Pain redux

Back from US.

Woke this morning to the abrupt end of jet-lag and the return of the pain. After a day sitting at home in a fog, was wide awake at 6:30 am, but not exactly bushy-tailed.

I lay there with the covers over my head until The Sob burst out at about seven. No point in just lying there crying so I got up, staggered to the bathroom and stood under the shower, my mind shouting, "STOP", drill sergeant style.

Someone has found that piano and helpfully given it back to me, thinking I had dropped it by accident somewhere.

I am work. That's the only thing I've got that makes me real.

Some time soon, I'll tell you about my theory, that K calls a simple philosophical misunderstanding, that I don't really exist. I try to do things that make me seem real to myself, but I'm afraid it is very unconvincing.

He's going to spend his birthday next week in North Africa. Tunis. (It's not as exotic as it sounds; we're actually quite close. To a North American living in, say, Denver, it would be the equivalent of driving to LA for a weekend.)

Love's a sweet passion

It's love that burns, so much that it is how we can tell that the soul is a real thing. The pain of love is real, and nothing abstract. I understand why Hell is the last horror, and also why it is, as the great theologians said, a manifestation of the love of God. It is God's love rejected, and unrecoverable.

It is separation, which is the one thing that love cannot abide. Separation makes love a torment. Hell is a fire, a separation which cannot be escaped. But even so, it cannot stop being love, even in separation, even when it is only torment.

If Love's a Sweet Passion, Why Does it Torment?

It is such an ancient question, one wonders that anyone still asks it. But it won't leave us alone. Poor humans...

Symptoms V

The night waking has stopped, but I am six time zones away and my poor wee brain can't remember whether it is the middle of the night or first thing in the morning. For all I know, they are actually continuing.

I am about to embark on a week of distraction. I hope it all goes along without pain. There are important things to do, and people to meet. It all has to be very upbeat. I can fake upbeat.

Watched a film tonight about human love and human evil.

Love did not win.

Washington

Off on a plane tomorrow v. early.

Had two days off with fever and swollen face from tooth infection. Happy to be able to spend two days loafing about doing nothing much. Antibiotics, however, work and am now back in the world again. Drat.

I understand why the happiest news my mother ever received was that she was dying of cancer. She had wanted a legitimate out for many years. After the death of her husband, (not my father) she seemed to decide that there really was no point in trying to get back into life. She hovered around the edges of it for years, just waiting. I sometimes wonder if she died because she was just fed up. People survive cancer. But maybe they are the ones who want to survive it.

But for me, nothing so nasty as cancer. Just an infected face and headache. Plus, all the fun and excitement of a root canal in a foreign country when I get back.

They do say that the way to beat depression is to give yourself things to look forward to.

Eating

I'm eating.

There is a Chinese place around the corner from my office and they do great duck.

So, I'm eating.

The Evil Brain is screaming, but hey...

it's Chinese roast duck!

So, shut up.

Keeping Up Appearances

I once knew a young man who had just been ordained to the priesthood. After a year, he was asked what his impressions were now that he had been on the job for 12 months. He replied, "Before I was a priest, I had no idea there was so much suffering in the world".

People hide it. You just can't go around being outwardly miserable all the time. It can be lonely, hiding, but it is worse when everyone knows. Much worse. But maybe I'm just being English about it.

I think one of the worst long-term effects of the hippie-generation, has been the idea that one must share everything.

No, really. That's OK. I don't want to know.

I don't want to be known either. So the blogging impulse is a funny one isn't it? Maybe I do want people to know after all. I just don't want them to know about me.

Like a Prowling Lion, Seeking Whom to Devour

I have long ago decided that most of the stuff that Professional Head People write about depression is rubbish. It is also boring. "Dysthymia"! Hmp! Who would ever use that word in real life?

So I have decided to use my own terms. You may have noticed a few of them thus far.

