Friday, November 11, 2011

Depression, continued...

I have written reams about depression.  I still have no answer though I have been flooded with information.  Sadly, none of the information seems to benefit me.  I have lost the will to live.

I recall Melville's story of Bartleby the Scrivener.  Here was a man with a bone-tiring occupation of copying figures all day.  One day, for no reason it seems, he quit doing his job.  When his employer upbraided him for sitting and doing nothing, telling him to get to work, he blandly replied: "I prefer not to."  And from that point on, his life degenerated because he had said the great "No" to the universe.

I feel like Bartleby.  I cannot engage with life.  I have no ambition other than to survive another day.  My thoughts constantly condemn me, I think I have lost hope.  I don't think I've ever quite passed this existential Rubicon before.  Hope is the condition for survival; without it we are lost.  Hence I am lost.

Life, frankly, terrifies me.  The smallest tasks have become so anxiety-ridden I don't know how I perform them.  Washing the dishes is an overwhelming undertaking.  I do not know what to do with my free time, which is almost all my time.  I cannot write a lick of poetry, my music is moribund, my creativity vanished. 

There is no magic bullet for me--neither medications nor therapy.  Of course, I do both, but with little or no result.  My therapist sympathizes with my plight and tries to make me make an alliance with my observing ego over and above my experiential ego, to stand back and say, "That's your depression talking.  Don't go there."  Yet it seems I am helpless to resist the spiral of self-consumption, unable to distinguish the better or more objective me from the me of experience.

I'm blogging today in an attempt to give expression, to in effect organize my plight.  But again I suffer from paucity of thought.  I don't have much to say.  If people call I can hardly carry on a conversation.

Depressed people must be the most boring people on earth.

Self-consumption, self-obsession--a human is designed to look outside himself, to act upon his environment, to engage materially and socially.  I cannot.  Thank God I can still read. 

Having given up alcohol and other vices, cigarettes remain my last comfort, though they are killing me.  They taste bad and I cough and wheeze.  But they are a momentary oral satisfaction, just as food.  I can still eat.  I have become infantilized. 

I feel I ought to be institutionalized until I can somehow improve.  Yet I was institutionalized for 45 days last February and March with little result.  And twelve courses of ECT could not shake me out of depression.

Depression is an inadequate word to express the horror in which I exist.  Brain fever or melancholic seizure or simply "hell" better fits the state.  I cannot seem to will myself to will myself to live.  Suicidal thoughts plague me, indeed I am committing slow suicide through continuing to smoke.  I want an end; I would welcome death but am morally opposed to suicide, not only because it is the most selfish act one can commit but because it leaves loved ones holding the bag of guilt and sorrow.  My father committed suicide.  I envy him but refuse to succumb.  In fact my goal, my only goal at present it seems, is survival--and my chief accomplishment is not to commit suicide.

Last night my wife nearly forced me to attend a local open mic affair where I played three original songs to a great reception.  But it was not me playing; it was some robot mouthing the lyrics and strumming the chords.  Praise from others did not affect me.  I suppose criticism would have had a greater effect, since I twist everything into self-criticism in any case.

I have prayed and prayed but am entirely aware of the truth that "God helps those who help themselves."  Yet I don't know how to help myself, and when I contemplate activities, the chronic pain in my spine severely limits what I can do.  I can't volunteer to help extirpate local invasive flora, for instance, for digging would put me on my back for a day.

I did have two miraculous weeks from late September through early October when I popped out of my depression suddenly, and I thought it would last.  I was so relieved to be out of it!  Suddenly the darkness lifted and it was as if the whole experience had been unreal.  Just as suddenly the mood shift abandoned me. 

In those two weeks, among other things, I bought a wetsuit for local diving, I made arrangements to play with other musicians, I started a support group for depression, I was suddenly engaged in life.  But that life was taken from me.  I think of the story, "Flowers for Algernon," where the retarded man becomes intellectually gifted from a medication, but eventually the medication wears off and he sees himself descend from intellectual heights back to his former state and can do nothing to stop his fall. 

If you are not clinically depressed, fall down on your knees and give thanks to God.  I certainly would.  My greatest joy is not to be depressed.  I know of no worse disease, truly, and I have seen them all as a physician.  Depression is the soul-destroyer; do everything you can to maintain your optimism in the face of trying circumstances, let nothing drag you down into the pit of self-obsession, do everything you can to stay engaged with life, no matter how lowly your occupation, your disability, your situation.  Hang on to hope with your fingernails if you must; this is essential, for once you fall, you will certainly fall again, as most severe clinical depressions recur at some point in one's life after the first.  In fact clinical studies agree that after one depression a patient ought to be put on maintenance medication to prevent a recurrence--for life.

Depression damages the brain anatomically.  In autopsy studies, the central emotional regulator, the amygdala, has shrunk up to 20% in depressives.  This is a real disease, as real as tuberculosis and in my view, more deadly.  30% or more of bipolars die from it, either by accident in the manic phase or suicide in the depressive one.  Childhood leukemia has far better results in terms of treatment.

I did not want to write this today.  I wrote it for my own "health."  I do not know how it can help others, though folks have told me that my experience has somehow helped them.  May it be so.

To survive another day.  My goal.

Beyond kilorats,

CE

Monday, October 24, 2011

Vicissitudes

For no obvious reason I could determine, I popped out of my nine-month suicidal depression for a little over two weeks, but they ended precipitously on October 13, curiously the anniversary date of Kathleen leaving me when I was manic.

I was lying on the couch listening to her singing as she cooked.  Then I thought, "What if I were to lose her?"  Then without warning, though I tried to hold on, I felt myself spiraling back to oblivion where I have been since, an oblivion worse for having tasted normality ever so briefly.

This is a puzzling disease.  I was myself for two weeks, then suddenly I am not--lost again in the morass of unendurable self-annihilating miasma, back to suicidal thoughts, complete disorganization of the mind, the horrors, the inability to make a decision, lack of interest in all things, terrified of everything and nothing.

Nothing really changed except my mood, but I must have been extremely vulnerable, and I don't know if the anniversary reaction helped trigger it or not.

Now I am toughing it out again, have gone back on antipsychotics for survival's sake, and today, thank God, I was a little less worse than yesterday.

Back to 6 Kilorats,

CE

Wednesday, October 05, 2011

Surviving Depression

Accept. Endure.
By acceptance you de-fang the monster of the mid-brain who dwells in your very DNA, the inevitable inheritance of the reptile within, which accuses us constantly of failure in our dark times.

Depression is an evil in need of healing. To accept evil is not to bow to evil; to deny evil is to bow. The devil cannot fool those who believe in him.

The chief human problem is not lust, or desire, as Buddha averred, no--it is imperfection, how we hold ourselves accountable for aspects of our nature ungoverned by will, how we punish ourselves for lacking the wisdom to avoid tragedy only after the tragedy has passed. There is no predestination but living out our natures. To suffer our brokenness is the ultimate acceptance, knowing the self that survives is the true self, undeterred by the opinions of others, immune to reputation, inured to criticism (though always ready to examine itself if not mood-impaired).

Too many fail at suffering because they lack endurance. Suffering begs for the easy way out, whether by religion or a bottle of booze. Unendurable pain can be endured; if not, the human body will pass into unconsciousness. The worst part of suffering is fear: fear makes pain more painful in its apprehension. This is living in the future. All we can bear is the present. If we can endure the present for one more minute, we can endure for another, and stitching minutes together we can endure for as long as required.

In the case of a good man, suffering is rarely deserved. To link behavior to just deserts is a fatal mirage, one that Job shattered. One must accept illogical, individualized suffering as no more than one’s due in this life. Humility demands this.

Blaming God for our suffering diminishes him; blaming ourselves feeds our narcissism; blaming others is futile, they are only agents. What we can do is endure, when all pride is gone, when all options are spent, when suicide endeavors to seduce us with a false peace.

