Friday, March 06, 2009

"Best of," cont'd: Recovery from Depression: Three Posts

I edited these posts for extraneous information but included the meat. Though sequential they are not necessarily consistent in their connections. But it's interesting to see that just over a year ago I entered recovery from depression.

From 4/5/08: How It Happened

I am now in recovery from depression, neither cured not expecting to be. It is a chronic disease in my case, and it would be unrealistic not to expect another occurrence or two in my remaining lifetime. When I think back on my life, before my diagnosis I suffered 5 major depressions; since I have suffered 3 more. The longest was the recent one, two years, provided I remain in remission. The deepest one was at age 29 when I was finally ushered into treatment.

Thus through age 29 I suffered five major depressions, and since being diagnosed, through age 53, while under treatment, I have suffered three more. This is not statistically significant in terms of prevention, unfortunately, but who knows how much I would have suffered without treatment? Just as alcoholics are in recovery, think of me as a melancholic in in recovery, though this parallel cannot stand much scrutiny, as the latter is more difficult to treat, in my experience.

Now you may rightly ask what concatenation of fortuitous circumstances led to my current recovery. In no particular order:

Spiritual: My friend Eric had a dream about Christ weeping over my body and healing me. About two weeks later, before the new antidepressant had had any effect, I wept in prayer while trying to pray as honestly as I possibly could. For the first time in I don't know how long, I felt some brief, inexplicable connection with the Light, a momentary piercing of the veil, so it seemed.

Chemical: On March 24 my doctor changed my antidepressant again। Within a week we upped it to therapeutic levels. Two-and-a-half weeks later, the usual time frame for response to an antidepressant (2 – 6 weeks), I began to feel a little better. This was on Thursday, April 10, when I was stranded in Lost Hills, CA, with a cracked radiator. Being confronted with a minor crisis was a pleasure in my state, as it got me out of myself. Thanks to a tip about some mechanics who hung around their shop late, we were able to move on the same night. (FGI (for general information) a plastic radiator can't be fixed with “Insta-Weld.” It must be replaced.)

Physical: Though ECT and Invega (an anti-psychotic whose effects on me were similar to the demonic Haldol) made me worse in Jan/Feb of this year, I requested an MRI of my brain while hospitalized and they discovered a bilateral, chronic maxillary sinus infection (everyone in my family seems to have allergies but I never paid them no mind). I remembered a case as a family practitioner where a depressive perked up after I treated her chronic sinus infection, so I went to our family doctor and requested treatment. After a month's antibiotics (the first two weeks spitting up a lot of schmegg), not only was my depression better but my voice had improved markedly. It's timbre and resonance had returned, I was no longer singing through pockets of mucous that robbed me of my natural timbre. So add this to my list of fortuitous concatenation of circumstances.

Behavioral and Social: In visiting my daughters and my oldest friend, though cruelly prevented from seeing my grandson, I had a chance to pretend to be myself, to pour myself into the mold of the upbeat, humorous, philosophizing, friendly, garrulous (and sometimes offensive) person I usually am. My second daughter, Keturah, invited me to Happy Hour the next day, April 11, and we had an exotic martini-drinking jamboree/competition at half-price. I was also able to see Sarah perform in a play for only the second time since middle school. And I sat for two hours in an old familiar bar, Joe Jost's, with Eric, talking while trying to avoid any mention of depression. I was so sick of talking about it.

When I returned home I continued to pretend to be myself with dogged courage. There were times when melancholy begged admission, but I refused to discuss my depression। I lied to Kathleen about how I was feeling as a matter of course. I even avoided seeing my psychiatrist because in nearing his office I burst into tears at the memory of all the times I had sat in his office depressed. I told him by e-mail and he understood। This Wednesday I will likely be well enough to see him.

Socially I should also mention that traveling 1200 miles with my stepson, Derek, was a tonic He's funny and upbeat Among other things he taught me the difference between Hip Hop and Gangsta Rap (through a plethora of too-loud examples).

In returning home my volunteer work began to pick up, obligating me to work with others while Iavoiding any mention of my condition. I am now involved with six different volunteer groups, including a musical gig for a group sing with the homeless and mentally ill every Friday.

To sum up, there was Eric's dream and my later prayer; a significant change in medication (I went off two meds and on two others); the discovery and treatment of a chronic infection, and the social/behavioral opportunity to be myself, a chance I clung to like a life raft in a flood. Without all three features I do not know if I would have improved, but I consider the change in antidepressants the most important, as without a slight elevation in mood I would not have thought of pretending to be myself. Antidepressants sometimes make you just well enough to get better with other help. And that help comes through doing, not being, as my shrink is fond of saying.

From 4/8/08: In Danger of Mania?

I had a manic dream last night, something so rare I can't remember the last one. And it's the second night I've had one. I attribute it to taking my second dose of Effexor too late. I need to take it in the afternoon apparently. But just as depressive dreams often warn me of on oncoming depression and have prevented its clinical eruption by such caution, so likewise my body may be warning me of flipping past euthymia into hypomania if not careful.

In the first night's dream I battled an armored dwarf who came after me with a machete'; after I disarmed him, he picked up a battle-ax and assaulted me with increased vigor। Again I disarmed him easily and told him that if that sort of behavior turned him on, I might have to pay attention, but that his aggressions would be better served in some other way. He was crestfallen and felt diminished, though I didn't discount future attacks. I acted as if this sort of thing happened every day and that I was more than competent to deal with murderous dwarfs. Which reminds of the time when, while manic, I kept a police dog (German Shepherd) at bay with one hand, slapping him repeatedly when he tried to leap, keeping the other hand free to smoke, gesture, and reason with an arresting officer. The dog gave up; he realized that I was too quick for him and I don't know how hard I slap when I'm manic; very hard, I expect. I still have scars on my right hand from the occasional tooth.