Evil Brain: I have, like many depressed people, particularly people whose preferred mania involves food-related problems, have two "voices" (no, I don't "hear voices") in my head. One of them is me, a nice, normal person who just thinks ordinary stuff like "what should we have for dinner" and "I really need to buy cat litter before going home". The other is what I have always called my Evil Brain. The Evil Brain is a monster, and as a Catholic, I have sometimes wondered if it is not actually some demonic voice trying to destroy me. It often sounds like it. When I am badly depressed (not so much today), my Evil Brain will whisper, and sometimes shout, all those terrible things that make me depressed. It will sometimes not need to use words, but will just project images and memories or ideas that are upsetting. Ten years ago, when I could not eat and was losing weight drastically, I described the whispers my Evil Brain said to a friend of mine, and she exclaimed, "Your Evil Brain sounds like the Devil!" I've been told that if the things my Evil Brain whispers to me were to be written down, they would be exposed as a bunch of obvious nonsense. This has been suggested to me by several people, both Professional Head People, and normal people.

The Evil Brain is particularly exercised about food. It often forcefully forbids me to eat and threatens me with awful consequences if I do. And when I ignore it, it often becomes a kind of screaming torment, a punishment for breaking the rules. But this is only when things have really moved along. We're not there yet.

The Litany: Some time when it is running in my head, I shall remember to write down in a note book the actual words of The Litany, but the general gist is the same. "You're bad. You should die. No good thing could possibly happen. You do not deserve this nice thing. You have allowed all the things that you should have done to slip past you in life and now it is too late..." etc. You get the idea.

Whom resist ye, stedfast in the faith, knowing that the same afflictions are accomplished in your brethren that are in the world.

Sunny today

Was in the office, hiding, until the ten o'clock train home. Not accomplishing much, but at least quiet for several hours. After initial feeling of OKness through most of the daylight hours, physical anxiety flared up at dusk with shakes and The Sob simmering down just under the surface followed, as usual, by The Litany. Hard time concentrating on work through all this mental noise. Managed to produce two of three daily deadlines, one of which was a feature, so that's holding up at least.

Took a big chance and showed K this blog, and the post below. He said he has great faith in me and that writing it out is probably a good idea, esp. considering drug therapy is not an option.

Chatted on facebook with mutual friends in Denver about troubles with K. They say that K, though he is "one of the best men" they know, he can be difficult, sometimes even cold. They are praying for us. For me. It's good to know.

Ran into K on the train on the way home. (I mentioned we live in the same town). At first felt only surge of panic. Calmed down and had a pleasant ride home chatting about simple things: politics, religion...

Night waking continues. Three am to four, right on schedule. My troublesome molar has infected again and the anxiety was all about whether I was going to be able to get treatment for it in Foreignland. Laid awake worrying and squirming. Cat, v. annoyed, went and slept in the sitting room. Finally slept with head resting on hot water bottle.

Sun came out today. First sunnuy day in weeks of rain. Rode into the city with K, as we used to do every day. It was quiet. I watched the countryside, he read and worked. Parted with smiles. No pain.

Ran errands before going to the office. Starting to think about Washington next week. Turns out that in this country you can get anti-biotics easily over the counter. All anxiety for nowt.

Feeling almost lively. Probably the sun and cold. Winter should be cold and crisp, not this upsy-downsy humidity and freakish mid-January warm days. Must buy a pair of waterproof boots for Washington.

K

I wrote below:

"I live in Europe now and recently fell in love, most unexpectedly, with a younger man. Even more recently, he gave me the boot, which was the trigger for my current interesting situation."

and promised to say more about K later.

K is an American graduate student who lives in the same town and goes to my church. We both inhabit the same social circle of English speakers living abroad in this big city, and we have many of the same cultural, political and religious ideas and we share a similar sense of humour. For these and for no reason, I suppose, we hit it off last year and shortly after I arrived, he was, as he put it, "chasing" me. After a short period of hesitation and doubt, (mostly self-doubt), I allowed myself to be caught.