Accept. Endure.


Thine at 1 Kilobunny,
 
CE

Tuesday, September 27, 2011

New Publications

Flowers of Heraclitus in The Flea

Feature (five poems) and essay in Blue Fifth Review

I have been silent a long while while spambots invade this blog. 

My silence has been a reflection of the fact that I have written enough about depression for a lifetime.

I am presently emerging from a near year-long suicidal depression by the grace of God and a fortuitous concatenation of circumstances, of which I can only say, no doctor could explain it, no poet can contain it, it is, simply, a quite irrational miracle.

Carry on!  There is always hope, even when you can't feel it.

Thine as always,

Craig Erick

Friday, August 05, 2011

Composure (flash fiction)

I received in the mail yesterday a challenge for a flash fiction contest, which resulted in the anecdote below.  The requirement was a thousand words or less.  I hope this little diversion brings a chuckle to your brain.

Composure


It was another day at the walk-in clinic in a poor section of Santa Ana where I struggled to communicate with Latino families, and where my Irish Catholic boss was the worst I’d had. He was building a bowling alley in his house while refusing to provide hand soap in the examining rooms, so I used to carry a bar around in my pocket to wash between patients. By concentrating on the needs of patients I was able to put the substandard working conditions out of my mind, though I later became so enraged that I quit.

A black woman in her mid-twenties pushed open the glass door of the entrance and came to the reception desk to register. She was neatly dressed in a yellow polo shirt and sharply creased jeans. Brand new Nikes completed her outfit. Her undyed curls were of moderate length, she wore eye shadow and mascara but no lipstick, foundation or blush. Maybe 5’4”, she was curvaceous without being given over to pulchritude. After a short wait the nurse took her to an examining room and recorded her vitals. In my long white coat with a stethoscope hung about my neck, the equivalent of a priest’s collar, I entered the room. I sat down on the swiveling stool while she sat high on the examining table.

“So what brings you into the clinic today?” I began.

A look of brief disappointment passed over her face, quickly deflating into a grim resolve. Lucent brown eyes fixed me levelly as she said, “I have a discharge.”

“Oh,” I said, in my professionally compassionate voice, not yet tainted by greed or constant overwork. I was too young for that and hoped I always would be. “How long have you had it?”

“About a week.”

“Is it getting better or worse?”

“If it was getting better you think I’d be here?” she said.

“It’s always wise to come in,” I said in mollification, hoping she did not think me too dense. “Can you describe it?”

She glanced at the crotch of her jeans as if this might remind her.

“It’s kind of yellowish and thick.”

“Any odor?”

“Doesn’t it usually smell down there, Doctor?” she said without embarrassment, though a smile pulled at her lips. I wanted to laugh but maintained my professional composure.

“Are you in any pain?” I continued. “Does it burn when you urinate?”

“Not really,” she said.

“Is intercourse painful?”

“I haven’t had any since this started.” She twisted her neck and rubbed it.

“Have you had any new sexual partners recently?” I asked routinely.

She gave me an emphatic “No!”, shaking her head in disgust.

“Well then,” I said, “We’ll have to take a look. The nurse will be in to get you ready OK?”

“OK,” she said, rolling her eyes. I left the room. When I returned she was up on the table with her pale heels in the stirrups, her legs spread wide and a blue paper drape lined with clear plastic covering her legs and groin. I pulled on my gloves, the nurse warmed the speculum and I gently inserted it in the bluish vulva before the pink vaginal folds all races have in common appeared. The discharge was obvious, thick and purulent, typical for gonorrhea. I looked up at the cervical os, and the discharge was ultimately coming from her uterus. I took a culture and swabbed a slide for a gram stain, but the diagnosis was not really in question. There are only so many kinds of vaginal discharge and this one was as old as the oldest profession.

While the speculum was still inserted she asked expectantly, “So what do you think it is?”

In my bluntly lighthearted manner I told her, “It’s not something you get from toilet seats.”

“So I assumed,” she said coldly. She tilted her head back and stared at the acoustic ceiling tiles, her lips pursed in disgust. (Being tall I could see her face above the drape.) “Damn!” she said. “Damn, damn, damn! And I trusted him! And he swore he’d been faithful! Damn his skinny little black ass!”

“I’m sorry,” I said, preparing to remove the speculum, when she blurted, “You know, Doctor, sometimes I wish you would just sew it up! See-oo-ww it up!”

I laughed so hard that the speculum clattered to the floor and the nurse joined in and finally Marie did, too, although her laughter was different, more a sarcastic confirmation than any belly laugh. Embarrassed but only slightly, I picked up the speculum and handed it to the nurse, my hand still shaking from laughter. I thought I might collapse on the floor. It’s the only time I remember laughing during a pelvic.


Thine,

CE

Thursday, August 04, 2011

Brainstorm, continued...

It's been a year since my mania began; it was on August 3rd, 2010, when I experienced an unexpected healing in a shamanic ceremony, led by a local who specializes in such things.

I had an out-of-body experience and saw my body dissected down to muscle and the yellow fat flowing down to drip off of my feet.  In the ensuing mania I lost fifty pounds, thirty of which I've since regained in my depression.  Later the shaman told me that sound, on occasion, could ignite a mania--he heard this from a fellow student at a course in the use of music spiritually.  But by that time I was already gone, so it couldn't have been this event that launched me.

This is a problem in mania; sometimes real things do appear to happen, as in my weight loss, something I'd wanted for a long time in my fight against the metabolic changes wrought by simple belly fat--"the metabolic syndrome."  It could as easily be called "the retribution of abdominal obesity," but the word "obesity" could offend the afflicted, so like most terms in medicine it has been sanitized into a syndrome--which results, of course, from lifestyle--overeating and a sedentary existence.

In any case, if we call that the beginning of my mania, the whole thing lasted five months, a personal record.  It was, per usual, interrupted briefly by a forced hospitalization when I was transferred to the hospital in handcuffs.  I've been forcibly arrested and incarcerated for mania thrice, though I've had other minor brushes with the law not related to mania.  The longest term I spent was forty days and forty nights in hospital and prison back in August of 1987. 

Curiously one daughter maintains that a close relation, also bipolar, has had a tendency towards mania in August, which raises the suspicion of Seasonal Affective Disorder as another provocation for the outbreak of the up side of the illness.  Of my three protracted manias, two began in the late summer and continued into the fall, but another began in the spring, the one that resulted in my forty-day incarceration-- when I had my only experience of prison (as opposed to temporary jailing).   But I digress, which is a good sign, since in depression I am usually afflicted with a paucity of thought.

Back to the reality of mania: Besides the weight loss I had a number of supernatural experiences, some confirmed by witnesses.  For instance, one night from the bluff a friend and I witnessed a Viking boat lit up with lights heading southwest at night.  We saw the same boat on another occasion, and he will swear to its reality.  But there is no Viking boat in Mendocino, so was it a shared delusion or was it real?  On another occasion, standing on the apron of rock that makes up our shores, a rogue wave seized me and I was transported upwards and entirely disappeared from my friends, suspended in a tube of whitewater where I spun like a cat and landed, mainly unharmed, in another place  on the rocks.  I disappeared from sight in the wave.  Whether my manic reflexes saved me or I was just lucky, I don't know.  But the episode certainly approached the supernatural, or at least supernaturally luck.  I could have easily broken my neck and drowned.  In my subsequent depression I have often wished that were the case!

Of course, what goes up must come down--"Riding high in April, shot down in May"--and I had a great crash in January that eventually necessitated hospitalization because I was acutely suicidal.  I have rarely felt so bad, and considering the source, that means very bad.  I was hospitalized for 45 days, including 12 EC T treatments, with little benefit save that when I was discharged I was no longer "actively suicidal" though I suffered greatly from suicidal thoughts and have since. 

