that my inability to receive love and laughter could be a form of the Devil's pride, a "You can't help me!" game. But it's not like that. If only God could reach his healing hand inside my empty chest and light a spark, a small flame of Craigness, a hint of self, I think I could make it back. But that isn't happening, and if I start frequenting Pentecostal churches or healing services I'll just end up feeling worse, like my lack of ability to be healed is an insult to God and man and faith.
Too bad we are symbolic creatures, too bad we can think about our inner states in words. If I were a cow and depressed, I'd just stop eating and socializing and eventually die. Because I am a man I can by sheer will make myself get up, get dressed, eat something, try to do something, even though all of it seems like play-acting self-deception of the lowest variety. You see, I don't believe in me. I lack faith in my own existence. If I knew someone else in this condition my fervent wish would be for their death and release from this vale of tears. I don't know how to feel any lower. Feeling low is all I know. Or better, feeling alienated from my former self. After oodles of medications and ten shock treatments I'm just as bad as before if not worse, because I'm having my last hope taken from me. I can't imagine living another 20 years like this; I wouldn't wish it on my worst enemy. I would do anything to get well that doesn't involve hurting another person or creature. The greatest kinship I feel is with plants, if I feel any kinship at all.
So this is my condition. This is what I'm being treated for. This is what I'm indebting myself for financially to have treated, piling up debts for the future should I ever get well enough to pay them. I don't want to be a human anymore; I would be insentient as a stone, I can't stand the pain anymore, I understand why adolescents cut themsleves for relief, but in my case a good cut wouldn't help because it would have to be sewn up. Am I making sense? I'm no better than a sock monkey; no, worse, because sock monkeys don't have feelings. I don't know how not to feel, you'd think this array of drugs would turn me into a walking zombie, but even they are not powerful enough to make me feel any different. I offer myself to you, the reader, and ask for your good will and wishes, even prayers if you can utter them. It would mean a lot to my friends and family if I could get better; I ask you for their sake, not mine. I'm told I was once a good man who did much good in this world, but now I don't even feel a man, more like an oyster for the walrus to weep over.
Please bear with me as I endure this. I'm not going anywhere. I promise not to intentionally hurt myself until I blog again, though I don't promise to continue blogging, for what's the point? For folks to read this? Who wants to read this? I certainly don't and I feel ashamed to broadcast it in a blog like this to the unsuspecting. Yet if you have any loved ones who suffer from biological depression, perhaps reading these remarks will give you more compassion. We don't want to be depressed. We'd do anything to get out of it--take any pill, have any current applied to our brains, you see what lengths I am willing to go to? And I so want to get well for my beloved wife, I know her seeing me like this is a torture that is hard to match, because I know, to a lesser extent, what it is to endure one of her depressions. And with that I leave you.

12 comments:

  1. Dear Craig,

    I shall pray for you. Faith it is that keeps the birds aloft--as I believe Millay said. I have faith you WILL recover. Depression is so physical though --I know how it can weigh you down so you can't lift a finger. I'll pray for a lightness to surround you and ease your burdens. A friend, T.

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  2. Anonymous4:00 PM PST

    "You'd think with all the advances in biological psychiatry that someone somewhere would have an answer for me."

    Indeed.

    Surely being depressed is less disabling than thinking about being depressed. One would 'think' that a rabbit suffering from depression lacks the self-awareness to fret its condition and thus merely suffers depression as one would suffer a sprained ankle.

    CE, I still believe your calling is to write write write about this with your powerful arsenal of medical knowledge and writerly skills. I know it's not the fame you expected for yourself. But I think thsi running monologue will have value to someone, if it hasn't already.

    take care
    norm

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  3. Anonymous4:01 PM PST

    Wow, craig... I came across your blog in passing and thought I might reach out. I truly understand where you're coming from. I, too, have endured a cocktail of drugs including wellbutrin. How little task can seem so stress inducing, I still have issues with brushing my teeth nightly (not to share too much info). My point is, I feel you and wish I could do more to help. On a side note, you might want to check out dailystrength.org , I find it's a great site for depression- at least in terms of finding like minded folk. Hope it helps... but most of all, just know you're not alone.

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  4. More prayers, I wish I had more to offer.

    Norm is right, writing about this helps us all.

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  5. Interesting that you have enough of what you refer to as "intellectual knowledge" to know that Kathleen loves you, but sometimes not enough intellectual knowledge to realize that this Thing telling you you're "unworthy to be loved" is the sickness itself talking.

    I sense in you the unusual ability to observe yourself as if you were outside yourself. Your intellect is grounding you through this and sometimes you write as if the illness is happening to someone else and you're just an observer. This is probably a good thing. It is helping you even if it doesn't feel that way, I suspect.

    "My essential Craigness is gone, my way of looking at the universe, my take on literature, humor, my daffy take on so much, it is not there."

    Actually, in the brief period I've been visiting your blog I've seen countless times were you've shown great humor and a bit of daffiness too. This isn't cheap praise I'm giving you, I wouldn't do that. I'm serious. I'll admit I don't know squat about your Craigness because I don't know you, but you are indeed a marvelously humorous and witty individual. Much better than most.

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  6. Would you consider participating in a clinical study of deep brain stimulation? I know I'd previously mentioned that piece I saw on 60 minutes to you about this experimental new way of stimulating an area deep in the brain called area 25 with electrodes that are implanted in the brain.

    I just found this information on an upcoming clinical study:
    Clinical Study of Deep Brain Stimulation for Depression

    The results I witnessed on the 60 Minutes piece were nothing short of life-changing. These were people, who like you, were literally crippled by their depressions.

    It's worth looking into, friend. Especially if the ECT and the scary amount and combination of meds you're taking isn't easing your suffering.

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  7. Oh, I guess I didn't really finish that comment.

    The patients who underwent deep stimulation of area 25 for depression were people like you who literally couldn't live normal lives anymore due to crippling nature of their depressions. The deep brain stimulation completely changed them, alleviated the depression and allowed them to live normal lives again relatively free of depression.

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  8. Hello Craig, I've come here through Merelyme's blog. I've suffered depression but nothing like what you describe. Your talent as a write and great knowledge does give you a unique opportunity to share with others. Please keep writing.

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  9. IKD...you can jump on anything, any new treatment...before deep brain stimulation, there was VNS, first developed for seizures now approved for depression...but look at the company, their ethics...they kicked them off the stock exchange. We can't jump on every cure companies offer us without studying, doing our homework...brain stimulation has the potential, perhaps, to help alot of folks...but we've fallen for alot of things that didn't work, made companies alot of money in the process. We not only have to weigh the side effects of considering a study now, but the integrity of the companies doing them...imho...and seriously weathered opinion.

    Pat

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  10. I can't imagine what you're going through. Just try to keep writing is all I can say. Best wishes to you from New Zealand.

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  11. Thank you, all, all such generous souls, some who have never met me in the flesh. Aread 25 intrigues me, but I think it will be a while before I let an electrician play with my brain!

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