Things went well and we grew very close. Closer than I have allowed myself to become to anyone in my recent history. We talked about marriage, because we both believe that that is the natural end of "dating" (faugh! what a horrible neologism!). Then, a month ago, after we had begun to experience various problems, he suddenly broke it off. It was not completely unexpected. I had done the same thing to him in June, then changed my mind. We had had problems, things had been difficult.

But he was serious. He believes he has done "the right" thing for reasons which I can't really understand. But I knew it was wrong. It was wrong like water flowing up hill was wrong. He has since said that he is "open to reconsidering". I still do not know what this means.

It has been a month plus a few days and I find that I almost panic when I think of the time flowing along, taking us further away from the time when we were happy together. And of course, the memory of our happiness is now like swallowing a red hot coal. Pain seeing him. Pain not seeing him...the usual thing with love.

We had our break-up discussion on December 7 and I felt as if I had been cut in half. That was the most memorably bad week I have experienced in the ten years since my previous serious depression.

There is more to all this story of course, but I have many reasons to not write about it too much now. I am finding it difficult to get this much out and I can feel the pain starting to build like a fire of dry paper as I write. I also do not want to write about K in a public forum. It is his life as well and he has his right to privacy.

But the depression that had grown from low levels into the middle range during this year's dreadful summer, suddenly flared up after this and took possession of most of my thoughts.

We still see each other a great deal, and that has been very hard. I made the decision right away not to withdraw from him. Partly because I hoped to mend things, but also because he is at the centre of our social set and to withdraw from him would have meant withdrawing from everyone else, and changing churches. How things are now, I can't really say. I don't know where we are going, but I cannot give in. Something in me refuses to let go, and K has not withdrawn either.

How commonplace, though, to be pining for love. How sad to be doing so in one's forties.

Symptoms IV

Hard to type. Normally, that is, in an undepressive state, my typing speed ranges between 60 and 80 wpm with few mistakes, if I'm concentrating.

In the last few weeks, I have slowed considerably and have difficulty typing even straightforward sentences and simple words. Most common error is transposing letters. My fingers, which usually fly over the keys, are awkward and don't seem to remember where they should go. The thought of a particular word and the movements of my fingers to type it normally have very little lapse, but now there is a notable time lag.

It's been years since I've read a book about depression. Do any of them note a fall in manual dexterity?

The weekends are the hardest

I don't know about anyone else, but I find that weekends and holidays are a source of dread when I am depressed.

I live by myself and have a long commute and I like my work so the times when I am not at work are times spent alone at home. When I am not depressed, I cherish my home-time and spend it doing a lot of different things. I live in a town near the sea and love beachcombing. I have a garden and in winter I like to draw and I have a lot of books that always need to be kept company. I also have a lot of friends.

My sleeping patterns have shifted and between night waking (usually three or four am and awake, in considerable mental pain, for more than an hour before getting back to sleep) and just wanting not to deal with the world, I have been getting up later and later. On weekday mornings, I can usually get myself going at a fairly reasonable time, say 9 am or so. An indication that the depression is still in the "moderate" range. This gets me to the office in the early afternoon and I can work comfortably through into the evening. This suits my editors well because they are six hours behind me. I like my work and I find it helps me to not listen to my Evil Brain, so it is a useful distraction, at least.

But weekends are a horror. In the Twilight World, the first moments of wakefulness are very hard to take. There seems no reason at all to get up and the day ahead looks like a bleak empty road up hill under a grey sky. When I am up, I want only to go back to bed and being alone for many hours at a stretch means that the pain can gather and the negative thoughts can really spiral.