Which brings me to the present, which often seems an eternity in my intense dysphoria.  I like that word, "dysphoria."  It means mental hell of such depth that it is indescribable to those who have never experienced clinical depression.  But there should be a better word.  William Styron, in "Darkness Visible," agreed that "depression" is hardly adequate to describe such a state, and compared it to a seizure or brainstorm--a complete failure of the normal neuronal circuits so that the mind turns to itself in an orgy of self-destruction.  Is there a better word?  Global revulsion?   The bell jar just won't cut it--feeling disconnected is one symptom, but disconnected and thoroughly suicidal is another depth.  There is no adequate word for depression, but I have a poem that explores the subject, maybe my best poem about it:

Eternal Recurrence


Psychologists call mania
a defense against depression
but I find that silly.
There is no defense
against depression
and no adequate metaphor
for its recurrence, but I’ll try:

You love someone with all your heart.
They are brutally murdered.
After an interminable grief
they magically reappear
and you fall down on your knees
and thank God with tears.

The second time is worse.

After the third funeral
you dread their resurrection
as much as their death
and love becomes a poisonous thing.
You would drive a stake
through their heart
if only you could.

***********************

Yesterday I saw my psychiatrist and finally persuaded him to put me on a stimulant in addition to all my other medications.  He had been reluctant to do so, fearing mania.  But I promised to see him weekly after I started it so he could satisfy himself that the risk was decreased.

Incidentally I just read a new review of the treatment of bipolar depression in the Psychiatric Times, and there is really nothing new and no good treatment for the malady, why there are so many treatments--the proportion of treatments of a disease are proportional to the inadequacy of such treatments.  Nevertheless, in a couple of trials, Modafinil, a new type of stimulant, proved somewhat helpful, so maybe my review of the research led my psychiatrist to relent.

Another thing that helps short-term is sleep deprivation, so I tried to stay up last night and got very little sleep, followed by my first dose of the stimulant, why I had the courage to blog this morning, so it seems.  But my fragility is intense--if I get a couple of days feeling slightly better I start to make plans, which immediately fail me when the darkness returns.  This is intensely frustrating.

In my last post-manic depression writing helped me rise out of it, especially when I started getting published a great deal, and the literary Net became my sustenance.  Perhaps returning to workshops there might be of some benefit to me, but I have nothing to post and limited confidence in my critiques, though likely enough to participate.  Anything that occupies my mind is welcome, however much the struggle.  For the most part I've been reading semi-trashy novels and "cowering in my cubicle," a phrase invented by my good friend, Ralph.  Most tasks I initiate I can't complete and are then forgotten.  This morning I summoned the courage to face my backlog of e-mails but found myself blogging instead.  Whether I have any remaining readership is not important, only that I write something.

Perhaps daily blogging will help, but I won't demand of myself to do it daily--presently it is a huge burden to even shower, and I've been failing at flossing, often my last boundary before complete oblivion.  I have never achieved a catatonic state, where the patient cannot respond to anything and goes completely silent and may cease to function altogether, soiling themselves and as helpless as a newborn--though I imagine there is some relief in that infantilization.  My ego, though tattered, is too strong, I believe, to descend to such a state, at least so far.  In "Noonday Demon," a book I strongly recommend to those interested in my malady, the author at times could not even feed himself and his father had to cut up his food and fork it into his son's mouth.  I haven't been that bad behaviorally, but I have certainly been that bad internally.  I can't tell you how painful this illness is--refer back to the poem above--and only suicide promises an end to pain, though who knows?  Certainly medieval thought reserved a special purgatory for such an act, but at least purgatory ultimately holds the hope of salvation, something a severely depressed person cannot imagine.  Having some hope is better than none at all.  If I knew there were an end to my torment I could suffer it more stoically, perhaps, and I remind myself that this is a cyclic illness and I will likely get better someday--perhaps even today!  Still, with every recurrence there is greater chance of recurrence, and autopsies reveal that those who have suffered severe, recurrent depression suffer loss of brain tissue, particularly the amygdala, an important organ in regulating mood and many other important synthesizing operations.  I fear my amygdala has shrunk, and I suppose the amount is proportional to the amount of shrinking I have required to survive.

Here ends my epistle for the day.

CE

unratable







XI


It’s not for flaw of character I weep
But for a flaw of chemistry, my dear.
Inside the gyri of my brain it creeps
Infecting all connections, engineer
Of all the darkest petals of the mind
Blighted and browned, hideous to behold,
A monster to myself, a worthless rind
Upon a garbage heap informed by mold.
The green fuzz on the peel is the thing.
But shouldn’t fungus more concern the dead?
I feel its hyphae in my reasoning;
Can’t someone suck this poison from my head?
If brain were foot I’d apply fungal cream
Or perhaps I should begin with trephining.

Tuesday, August 02, 2011

On and On....

I'm four and a half months out the institution where I spent 45 days and finally, as medications did not improve my state, underwent 12 ECT treatments. 

For those who think the procedure horrible, it's really humane and the only side effect for me, besides feeling a little fuzzy, was a headache.

Unfortunately they did not work, just as my medications are not working.

Altogether in my life I've had 33 ECT treatments.  At thirty, when I was first diagnosed, they worked and I went back to a life, my life.  The last two courses--March of 2008 and this year--did little or nothing.  I left the hospital no longer "actively suicidal" but still profoundly depressed, as I am now.

I take an antipsychotic, a mood stabilizer, an anti-anxiety medication and an antidepressant.  So much my cocktail.  But my dysphoria (the polar opposite of euphoria) is still intense, and the pressing, circular thoughts of suicide daily afflict me.  I make bargains with myself--I won't do it until my next AA meeting, yada yada yada yada.  Thus I forestall my self-destruction, though I pursue it through lesser means like chain-smoking.  What most prevents me is the sorrow it would cause my loved ones, and their faces parade before me when I feel utterly forsaken.  This struggle is not new.  I've weathered it before.  This is a cyclic illness and I must remind myself of that.  Someday I will feel better.  In fact, just recently, I had a four-day uplift in mood which quickly slipped through my mind's fingers.  During that time I briefly developed ambitions--volunteer work, a musical project.  But with the return of the albatross all seemed lost. 

I believe this is the worst disease to afflict mankind, and furthermore, in the history of Christian philosophy, no sin is greater than despair.  In a way, depression--sloth, accidie, melancholy (to use more medieval terms)--is also a sin of pride.  The great "NO" one speaks to the world is a narcissistic collapse of pride, proving that one's self-esteem was a chimera to begin with.  Although one feels no pride in this state, one can assign it--to say to God that you are incurable and that he made a mistake, to wish you were aborted as Job did--is an inverted sort of pride (although I take no pride in it).  Still, shall the creature say to his creator that his life is of no account?  And cancel the phantom debt by dissolution? 

"To be or not to be."  At what degree of psychic pain is it permissible to end one's life?  It has been argued that chronic, unremitting physical pain is a moral justification for suicide.  If so, doesn't psychic pain, which I find much more difficult to endure, qualify as an even better justification? 

I spoke recently with a dear friend who haltingly tried to formulate her sentiment towards me.  It amounted to this: she wouldn't blame me if I did commit suicide.  Having had brushes with severe depression, she could only imagine the suffering I endure, or rather she found it unimaginable.  In any case it was as if she granted me permission.  But she is not God or fate; she is simply an example of extreme Christian charity in my view.  God bless her for her understanding.  Tearfully I received it.  I told her it was the most charitable thing anyone had ever said to me.

But I will not do it.  I must hold to hope.  I have weathered this storm before and I will do so again.  I probably ought to be hospitalized or institutionalized but have no desire to return to those puke-yellow walls or gray carpeting or the smile of psychiatric nurses trying to understand when they have no idea of the burden such patients suffer.

