One Man's War on Depression

Changing Meds Makes for Difficult Days

2012-02-16T16:38:00.001-06:00

My patterns of depression are so familiar now, I may as well copy and paste my last blog post into this one.

Major Depression struck again a couple weeks ago. And it was pure hell.

I missed one day's work and struggled like crazy to make myself keep moving for several days afterwards.

My doctor and I decided we needed to be aggressive in trying to stop it, so he changed my meds. I'm now taking Effexor along with Abilify.

The change from Cymbalta to Effexor proved to be a cautionary tale. I had been taking 60 mg of Cymbalta, which I had some success with after a mental health meltdown last summer. To transition to the new drug (Effexor), I was instructed to drop down to 30 mg of Cymbalta for three days before starting out on a small dose of Effexor.

Only I didn't do that. My Cymbalta pills weren't the kind you can split in half, and I never got new 30 mg pills for the three-day transition period. So I just stopped the Cymbalta cold turkey. I won't do that again.

Wrenching anxiety, stomach aches and feelings of utter hopelessness soon came.

It was a brutal stretch, probably ranking in my all-time Top 10 list of major depressive episodes.

I'm not exactly copacetic now, but I'm much better. The suicidal ideations that haunted me have subsided. I feel more hopeful than I did even a week ago.

I've now ramped up the dosage of Effexor as the doctor prescribed, and I think it's beginning to pay off.

Those who suffer from depression can relate to the difficulty of changing meds. We often get worse before we get better. And that's really frustrating.

I haven't figured this thing out yet, but I'm trying to remain optimistic about the future. It generally takes 2 to 4 weeks for a new antidepressant to really help. My doctor says it takes much longer—maybe six months—to get the full payoff.

So I wait patiently, doing the other things I know help (exercise, eating less junk, etc.)

I only wish Punxsutawney Phil hadn't seen his shadow. I hate darkness and winter and am ready for it to end.

My guess is many of my fellow depression sufferers feel the same way.

P.S. I hope the few of you who know me understand the difference between the sort of fleeting suicidal ideations I occasionally have and the more serious suicidal thoughts that others experience that involve plans, etc. I've never gotten that far before and don't plan to. I have too much to live for and a burning to desire to defeat depression. I share the brutal realities of depression only so others who feel them like I do don't feel so alone.

The sun is shining after days of dark skies

2012-01-25T15:10:00.000-06:00

Last week I slipped back into a pretty serious episode of depression and anxiety. And I don't know why.

I'd been taking my meds and staying fairly active, at least getting on a treadmill for 30 minutes a couple times a week. Not intense exercise, but at least I was doing something.

This week, lo and behold, I feel much better. Could it be the sunshine after days of dreary skies brightened my mood? Or my intentional effort to eat better? Praying for relief more fervently? Going for a sweat-inducing run on an unseasonably warm afternoon yesterday? The long-awaited debut of "American Idol"?

I'm not certain, but it's probably all of the above.

One frustrating aspect of depression is it's easier to deconstruct good days than bad days. Let me explain. I just laid out a bunch of reasons that probably explain why I feel better this week. Only I have no idea how I got to that bad, dark place last week. Did irrational anxiety about things I can't control start me down the slippery slope to depression? Was it the new drug I was taking as a replacement for Valium, which I usually take as needed when my anxiety gets really bad? Was it those ghastly gray skies, day after day?

I don't know for sure, and neither does my therapist. She flipped back through her records during our bi-weekly session today and noticed that two weeks ago I reported feeling flat. Walking me through last week, we figured out one difficult and stressful task at work—in which I had no clue what I was doing but was too ashamed to admit I was confused and needed help—may have been the final shove toward despair and depression.

So what did I learn from this experience? My psychiatrist took me off that new drug that just made me miserably drowsy. (I'm back to Valium as needed). My therapist coached me to be more self-aware and to look for "cues" that I'm slipping, because if you know you're slipping, it's easier to stop the slide.

A cue might be "all or nothing," irrational thinking, i.e., "I stink at this project and I'm going to lose my job." Had I stopped those inevitable racing thoughts, I could have just slowed down and asked for help.

Only that's not easy for me to do. My sagging self-confidence, which I wrote about in my last blog, sometimes leads me to believe that I can't make mistakes. My ruminating mind tricks me into believing that if I ask for help, I'll come across looking like a dope. How messed up is that?

I feel pretty good today. The sun is still shining and I'm able to focus better. And I know winter, the hardest time for me every year, is one day closer to turning into that hopeful time of spring, when the days are longer and less depressing.

Tomorrow, I leave for a three-day spiritual retreat. I won't get into the details just yet, but it's 72 hours without cell phones, emails or even watches. I look forward to sharing about that experience when I get back—and hopefully how it changed me for the better.

Depression stole my swagger

2012-01-10T16:41:00.001-06:00

There are a lot of miserable symptoms of major depression. Despair. Fatigue. Loss of interest in things we once enjoyed. Stomach-churning anxiety. Real, physical pain. Those are just a few.

Worst of all, this soul-sapping brain disease can steal our self-confidence.

At least that’s what my wife noticed recently.

After a tough six months of on-again, off-again depression, I’ve come to realize she is exactly right. Depression stole my swagger.

I was once brimming with self-confidence. Not arrogance, but confidence in my ability to accomplish anything I set my mind to do. Then I crashed and burned with my first major battle with Major Depression.

Sadly, I can’t remember the last time I felt truly confident.

My current meds and time with my therapist are helping me survive each day, but I’m sick of just hoping to survive. I want to start really living again.