In last night's dream we were in Mexico (Kathleen and I and her mother and Derek), where I would become enraged at the slightest deviation from my way, to the point of belittling my dear wife and shocking her mother while I ran around a beachside Mexican resort looking for conflict with with anyone from “the dark side।” I can't remember any physical altercations. It's pointless resisting me when in any case I'm manic, whether in a dream or reality. Either calm me down (which has been done by loved ones) or call the authorities.

At the supermarket yesterday late in the afternoon I snapped at Kathleen because I was “houchy” (so hungry I was grouchy), but luckily she didn't hear it। When my blood sugar dips too far I can get like that, in a mini-manic explosion of anger, but I got some Safeway sushi in time to quiet the demon.

This is the Scylla and Charybdis of my disease: in treating a depression you may overshoot into mania, and vice-versa. Yet as an informed consumer, the first logical step is to take my second dose of Effexor earlier; the second is to skip the second dose altogether. In addition I increased my mood-stabilizing agent, Klonopin, to 2 mg. last night, which made me sleep until noon, but I felt it a necessary precaution after two nights of manic dreams.

And yes, poetry has come back to me and I'm enjoying it. I have been posting at three boards and my poem, “Queen Melancholy,” was solicited by an editor.

The obvious question: Will Craig grow manic?

Not if he can help it. And it is much easier to tame a mania than to reverse a depression.

From 4/12/08: On Joy

Joy is much harder to capture in words than fear or sorrow. And by joy I do not mean contentment or happiness, but a deeper feeling, echoed in passages like Romans 8:

We know that the whole creation has been groaning as in the pains of childbirth right up to the present time, waiting in eager expectation for the sons of God to be revealed, for the creation itself will be liberated from its bondage to decay and brought into the glorious freedom of the children of God। For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord।” (NIV version, 8:19 ff.)

What is the Kingdom of Heaven but the indescribable joy of inseparable, insuperable eternal love, the very thing we craved from our first banishment from the dumb joy of the womb?

Keats comes closest, in of all places, his “Ode on Melancholy,” where the sorrow-tinged exaltation of which he speaks approaches Joy:

"But when the melancholy fit shall fall
Sudden from heaven like a weeping cloud...
Then glut thy sorrow on a morning rose,
Or on the rainbow of the salt sand-wave,
Or on the wealth of globed peonies;
Or if thy mistress some rich anger shows,
Emprison her soft hand, and let her rave,
And feed deep, deep upon her peerless eyes.

"She dwells with Beauty - Beauty that must die;
And Joy, whose hand is ever at his lips
Veil'd Melancholy has her sovran shrine,
Though seen of none save him whose strenuous tongue
Can burst Joy's grape against his palate fine."

Schiller's Ode to Joy, made famous by Beethoven's 9th, falls short of this standard:

Let the cosmos embrace you, you millions!
This kiss goes to the entire world!...
Whoever has had the great fortune
To know true friendship
Whoever has won the love of a devoted wife,
Add his to our jubilation."

(My translation, excerpted from the second stanza।)

This ode, written on the cusp when the Augustan age gave over to the Romantic, still contains more subject-object distance from joy than Keats. As such it may be that only my anachronistic eye fails to feel the joy of this piece, though the music certainly conveys it—music based on a German beer hall song, incidentally.

Yesterday I was sitting on an old redwood log facing a pasturer where wild turkeys flocked and deer feasted on the long grass. Stellar's Jays, supernaturally blue, hopped and pecked in the grass beside a robin. I listened to the bird song and wind and nothing else। I took my shirt off and lit a hand-rolled cigarette and guiltlessly enjoyed the smoke and the scene, experiencing a richness beyond words. In the distance small whitecaps erupted on the royal blue Pacific. There was nothing I wanted or didn't want, and to illustrate the paucity of words, I can only say I felt like I was in a Disney movie.

This is in part what Eliot meant by “the timeless moment,” that out-of-self experience of all- encompassing joy. When my cigarette was done I wandered out into the pasture, staring at blue-eyed grass and yellow-eyed grass and the lavender and white profusion of wild radishes. A six-point buck pranced away at my approach, his body leaping, his neck proudly erect like a war horse. Joy in his motion, joy in his freedom, joy in his perfection.

It is in our most extreme states that our hearts turns toward the numinous. If we think of God at all, we are most apt to think of him in our deepest sorrow or greatest joy.

There is a moment in “The Screw Tape Letters” where the protagonist is being oppressed by a demon with a mild depression, and he decides to go for a walk in the country. The beauty of nature transports him out of himself and back into awareness of God.

Afterwards the demon is scolded by his superior: “How could you possibly let the subject do something he enjoyed? You risked him getting out of himself. We want his pleasures circumscribed—the club, television, liquor, not something so dangerous as nature. You fool!”

Exactly. Extreme joy and sorrow are two paths to the same place, another point made in Eliot's “Four Quartets,” though not so directly; in its famous conclusion, sorrow and joy, earthly suffering and isolated moments of transport are fused:

“All manner of thing shall be well
When the tongues of flame are in-folded
Into the crowned knot of fire
And the fire and the rose are one.”

C. E. Chaffin

1 comment:

  1. Thanks for sharing such a nice information about depression recovery here, this could be very helpful.


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