Am I being self-indulgent?  Probably.  Is it a sin?  I don't know.  I don't have the gumption to do anything beside read brain candy (as in mystery novels) and take out the trash and walk the dog and floss my teeth and try to attend AA meetings and to make a pact not to raise my hand against myself until the next therapy appointment, the next meeting, my next visit to my psychiatrist.  I am blessed to have so much help but cursed in that I do not benefit from it in any tangible way I can perceive.  I ought to join a monastery if they would take me, or the Peace Corps, but my chronic back pain won't allow me to participate fully in life or live the rigors of such commitments.  Still, to have my life regimented by some other authority would be a great blessing. 

I wish I could offer the reader, if I still have any readers, more hope.  But I have always stated in this blog that my idea was to help others endure depression more than anything.  Although some go to their grave depressed, most recover in time.  I pray I might be one of the lucky ones.  I can't imagine living like this for another twenty years when every day seems like an eternity already.

Enough blathering.  Here's Dark Sonnet XIII, revised:

VIII


You want to die more than you want to live
And smile tightly, trying not to let on.
With luck you’ll pass for normal, forced to give
A weak impression than you’ve not withdrawn
Entirely. Get up, get dressed and shave
And go to work and earn your daily bread.
Each day is one day closer to the grave--
Still on you clomp as if your shoes were lead.
You’re only doing what you have to do
To engineer some cheer to fool your friends
Into believing you’re no more than blue
Or else distracted by important ends.
This dedicated sham can last for years
If you hide the embarrassment of tears.


Thine,

CE

Friday, July 29, 2011

Dark Sonnet II, revised

II



In horror of the groaning of the reef

At one more wave’s repetitive onslaught,

I listen to the outboard for relief,

A healthier racket than my jangled thought.

You there—do you cognate in straight lines?

Do thoughts follow each other, hand in hand?

Or is it that your insight’s without spines

Like a sea urchin’s skeleton on sand?

Vanilla life, vanilla in your veins,

Uncomplicated, unexamined days?

If only I could tender you the reins

To my life, could I sail through the quays

Untroubled, hoist martinis to the shore?

I’d give my soul for your white bread rapport.

Tuesday, July 26, 2011

Surprise/ Dark Sonnets Revised

For three days almost I have felt slightly better with no explanation; no change in meds or therapy.  Less rumination, esp. about suicide.

I've been reading "The Noonday Demon" again by Andrew Solomon, an excellent book I recommend.  He subtitles it "An Atlas of Depression," and certainly the moniker is deserved. 

Meanwhile I summoned the courage to revise some of the "Dark Sonnets" posted here before.  I hope to offer the revised series in the coming weeks, beginning with today's "I."

Namaste,

Craig

I


Once more this fell infection of the mind
Galls itself, one wound gouges another.
This pus of pitted surfaces will find
More cells to infiltrate, more smooth to smother.
I put a stethoscope upon my head
To eavesdrop on the stuttering machine,
Heard nothing but the clawing of the dead
Inside a skipping jukebox’s routine.
I dream of pills and guns and mangled cars,
The sordid images of methods used.
They haven’t answered “Is there life on Mars?”
As yet. From judgment shouldn’t I be recused
Until they do? Because no life in me
Obtains beyond blessed fatality.

Saturday, July 16, 2011

Bad Dog. Over and Out of It.

Today, unusually for him, our dog Scout scooted out the front door while I wasn't looking and went for a long romp before I whistled him home.  He didn't come quite home--he was cowering in the driveway, knowing he'd been bad.  He'd been out playing with other dogs, so I assume, and wouldn't come right to me--I had to pick him up and then enforce solitary confinement in the bathroom for a spell.  He knew he was guilty!

But he is not troubled by it; animals don't feel guilt, they only know certain behaviors issue in certain outcomes.  Lacking self-consciousness, they are in no danger of becoming Presbyterians.

Guilt.  Why I can't attend church.  In a depressed state one only hears of one's shortcomings, not the grace of God.  Just as in reading the bible, all the condemnatory verses echo in your head and none of the saving verses obtain.  For me religion was all or nothing--either we attained the ideal of Christ or we failed.  Lukewarm rehearsals and socialization in a religious pattern I could never accept at face value, the role of religion in general society.  I wanted New Testament purity, something I sought early on in my faith, attending any number of sects striving for the same thing.  Alas, these sects were built on personality cults and forms of brainwashing to attain a false purity, but they helped fill in an identity for me.  Anything's better than a vacuum (including a broom for sweeping linoleum).

See?  I refuse to lose my sense of humor.  I'm a refusenik.  Also a beat-up-on-myselfnik. 

My therapist keeps me in the woodshed with CBT (cognitive behavioral therapy), telling me not to wallow in depression but climb out through positive thinking.  She's never been depressed as I have, but she makes a good point.  If one can't control one's feelings, the best approach is to control one's thoughts, however difficult.  Nevertheless (and I have polled those bipolars close to me about this), for the sufferer it seems the feelings always precede the thoughts, one reason for medication working when talk won't.  But my medications are barely doing the job, despite my shrink's best efforts and the huge expense. 

Did you know that the new atypical antipsychotic, Abilify, costs $800 for thirty tablets in the USA?  I order 100 tablets from Canada for $400 for a net savings of about $2000.  But the drug companies want to outlaw even this loophole.  Greedy SOBs.  And Obamacare, dispensing with the cherry-picking of insuring only those without preconditions, won't be on board until 2012, and I'm sure the insurance companies will raise everyone's premiums to compensate. 

Trying to get private insurance for my mate has been a nightmare, especially in my condition; I finally settled on something called "CIA!"  I had to cancel two other policies that I'd patched together to resemble something like major medical insurance for her.  And over the phone, all the companies badmouthed each other.  Beware of Patriot health care for one; they're useless.  And NBLA won't refund your joining fee and premium for one month.  When you try to cancel, both entities send you to salesmen who try to talk you out of it, and in my condition it was hard to stand firm against their wiles, but I did.  Predators.  Capitalism is predatory, but at least it offers choices.

I have a choice to go camping with my daughter and a friend tomorrow down in Santa Cruz and I think I shall try to do it, although the first image in my mind were the high cliffs of Highway 1 where I could conveniently drive off.  I won't fall for it, but recall in Annie Hall where Woody Allen is being driven to the airport by Christopher Walken, who says "Sometimes I get the uncontrollable urge to cross the middle line and head-on another car."  However neurotically, Woody clings to life, so the look on his face was priceless.  They made it to the airport.  But I'm acquainted with such fantasies when I drive, though God knows I wouldn't act on it, since it would harm others--why a cliff is more inviting.  But I won't do it--my daughter wants me around to walk her down the aisle some day, and there are others who want me to stick around.  My therapist encourages me to stop all like thinking so I will at this moment.

Yesterday wasn't a bad day.  I did four loads of wash, did a large amount of grocery shopping, washed the car and cooked dinner.  Today I look back in amazement.  Two steps forward and three steps back.  Whoops?  Three steps forward and....clunk, down the basement stairs.  One step forward and vapor lock.  One step backwards and off the dock.  Tickety-tock, tickety-tock.  There's a crack in the engine block.

Quaker state will sludge your engine, avoid it.

Pennzoil rules!  Or Castrol.

Castrolization. 

Gomer Pyle saying "Shazzam!"  I dream of Jeanie.

Heironymo's mad againe.  When then Ile fit you.

These fragments I have shored against my ruins.

Shantih Shantih Shantih

Over and out of it,

CE

Monday, July 11, 2011

Vultures and a Tune

I mistook a vulture for a raven this morning, high above my garden.  Either because of the hour, or because he was very dark on his underside, I was briefly fooled until his flight pattern became evident.  Vultures are some of the smoothest gliders among birds.  I watched him, without flapping his wings once, afterwards negotiate the high branches of a eucalyptus, tilting slightly to avoid them, banking eloquently on the thermal.

When I was manic, which began almost a year ago before my great January crash that put me in the hospital for 45 days, I decided to change my favorite bird, the raven, for the vulture, because vultures clean up the detritus of death and their utility in the chain of nature's degradation is invaluable.  Life issues in death, whatever we do.  My father used to say, "None of gets out of this alive."