On Saturday shortly after I got up, the crying just started suddenly. I found myself doing those horrible loud gasping sobs that sometimes simply burst out from nowhere. A single thought can intrude and the emotion that rides with it is so horrifying that I am incapacitated instantly. At that moment, I knew there was no way I was going to get through the weekend unless I got out of the house. I dressed and went into the city and to the office. Even sitting in the office in front of the computer is better than being alone at home. Or I should say, better than being left at the mercy of my evil brain that seems bent on my destruction. I had intended to go for a walk through the city and then to a late Mass, but found that I was unable to bring myself to move from my desk. I stayed much later in the city than I had intended, and ended up on the last train home. I ate nothing on Saturday, having had a plate of pasta on Friday. My Evil Brain was telling me that having eaten pasta the night before, anything more than an orange and a few walnuts was too much. Besides, I was in too much pain to want to eat.

Sunday started out not too much better, and I slept until 11 after glaring at the window a few times. But for some reason, or no reason, the depression just lifted shortly after I got up and I felt better. I put some music on and bustled about doing housework. I called K and invited him over for a movie and dinner. We ended up having a nice time. (More on K later). I ate a whole meal, chicken, rice, asparagus.

That's the funny thing about depression. One day it can make you feel as if someone has handed you a piano and has instructed you to carry it around on your back; the next day, you wake up and the piano has just disappeared and you wonder if you imagined it.

I worry (of course, a huge part of depression for me is anxiety and worrying is one of the big warning-signs) that it will get worse. I have taken about four of those online diagnostic tests and each time have come up about half-way between "moderate" and "severe". I remember depression that was called "severe" and I remember that in the middle of it, I could do nothing at all. I couldn't possibly have held down a job that required concentration and the ability to organise my thoughts into sentences. What if it gets worse and I can't work? I have no savings and in this country cannot really expect to receive any sort of government help.

But today, at least, things seem to have lifted. The same searing pain does not seem to be laced through all my muscles and bones; the same ideas ('getting older') do not induce the same sense of panic. For some reason I can't understand, sometimes it is just like that. One day the volume is turned way up, the next day I can hardly hear it.

Had a nice lunch just now with a friend. Appetite just fine. But I can feel the worry simmering away under the surface.

Symptoms III

Out of breath.

Catch your breath.

Try to breathe in, but it staggers sideways and stops, not knowing where to go next.

Breathing out comes in quick little gasps, interrupted by little chokes.

More Symptoms

Sleep comes late, usually some time after midnight. Then the world intrudes again at three or four. The pain wakes you up and you lie under its weight, with enough room to shake. You struggle to keep the crying down under the threshold because if it gets out it will blaze through you and leave nothing sane. It will become a mania that can't be stopped, you will end the night screaming and clawing your skin. You lie still, hoping the pain will leave you alone if you do nothing to draw its attention.

You remember to pray, but the only prayer you can think of is to beg to be released. Suicide is not allowed, but you can pray for death.

You can ask, can't you?

People are funny

Not funny ha ha...

I think it's funny that I am willing to bare my innermost stuff (probably not all my innermost stuff) to the whole world, but I don't want any of my friends or colleagues or relatives or co-workers to know what's going on.

Not that they aren't figuring it out anyway.

I've been careful here to make sure that nothing of the blogger information identifies me and I think I'm going to more or less keep it that way. Though, of course, anyone who knows me even more than a little will recognise a lot of this, enough to identify me.

But something, I suppose, has to be said about who I am.

I am, more or less, a professional writer. That is, I write things on various topics and email them to a place in North America and the people who work in that place give me money. Doing something for money is what "professional" means. It doesn't mean I'm good at it. Every now and then, I've written things that I think are really good. I was just reading one today, in fact. But it is still hard for me to think of myself as a successful writer. Or really as a successful anything.

I sort of stumbled into what I do when I was looking for a real job. After a while, I figured I would just keep doing it, since it paid the bills and allowed me to live nearly anywhere. Now I do, in fact, live anywhere and it has actually just contributed more to my perpetual feeling of disconnectedness. So it seems absurd to me to describe myself as a writer. It sounds so important and high falutin when the reality of it seems a lot more squalid and silly. Words on the internet. What a laugh.