The Parsees, who are Zoroastrians, have for over a millennium disposed of their dead amid the towers of silence, where they are quickly consumed by vultures, a practice called "Dokhmenashini."  Their consecrated ground, in the middle of pricey Bombay real estate, has now become an embarrassment, I found out through this link.  Apparently the vultures have been devastated by a virus, and without their consumption of the corpses, a stench has risen in Bombay deemed a public nuisance.  Nevertheless the orthodox Parsees are resisting any interference in their ancient practice, hoping to raise vultures to replace the flock.  Given that timeline, Bombay will continue to reek.  But I hear the city doesn't smell too good to begin with. 

I "decided" to quit smoking today, but quickly succumbed to the habit, as I had four cigarettes left.  I ratiocinated that it's better to quit on a day with no cigarettes, i.e. tomorrow.  To quote the bard:

To-morrow, and to-morrow, and to-morrow,

Creeps in this petty pace from day to day,
To the last syllable of recorded time;
And all our yesterdays have lighted fools
The way to dusty death. Out, out, brief candle!
Life's but a walking shadow, a poor player,
That struts and frets his hour upon the stage,
And then is heard no more. It is a tale
Told by an idiot, full of sound and fury,
Signifying nothing.

Coincidentally my father used to recite this speech from time to time, a vestige of his brief career as a thespian in college.  Pretty dark stuff from Macbeth.  I do not wish to embrace this existential void, but in my present state I'm much more comfortable with death than life.  I've never really been afraid of death; it's life that scares me.  Not that I intend to do anything about it, but when I examine my habits--a lousy diet combined with too many cigarettes and only a daily walk for exercise--I see that I'm not caring for myself, that I may be hastening my death in a sort of slow suicide.  In this I am hardly alone.  But at present I have the willpower of a mayfly, having little to do and resenting whatever is required of me, or I deem required of me--like taking out the trash and paying the bills.  I'm a minimalist, reading mystery novels and chain-smoking, for the most part avoiding human contact, though I am not a misanthrope.

I'm not in a "pure" depression, as I'm not suffering weeping spells, but I suffer mightily from indecision and anxiety, not to mention the warring voices in my head, which I know are my own, which avoids the diagnosis of schizophrenia.  I know all of us are plagued by voices in our head, or sometimes tunes we cannot extirpate from consciousness.  I've had just such a tune in my head for several days since I thought of going to a studio and recording a new album, something I haven't done in almost two decades, despite the plethora of songs I've meanwhile written.  Here's a link to the tune, "Act Like a Man."  It's a solo acoustic version for which the original title was "Killing the Goddess."  Its 4/4 beat drums in my head.  If I go to the studio I will fill it out with harmonies and a bass line and drums and the rest.  If you listen to it, I hope you will not be haunted by it as I am.

If I had to summarize my present diagnosis, I'm a nutcase.  In interactions with others, or even posting here, I can pass for normal, just as Ted Bundy did so well, though I don't consider myself a Republican, as he did.

Not that I have it in me to be a serial killer, if you discount my drowning Raisin Bran with milk.

All for today,

CE

Sunday, July 10, 2011

Poem: "No Need for a Narrator"

Here's a rare poem in my recovery, as I haven't been able to write a lick:


No Need for a Narrator


The shadow of a raven’s wing
sweeps across the garden like a scythe.
Hummingbirds sample the centranthus,
hearts beating a thousand times a minute,
prehensile beaks straining for nectar,
sucking twice their weight in a day.

Bumblebees hover in poppies,
those frilly bowls of pink
whose bottom petals are marked
with four bloody dots.
For two days of high summer
they bloom until the northwest wind
strips them, leaving green bulbs behind,
strange spheres suspended
on pipe cleaner stems-- not opium poppies
although their milk is just as bitter.

Himalayan blackberry,
each purple branch thick with thorns,
encroaches on the buddleia.
They will smother anything
if not pruned back.
Gloves help but not enough.

A heron flies over, gangly in flight,
its thin legs trailing wasp-like
beneath the great gray wings.
Its bullhorn honk silences sparrows,
even the ubiquitous squawking of jays.

No need for a narrator
in listening for the thrush
and the call of sea lions echoing up the dell
above the ocean’s thrumming--
all anthropostulates have disappeared.


As to my mental state, to my great surprise, I had a good day yesterday, though I didn't do anything different.  The new antipsychotic medication, combined with a therapy session where, through my thick Neanderthal skull, the therapist managed to communicate to me that I had a choice, may have something to do with it.  I am not merely a molecule in Brownian motion; this molecule can choose.

She also pointed out that I had taken my marbles and gone home, said "Fuck you!" to the universe, that I refused to do anything required of me beyond absolute necessity.  I concur.  I do walk the dog, take out the trash, last night I cooked.  Nevertheless I am much like a self-centered infant who won't have his freedom abridged by potty training or any other requirement or limitation of my oral-gratifying, chain-smoking self.

(I do still go in the toilet.)

CE

Friday, July 08, 2011

My Illness, continued...

I've already made my private suffering public, and if this blog is of any use to other sufferers, perhaps the invasion of my privacy I have so willingly invited can serve some useful purpose.  The two comments on my last post seem to support this hypothesis.

Clinically I don't know how to diagnose myself exactly at this point; depression and anxiety fill the bill with the occasional relief of getting outside myself in viewing a raven's flight or watching my little dog prance in the high grass. 

Our garden flourishes besides, to use that cliche' a virtual "riot of color."  Nasturtiums spill out onto the path and up the deck; centranthus waves its pink efflorescences above exploding pansies; lavender is near full bloom and becoming too large for our little plot (I prefer the more compact bloom of the Spanish lavender to the usual Provence lavender); six dahlias are climbing up to the sun for their August revelation, and the heath called "Purple Beauty" is just that.

I dread my 2 PM appointment today with my therapist, who is using her own style of Cognitive Behavioral Therapy.  For those not familiar with this term, the principle invoked is that thoughts precede feelings and only by changing our thoughts can we change our feelings.  Paradoxically, as a manic-depressive, I have always experienced the opposite, that feelings precede thoughts.  I am overwhelmed by feelings when a depression strikes, the same with the rare mania.  And then the thoughts follow.  I can't think myself into a mania or a depression.  But once the mood takes hold, my thoughts naturally follow--I feel so low that I think I ought to do the world a favor and commit suicide, for instance, or as my past mania demonstrated in these pages, I feel so high that I think I am the new messiah and can solve all the world's problems in an eyeblink.  What has helped me in the past is medication, not therapy.  And on one occasion at the age of 30, ECT turned me around.  Sadly in '08 (thank you Sis, for your help) and this year, ECT did nothing but render my noggin even more foggy with no essential  relief.  It was like a good hangover, clearing the mind of anything but immediate survival, but like a good hangover, it didn't last.  The one tangible benefit of my 45-day hospitalization at UCSF was that I was discharged no longer "actively" suicidal.  That does not mean I am by any means cured of the thought, only that I recognize (and here CBT obtains) that my thought of suicide is a globalization for intolerable feelings.

How do I spend my days?  Reading, mostly, mainly brain candy--mysteries by P.D. James and Elizabeth George et alia, the latter being my favorite, as her deep characterizations qualify as "literature."  There are so many hacks out there, like James Patterson, whose cartoonish books I have suffered without much pleasure.  The point of reading, however, in my present condition, is pure escape.  Escape.  Escape seems to be my M.O. these days--to sit and have to listen to my twisted thoughts is a toxic experience I would wish on none.

At the base of it all is a lack of confidence, to put it mildly.  Lately I had to make a decision on a new vacuum cleaner and it taxed me to no end.  I finally settled the problem by buying the exact same kind, belt-driven, when I knew I ought to have bought a self-driven vacuum, but I was so anxious about the decision that buying the same vacuum seemed the easiest way out.  I found, push come to shove, that I couldn't really wrap my brain around an independent and logical decision, so I just went with habit.  Now I can look forward to ten years of changing belts and the burning smell that comes when the roller snags a long string of carpet.  Ecch.

I could list the cornucopia of symptoms for depression and anxiety, but there is no need, as they will come out in examples.  Suffice it to say that getting through a day for me is extremely heavy lifting, from the simple activity of washing the dishes to the more extraordinary courage it took to actually reveal myself in this blog.  Blog as therapy, I might add again.  Do not attempt this at home!

CE

Tuesday, July 05, 2011

Manic Posts Deleted

It's taken me a while, but I managed to delete nearly all my manic posts, when I was clearly delusional, because I could not endure the embarrassment of having them publicly displayed.

I began by saving them as a record of my insanity, but this became tiresome so I deleted the rest en masse, with the exception of "The Goodest Samaritan" series which I thought, though laced with some delusional content, an interesting narrative.

In my last post I said I would write about things only external to myself, but alas, I am not able to.  The maelstrom of my psyche forces me again and again to return to that slippery notion of self, and my self has vanished into a stream of voices that argue, but mainly condemn my being.  I'm working in therapy to rid myself of self-critical thoughts, but the fact of the matter is that I am nearly psychotic in my continuing depression and self-despite, though slightly more functional than when I was hospitalized for acute suicidality.

If anyone reads this, I do not ask that you should pray for me, although that is welcome, but rather that you embrace the light and try your best to ignore the darkness that threatens to swallow up our souls at every minute.  Nature abhors a vacuum, and darkness inevitably, insidiouly, invades--at least in my case where my defenses proved inadequate. 

"God is light and in him there is no darkness at all."  Hold on to the light within your own psyche as much as you can.

I have lost belief in my personal myth, the foundation of the self.  I am at such loose ends; the cat has unraveled the whole ball of yarn.  I don't know where to begin to ravel it up.

If I begin writing about my struggle with manic-depression again, forgive, consider it therapy.  Forgive the manic delusional content of my postings in the latter half of 2010, else laugh at them as I must, though my laughter is laced with pain.

Thank God for Kathleen and all who have stood by me in this indescribable roller coaster of pain.  To think oneself divine and then have the worm revealed, the self obliterated, is a death worse than death.  After the death of the self, how does one construct another to replace it when the basic faith in having a self is lacking?  This is my conundrum.

I have no poetry or wisdom to offer, just my suffering, and my caution to other bipolars not to buy into their grandiose delusions.  Alas, by the time mania takes over it is too late to get through their thick messianic skulls how far from the path of sanity they have strayed.

Thine,

 CE

Friday, May 13, 2011

On the NBA Playoffs and How to Improve the Game

The NBA playoffs are afoot, or ajump as the case may be. Did you know some players have been recorded as having a 44” vertical leap? Yes, many of these athletes are superhuman.


Remaining in the playoffs are Dallas, Oklahoma, Miami and Chicago. Miami will play Chicago to represent the eastern conference in the finals. Dallas will play either Oklahoma or Memphis to represent the west. I must say I think Oklahoma will prove to be the opponent of Dallas, which has never won a championship.

As for prognostication, Dallas will win the west and the eastern finals are already set, where Chicago vs. Miami is a toss-up, as Chicago has the better bench while Miami has the better starters. But Miami’s LeBron and Dwayne Wade will have to play near 40 minutes a game to win, and a seven game series, as it is likely to be, may wear them down. Still I favor Miami for the simple reason that the best basketball player in the world, LeBron James, is desperate to win a championship.

After Miami finally defeated the dreaded Celtics, a feat LeBron never accomplished with the Cleveland Cavaliers, he knelt in silence for what seemed like an eternity before rising and talking to reporters. Whether he was praying or savoring the moment, I don’t know. But he’s hell bent on winning it all, and when it comes down to the decisive fourth quarter of championship basketball, it’s a distinct advantage to have such a superstar—with apologies to Derrick Rose of Chicago, this year’s league MVP.

Dallas, which will almost certainly win the west, like Chicago, has a better overall team, but again here the same principle applies. I think Miami, with LeBron and his fellow superstar, Dwayne Wade, will play with such desperation as to brook no defeat. One delight of the NBA is that superstars really make a great difference among the ten players allowed on a court. I could be wrong about Miami—as I said above, Chicago could wear down Miami’s superstars, as could Dallas in my presumed finals, but I don’t think it’s going to happen, and I believe LeBron will finally attain his elusive NBA championship, the very reason he chose to play for Miami for much less money than he could have received elsewhere.

Despite these playoff considerations for a true fan like myself, there is much wrong with today’s NBA as a spectator sport. My following points for the game’s improvement owe much to Chick Hearn, late announcer for the Lakers for 40 years, who knew more about basketball than most coaches or players. (He had been a good college player himself, I should add.) Here are the changes I suggest:

1. The size of the players has outgrown the 94 by 50 foot court. The court must be enlarged, at least to 100 by 55 feet. The bodies take up too much space for maneuvering—it’s always jammed, and the size of the players can make a defense stifling because there’s no room to move. This is why this era has become the arena of the lightning quick point guard, ala Derrick Rose, Rajan Rondo, Chris Paul and others. These shorter and faster players are able to maneuver among the big trees and get shots off before the more cumbersome players can get their hands up. In addition they can dribble between the redwoods to make uncontested layups as they screw their bodies through incredible gymnastics to score. And if they don’t, the redwoods usually foul them, and these shorter guards make most of their foul shots, which amounts to two points anyway, the equivalent of a basket. In short, the court is too small for the size of today’s players.

2. The basket is too low for today’s seven-footers who make up the front court, the centers and forwards. Dunks are passé’. Recently, at the All Star dunk contest, Dwight Howard slammed a hoop that was raised to twelve feet. An exceptional athlete at near seven feet, 12 feet may be too high for the rim adjustment, as Howard, like a few other players, is often referred to as a freak of nature. But I think raising the rim to eleven feet is reasonable, and would require more skill on the part of players, who could not, with easy abandon, dunk their shots home. They would have to learn to shoot better and maneuver like the smaller players, adding skill and finesse to the game. There are some seven-foot exceptions now, of course, though rare, like Dirk Nowitzki of Dallas who shoots three-pointers as well as anyone, as well as impossible fall-away shots balancing on one foot, right and left both. He, like other skilled seven-footers, would not have his game curtailed by a higher rim, which would make him even more devastating because of his skills besides dunking.

Unfortunately, the enlargement of the court would cause the loss of roughly one row of the most expensive courtside seats, but this is a small price to pay for increased entertainment. The greedy owners would be upset by this, but the game must evolve to accommodate the increased size of superathletic behemoths. in consequence they would be forced to learn more fundamental basketball skills which have made the game great.
3. Foul shots may allow the players to rest in a frenetic game that requires constant sprinting, but fouls shots are boring, except for perhaps the fourth quarter, when foul shot skills might prove decisive. But for at least the first three quarters the team that was fouled should simply be awarded two points while the ball is taken out and the game can quickly resume.

4. Time-outs are excessive and should be limited to one full two minute timeout and one twenty second timeout per quarter, with perhaps one more timeout allowed in the fourth quarter. Naturally commercial concerns with their incessant TV advertising would be horrified by such a prospect, but timeouts significantly slow the game.

5. That these adjustments ever be made is likely a fantasy, given the dominance of business and hype over the purity of the game. Yet the late John Wooden, greatest college coach ever, has been quoted as saying that if you want to see real basketball, watch the women’s league, which is played almost entirely below the rim—though a few women can dunk, but only barely, and not from a standing still position like the men.