I am also a Christian, but not a very good one. I really do believe that everything the Catholic Church teaches is true, without exception. But being a "believer" I have noticed, does not make one "devout," no matter what the media thinks. I might write quite a lot about this later.

I am white, a woman, over 40 but under 50. I was born in Canada and have lived in nearly every part of it over the years. My relatives live all over the place but most of the ones I know about live in the US and Britain. I have lived in Britain as well.

I live in Europe now and recently fell in love, most unexpectedly, with a younger man. Even more recently, he gave me the boot, which was the trigger for my current interesting situation.

I wear glasses.

I have a cat.

(There, if that isn't enough to give all my friends the clues, I don't know what is.)

No Cure

There is something about depression that the doctors and Mayo Clinic websites don't tell you. There is no cure. They cheerfully tell you that if you are in some kind of extreme situation, that you must "contact a health care professional". It sounds very comforting, but it is, unfortunately, rubbish. Health care professionals are utterly at sea with most of this stuff, where they are not outright incompetent.

My own past experience with doctors in North America has taught me to stay far away from them, even in situations that others might regard as emergencies.

Depression is usually called the "common cold" of mental illnesses, but it is also one that remains stubbornly difficult even to treat effectively. In our awful world, nearly everyone is at least moderately dysthymic and most people will experience the symptoms of a major depression at least once in their lives. And yet...

Despite what is said about the "new" anti-depressants, they are not miraculous. Often they don't work at all, and in some case, actually make the symptoms much worse.

This last happened to me. Ten years ago, I was treated in the now-usual way for depression by being loaded up with drugs. Nothing was offered in the way of talk-therapy (for which I am now grateful). I was given the standard SSRI drugs, plus helps for sleeplessness. I got worse. They increased the dosage. I got much worse.

This continued until I was a walking experiment. I ended up on five or six different anti-depressant and anti-anxiety medications and I was a basket case. I slept two or three hours every other night. I walked compulsively and was unable to stop moving. One day I walked for 18 straight hours, sitting on park benches and garden walls for only a few minutes at a time. I lost 40 pounds and could only eat tiny amounts of fruit. My short term memory was shot (Ativan) and I often could not remember if I had spoken with or seen someone only a few minutes after leaving them. I repeated myself in conversations with people, being unable to remember what I had said or where the thread of conversations were going.

In my brief visits with the doctor, sometimes with six weeks or more between appointments, he would ask me how I was feeling. I would tell him and then he would prescribe me either a new drug to be added to the rest or an increase in the existing ones.

At one point I protested, saying that I was not soup, that you couldn't just keep throwing different things into me to see how it would work out. There had to be some kind of plan. He responded by getting personally offended. "Don't you trust me to prescribe the right medications?" This after nearly a year of steady deterioration and incapacitation.

Finally, I was told during one of my many short visits "inside" that if I didn't improve, I would probably die. They started to use the term "non-compliant," which technically meant that I was not responding to any treatment, but was used as if I were somehow doing it on purpose.

Finally, something in me woke up and said 'enough'. I had been told by a friend about a pschyopharmacologist who had helped. I had to insist on a referral to this guy (under Canadian health care rules, you can't just call a specialist, you have to be referred by your attending physician. If the physician doesn't approve the idea, or if he is offended at your lack of trust, he won't refer, and you don't get a second opinion.) But I managed to convince my GP to send me to him.

In a five minute interview, he asked me questions about my medical history (no one else had ever done this) and discovered that I had been diagnosed in childhood with temporal lobe epilepsy, which exacerbates the symptoms of depression. I had never recieved treatment for my epilepsy which, in 1979, they told me would "naturally burn itself out" when adolescence hit. And it is true that after age 16 or so, I only had seizures extremely rarely, and then only under heavy stress or when I was having a high fever. I had even stopped thinking of myself as someone with epilepsy.