I’m a true fan, and a dyed-in-the-wool Lakers fan, but their time has passed, unfortunately, for the present, having been swept by Dallas in four games. And perhaps Kobe Bryant, their superstar, couldn’t dunk an eleven foot hoop, though he might have been able to do it earlier in his career. Nevertheless he possesses skills, like all great players, that make this a non-issue. Skill in basketball is what needs to be promoted, not mere size. I guarantee that if these changes were made the NBA would prove to be more popular than ever. For now, watching the sleek point guards penetrate the key through a rack of redwoods has begun to resemble a running back plowing through linebackers, making basketball more resemble football every day, though inevitably rewarded by the interruption of compensatory foul shots.

I know I have not blogged for a good while due to my mental illness, which is on display in my many manic posts from last fall and winter, but one aspect of my recovery, so I hope, is not to write about myself but external subjects. Occasionally I may update my own struggles, which mainly concern overwhelming anxiety at present, though that is preferable to abject suicidal depression. I also intend to delete my manic posts as I find them embarrassing, so if you have any ambition to review them as a record of my manic phase, I suggest you do it soon.

As a metaphor for the state of my illness, I am in purgatory now but not in hell, thank goodness. And thanks to those who have followed my blog all these years, in which I hope I can continue to come up with subjects external to myself.



Thine in Truth and Art,



C. E. Chaffin

Thursday, April 07, 2011

Traits of the Healthy and the Depressive

Although it's been 26 years since I left my psychiatry residency, psychiatric journals continue to follow me wherever I go.  The drug companies just won't give up on their advertising if there's a chance I might still be prescribing.  I even received journals when I lived in Mexico (without ever informing the publishers of my whereabouts).  I do read them from time to time, though usually not in depth, but when I run across a useful article I'm glad to share.  And in this month's Journal of Clinical Psychiatry there's a useful article (with the usual insufferably long title, "Psychological Characteristics of Chronic Depression: A Longitudinal Cohort Study").

Scientifically (and I won't bore you with the research methods), three traits stood out that differentiate the healthy from the chronically depressed: extraversion, rumination, and external locus of control.  Introversion marks the depressive while extraversion (an outgoing personality more deeply involved in activities external to the self) marks the healthy.  Rumination, the mind-numbing circular contemplations of the self and its shortcomings, also marks the depressive, as does a perceived external locus of control--or feeling more a victim of life than its engineer, beholden to gods or bosses or limitations imposed by society.

Other traits of the healthy, suggested by the study but not rigorously affirmed by science, include agreeableness and conscientiousness (this is not to say the depressed aren't conscientious, even overly so).  So our picture of the healthy individual portrays an easygoing, outgoing personality with a sense of personal control over his life.

More traits of the depressive, again not rigorously confirmed by this study but only suggested, include higher levels of neuroticism, hopelessness, aggression, and risk aversion.  It might be instructive to list these for the record:

Characteristics of the Chronically Depressed:

1) Neuroticism (behaviors associated with anxiety, fear of others' opinions, indecision and inhibitions that do not serve the self).

2) Hopelessness

3) Aggression (Freud famously argued that depression was aggression turned against the self).

4) Risk Aversion

5) Rumination

6) External Locus of Control

Characteristics of the Undepressed:

1) Extraversion

2) Agreeableness

3) Conscientiousness

Now what do we make of this?  How can this be applied to therapy for the depressed?  Conscientiousness may possibly be taught, but how does one come by extraversion and agreeableness?  Are these learned traits or inborn?  How much can they be promoted by therapy?  Aye, there's the rub. 

As medical intervention has recently failed me, in a 45-day stay at a university hospital with maximum medications, group therapy and 12 ECT treatments, I have turned to psychotherapy out of necessity, though I have little faith in the method, as twice before "depth" psychotherapy has actually made me worse.  This time I have at least selected a cognitive-behavioral therapist, whose method is most endorsed by research.  And what does this method involve?  No less than re-programming of old, self-defeating tapes and the substitution of new behaviors.  Or simplistically, "Act as if you are not depressed and feelings should follow."  Try to identify what thoughts are associated with negative feelings and endeavor to combat them--catch yourself in mid-dip and argue with yourself, trying to put a rational perspective on things.  Do not give in to your irrational inner child, fixated in early development, self-indulgent, afraid and non-functional (as an adult). 

I can see from this inner landscape, as my therapist has also advised me, that it is hard work crawling out of the hole.  And I have never been impressed by how much people change over time, in fact the opposite seems true: people don't change very much.  But if I am to have a hope of being delivered from the depressive side of my manic-depressive disease, the side that unfortunately dominates, I need to take my psychology in hand and do something about the way I think, feel and behave.  This may seem obvious to some but in my experience it is novel, as it seems to me that when the proper cocktail of medications has been discovered in the past, I became well and did not feel a need for therapy.  In fact, I may have become agreeable and extraverted, though I have always been conscientious--if not financially then at least interpersonally, , especially in keeping my word.

The wisdom of this article I may have compressed long ago in my own capsulized advice about depression:

1) It is better to do something than nothing.

2) It is better to do something active than passive.

3) It is better to be with or around people than alone.

4) Try to set an achievable goal each day, however small.

Still when one is seriously depressed, following this advice or even more daunting, trying to achieve agreeableness and a sense of personal control are almost unimaginable.  But courage, my friends, courage.  "Never give up, never ever give up" quoth a famous depressive, Winston Churchill.  I need this kind of courage if I am to save myself. 

If psychotherapy doesn't help, what do I have left?  Voodoo?  I'd much rather sacrifice a chicken than work hard to reverse my dysfunctional,ingrained mental processes.  But to what do I owe them?  A genetically inherited disease beyond my control, a malady of the brain? (Studies have confirmed that depression changes the very structure of the brain, up to a 20% decrease in the volume of the amygdala, for instance.)  How can psychology affect this? 

Obviously it is not one or the other.  It is both nature and nurture.  Talking oneself out of the pits must be of some utility or it would not be so firmly in practice.

The etymological root of therapy is "correction."  Can I be "corrected" at this late date, at age 56, when my brain has already been changed by my disease?  I have to hope so.  And hope is so essential to surviving depression.  I can't think of anything more valuable.  Despite past experience, I must imbue the psychotherapeutic process with hope.  Then again, how can one hour a week compete with the other 167?  One hopes that the patient can apply the lessons of therapy during the hours away from the therapist, else all is in vain.  But ideally we need some kind of boot camp for depressives, as modeling is the best form of teaching, and in these camps there should be more healthy individuals than sick ones. 

One of the great disadvantages of a mental hospital, one I recently experienced, is that all the sick people are thrown together.  Who are they to help each other?  The staff is not powerful enough to successfully model new behaviors.  They are too often lost in paperwork anyway.  It would be so much better to place a mentally ill person in a healthy family for a time than subject them to the idiosyncrasies of other patients.  But health is at a premium, and would fetch a premium price, and besides, this approach is not likely to ever be implemented while present models of disease and health predominate.

Still, if there is a family out there willing to adopt me for a time, I would seriously consider it--with my wife's permission, of course (is that too much an expression of an external locus of control?).

Thine as ever,

Craig Erick

Tuesday, April 05, 2011

The Beat Goes On

That is, beating up myself when my mind has nothing to occupy it, which is frequently.

I have seemingly exhausted what western medicine has to offer--45 days at a university hospital with maximum meds, group therapy and 12 treatments of bilateral ECT with the current turned up to the max my brain could tolerate.

Early on in this disease, as a Christian fanatic, I was sure that my overwhelming depressions were due to God' desertion, to a failure of faith.  That model failed miserably.

Next I embraced the medical model.  That seems to have worked for near 25 years but it has failed to work now.

Thus I have entered therapy again, Cognitive Behavioral Therapy, but after two sessions see no light at the tunnel's end.

Sometimes I think if I could just forget about myself and stick my nose in as many mundane tasks as feasible, from cleaning my desk to weed-whacking, that I might improve.  In the past, however, frantic work did not improve my overall mood.  I'm open to anything now, eastern or western, however irrational it appears on the surface.

The old word for depression was "sloth" or "accidie," a certain torpor of spirit and withdrawal from the world.  Of this I am guilty.  But to treat this behavior as a moral failure seems cruel.  Nevertheless Christian theology holds, for the most part, that despair is a form of pride, as it usurps the hope of God and the faith that our experience will somehow redound to his glory.

I am so far removed from such an attitude it's not funny.  And I haven't written poetry in six months.  Furthermore, I must warn folks about my blog from 8/3/2010 until the end of December, when I became fully manic and entered a fantasy detour where I thought I could save the world.  I leave it as evidence of the flip side of my disease, and as a record of a creative psychosis it may entertain some.

In my depression I cannot even save myself.

Thank God for my wife, Kathleen, who helps keep me on the planet.  I am so grateful for her and for my family and friends.  They believe in me when I cannot.  Oh to believe in myself again!  Oh to have an innate  sense of self again!

I have felt the need to apologize for my mania, recorded here as mentioned above, but such an impulse is ridiculous since I had no control over it to begin with, just as I am now snake bit by a serious depression (again).  Perhaps the psychological model will help me; it never has before but I'm desperate.

I'll close with one of the 28 dark sonnets I wrote during the first half of 2010, when I was also suffering a serious depression--though not as serious as this one, I fear, where I feel global paralysis and abject but unfocused fear.  What do I fear?  Depression.  How shall I overcome it?  I have no clue, but just blogging today is one tiny step forward. 

Dark Sonnet XXVII




I fear disintegration into glass,
Into a million cubes orbiting free,
Reflecting only scenery as they pass,
Without a central hub, without a me.
The ego is a very slippery boss.
Few know the limits of his sour purview.
I know the limits; he is what I’ve lost;
All whirls in a pestilential stew.
A piece of me there, another here.
Who will collect the fragments in a pot?
Another year, another half a year
Where what I thought I was is what I’m not.
Dear brother, if your self escapes your skull,
Pray you do not spiral down to null.


Namaste,

7 kilorats,

Craig

Saturday, March 19, 2011

Back from the Hospital, Hanging By a Thread

I just returned from a 45-day stay at the UCSF mental ward, where they tried maximum medications and finally 12 bilateral ECT treatments to treat my acute depression with little success.  As they had done all they could do, I opted to come home, where I have a little more freedom and familiarity with my surroundings, and above all, a loving wife in Kathleen whom I desperately missed in the hospital. 

I wish I could report that I'm well but I'm not.  I'm still very sick and suffer from predictable weeping spells, suicidal ideation, anhedonia, sleep disturbance--in a word, all the symptoms of a severe depression.  Naturally this comes on the heels of a mania, recorded in these pages, which I did not correctly perceive for what it was as I was so happy just to be delivered from depression for a time.  But I'm paying for it now.

I ask for your prayers and encouragement.  There are times when I am so overcome by hopelessness I really don't know what to do.  I become paralyzed, the proverbial deer in the headlight.  The smallest tasks overwhelm me.

I ask forgiveness for any I may have offended in my manic phase; I said and wrote some cruel things when I was so sure that my judgment was divine and not just the product of a diseased mind, which it turned out to be, for the most part.  Naturally I am embarrassed and ashamed.  But I did not choose this illness, it chose me.  It is not my fault but it is my responsibility, and a terrible responsibility that is.  Someday I would like to feel like a useful member of the human race again but that day is not near.  Now I am barely functional, just doing my best not to give into suicidal fantasies.  Pray for me.  I hang by a thread, truly.

Namaste in any case,

Craig Erick

Friday, January 28, 2011

Hospitalization

I need to be hospitalized for acute depression, and we shall try today.

My manic journey is recorded on this blog.  It always ends badly.

I cannot write anymore about depression.  It is the soul destroyer.

I know I have spam problems with this blog and I know they will accumulate in my absence but I leave this as a note.

Namaste,

Craig

Tuesday, January 18, 2011

Eating Crow?

I am ashamed.  I fear much of what I've written since August has been as much the result of mania as any spiritual inspiration, and I cannot separate the two out.  But after every mania comes a depression, and I have entered depression.  I plan to see my shrink tomorrow and have already started myself back on medications.

To admit this is frankly devastating.  I really did believe I was healed.  I really did believe all the stuff I wrote about battles with Satan and Christ's second coming.  It was all more real than real--real in the way, say, dreams are more real than reality at times.  But now I've lost the feeling, the connection, and I don't really know what to do with myself. 
Meanwhile I have some mementos of my journey.  I have the necessary papers to change my name to Craig Erickson but I don't have the heart to file them.  I have a totem pole that was carved for me with my three spirit guides: my animal spirit, the bear; my wise spirit, the frog; and my spirit guide, the raven.  It was carved out of redwood by a man I met on my journey to Oregon and now stands planted in my garden.  I like it there but it does remind me of how high I was.

In "Flowers for Algernon" a retarded man undergoes a clinical trial of a drug which increases his intelligence exponentially, only to have the drug fail and all his love of Mozart and philosophy and such taken out of his hands and his being left empty.  This book has haunted me since I was a child, and it mimics the manic-depressive experience: "Riding high in April, shot down in May."

So what can I say about everything I've written during this manic journey?  Surely there is truth in it, but truth mixed with error.  Signs that I was out of control include a rupture with my daughter, my wife leaving, and the loss of one of my best friends.  Thankfully the rupture was repaired, and my wife has returned, but I fear my friend is lost forever.  I guess I just scared him away.  It's a terrible loss, although the friendship always did have its difficulties.

When my tears started I at first thought they were grief, but now I find that diurnal urge to cry--in the late morning and late afternoon--which is typical of my depressive phases.  I suffer anhedonia--I take no pleasure in anything.  One thing is like another and getting through each day seems an impossible burden as I don't know what to do with myself.  When I was manic I was active, I always knew what to do next.  Heck, I had new business cards printed up as a doctor, a "Soul Healer," and set aside the extra bedroom in the house to see patients.  Now the prospect of practicing medicine seems frightful to me.  And my chronic back pain would limit my ability to practice in any case.  But I thought that was to be healed as well, along with my manic-depression and metabolic syndrome (a fancy word for being overweight or obese).  Thankfully I did lose fifty pounds in the course of my experience, something I thought a healing, and it is the only evidence I have that anything I experienced was lasting or real. 

Yet it felt so real--I cannot begin to describe to you the heightened certainty, the angelic surety of my convictions during this period.  I felt as if my body was slowly being resurrected, that I was growing younger, and that eternal life would spread like an infection through the human race and the millennium would arrive.  More importantly I thought that I participated in a direct battle with Satan which resulted in him being bound for 1000 years so that righteousness could reign on the earth.  All of this is evident in my postings, which I will not delete as an example to posterity.  But imagine my embarrassment at being reduced to a mere "Craig," just one more mental patient gone awry.

Those closest to me suspected this all along.  Some few friends and acquaintances believed in my journey.  I am grateful to them for their faith.  But now I am faced with the horror of depression, and typically, a post-manic depression is the worst and most untreatable kind because of the heights from which the bipolar patient has fallen.  There is nothing like the bliss and confidence I experienced while in that state; it was like an acid trip that went on for five months.  And what's really puzzling is that some miracles did occur, as witnessed by others: healings, casting out of demons, and two sightings of Viking boats lit up at night sailing off the coast of Mendocino which I and my friend actually saw.  Can two people share a hallucination?  These sorts of questions can drive one mad.

I don't know what to do with myself now.  I have no confidence and no direction.  I feel snake bit, sucker-punched by my own defective brain.  And the sorrow of descending from feeling like a god back to a mortal worm is indescribable.  Still it would be remiss of me not to salvage something from the experience, so let me still sign off with

Namaste,

Craig

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