Well, since 1979 they have discovered a few things about epilepsy, one of which is that it does not go away, though the symptoms may change over time. This specialist reacted with shock when I told him how many and what kinds of different psychotropic medications I was on. He said I should not be taking any of them because with epilepsy, the effects of SSRI medication was effectively reversed. The more they gave me, the worse I would get. He said that they had 'lowered the threshold of seizures' in my brain and that the more I took, the more seizures I would have. This explained the weird symptoms I was having (the compulsive walking, the hallucinations and delusions...yes, it was just great!).

He gave me a strict schedule to ease myself off most of the drugs, keeping only the little oblong blue thing that was the only thing that would allow me to sleep (since forgotten its name, darn it!). I was to spend a lot of time sleeping and resting and not taking medication. Then when I was off most of it, he gave me a prescription for a mild anti-epileptic drug which I took for a year.

And it was only then that I had that experience they say you are supposed to get with the SSRI's. The sun did, finally, come out from behind the clouds. Slowly I got back to eating and sleeping normally and put on weight (a little too much!). I enrolled in a course in university and did well.

All this took a year. And I had been ill for a year. That was two years this fiasco took out of my life and if it had been the US instead of Canada, I would be suing the pants off everyone who had a hand in it.

So, now that I am no longer in North America, no longer in a country where medical care is easy to get, and facing another depressive state, what now?

Don't know, frankly. Am just gritting teeth right now and trying to keep my head above water. But even if I could see a doctor, who spoke English and was not trained in a third or second-world hell hole, I think I would give it a pass.

So the blog is a way of keeping track of what is happening. I am going to try to be as objective as possible. My model is CS Lewis who wrote a harrowing little book in which he criticially examined his reaction to the death of his beloved wife.

The idea of criticially examining my reactions, symptoms and thoughts as I go through a mind-altering experience, reminds me of that old Far Side cartoon in which a clown sits in a laboratory writing in a notebook: "Day fifteen. I can no longer resist the urge to throw a pie into the faces of my colleagues". Like one of those scientists in the movies who injects himself with the serum and then keeps a note book of what happens to him, until he turns into the monster and eats everyone.

According to the standard tests, I'm registering as somewhere between medium to severely depressed. I experience all the normal symptoms with a few extras I will probably write about.

We'll just see what happens, shall we?

Symptoms

I am finding the lists of symptoms on websites like the Mayo Clinic to be a little too dispassionate. I suppose they have to be "clinical," but they are not descriptive.

Do you ever feel as if someone is sitting on your chest? As if you either cannot breathe, (even though you are breathing in and out steadily) or as if the air you are breathing is not enough? As if it were poisoned?

On the edge of tears for the full day? Feeling the sob simmering in your chest ready to burst up and out?

Do you feel afraid but afraid of nothing in particular? Does your heart hammer away in your chest throughout the day? Do your hands shake. Do tiny sounds of terror squeek out of you before you can stop them?

Do you find yourself suddenly "waking up" from long periods of blankness where your mind simply went grey and wordless? Do you look at the clock surprised to find that hours have passed? That it is night and you did not see the daylight fading?

Do you find the presence of others intolerable? Do you both fear and crave solitude? Do you want to tell your friends to leave you alone because the pressure of appearing fine for their sake is exhausting you?

Do you wake in the morning and groan to find another day is presenting itself, like a hill to climb? Do you dream of escape and wake only to find the world is a prison?

Lies

At some point, a conscious decision has to be made, whether to live or whether to die. Until that decision is made, and acted upon, depression will continue to offer ways of self-destruction that are, essentially, deceptive. It will lie to you, whisper through the long sleepless nights that there are ways to kill yourself that do not involve actually killing yourself.

It will offer secret ways of disappearance that look, from the vantage of the twilight, like the door to another world.

You can fade away. You can dissipate yourself, like mist in the morning breeze, and no one will see or stop you.