Is that too much to ask? I don’t think so.

So what am I going to do about it?

I’m going to be more intentional about setting modest goals that I can achieve, whether it’s at work or at home. Achieving those goals will surely help build my self-confidence back. I am keenly aware that such cognitive behavioral therapy works, but it is difficult to be diligent about using those tools when you feel depressed and mentally exhausted.

I blogged earlier about the need to “fake it til you make it,” and I still believe that. I just wish it wasn’t so darn hard.

Today was a good day; what gives?

2011-12-20T16:32:00.001-06:00

Today was a really good day. I don’t know why exactly, butit was.

Never mind the troublesome fact that having one good day isblog worthy. That probably means I have a long way to go in fully recoveringfrom a crash-and-burn episode of severe depression last summer.

Yet that’s a blog for another day. Let’s get back to today.It was a whistle-in-the shower, think funny things, eat chocolate and enjoylife kind of day. Seriously.

Since I reverse engineered a bad day in an earlier blog,let’s walk back through today and see if we can identify what made it a goodone. The fact that I didn’t have to go to work today surely is a factor, but Ipromise you I have just as many bad days on the weekends as I do during the workweek—sometimes more. But in the interest of full disclosure, I was off today(work, that is).

I ate a healthy breakfast. I learned in apartial hospitalization program that good nutrition is key in battlingdepression. This morning, I had a wheat waffle covered in peanut butter. Nosyrup!
I went for a brisk walk. I’m a runner at heartbut can’t bring myself to run hard again just yet. I’ve lost my edge, lost thateye of the tiger with this soul-sapping illness. But instead of lying on my asstoday, I got it moving. I made two personal phone calls that I needed to makewhile walking, one to my mom and one to my brother.
I did not drink alcohol last night. Back when Iwas a heavy drinker, the next day or two (okay, three) were often brutal. Myanxiety would go through the roof. My depression would worsen. That was almosta guarantee.
I took some time for myself. I went and got amassage. I’ve blogged about the benefits of massage before. It really helps me.If you are screaming through the keyboard that you can’t afford a massage rightnow or don’t have the time for it, fine. The point is I did something for meand me only. That’s pretty rare for me but it’s critical in recovery.

Today wasn’t perfect. But what day ever is, even for“normal” folks? Don’t get me wrong. I am not trying to simplify acomplicated illness. Some days are brutal for those suffering from depressionno matter what we do. Truth is, today was a good day because of choices I madetoday, yesterday, and the day before that and probably even the month beforethat. I’ve been taking my meds and making my appointments with my therapist,for example.

I want to thank you for taking the time to read this blog. I write to cope and, hopefully, connect with others who suffer. If you had a bad day, take heart. Keep fighting. It will get better.

When Mornings Start Rough, Fake It 'Til You Make It

2011-12-12T17:10:00.000-06:00

Fake it ‘til you make it.

That’s what one great collegiate golf coach that I knowtells her players when they’re having a bad round. “Fake it ‘til you make it" means a bad start to a round ofgolf, or a work day at the office, doesn’t have to always turn into a badafternoon.

Sometimes you just have to fake it til you make it, or keepplugging away until things improve.

Too many Mondays are like that for me. Today was anespecially Manic Monday. At least the morning was. I awoke tired and depressed. The weather was depressing. Workwas even worse—at least until after lunch.

As I’ve blogged about before, there is a natural explanation for why mornings can be harder for those of us whosuffer from depression. It’s partly because our body naturally produces more ofthe stress hormone called cortisol in the mornings.

That can become a vicious cycle because an elevated cortisollevel only makes us more stressed out, which then leads to more cortisol, whichthen leads to even more stress and anxiety.

Enough with the science, which I have only a limited grasp ofanyway.

Sometimes I find, like today, if I can just grind through atough morning, I can end up with a decent afternoon. I end up setting smallgoals when mornings start out rough. Like make it to my 10 am coffee break. Finishthat letter I’ve been procrastinating. And then just make it to lunch.

That can be enough to propel me to the afternoon, when myenergy and mood generally improve. I’ll be honest here. It doesn’t always work.Sometimes all the coffee and positive self-talk I can stand doesn’t make tough startsturn into good days. But I try. We always have to try.

This is a bit dramatic perhaps, but we just need to rememberthe words of the late Jim Valvano, the North Carolina State basketball courtwho led his team to an unlikely National Championship and then died of cancer adecade later.

“Don’t give up,” Valvano said. “Don’t ever give up.”

Words to live by.

10 things for which I’m thankful

2011-11-21T17:22:00.001-06:00

10 things, in no particular order, for which I am thankful (From the perspective of a man who deals with mental illness).

1) My wife: She has stood by me through good times and bad. Compassionate but candid when I need to be called out for not trying hard enough. Would not be here without her and my kids.

2) Valium: Sometimes it’s the only thing that quiets my anxietyand slows down those racing thoughts.

3) My psychiatrist and my therapist: Good doctors who reallyunderstand mental illness are hard to find. If you are depressed andaren’t getting the help you need from an internist, I’d make it a New Year’sResolution to find a specialist.

4) Chewing gum: Gum is definitely underrated.

5) Drug companies: Tar and feather me for saying this, but ifthey didn’t invest millions in R&D, we wouldn’t have anti-depressants thatimprove the lives of millions. I have no problem with them making a profit.

6) Starbucks: They say caffeine can actually help withdepression. And their Mocha gives me mojo when I'm feeling down. So drink up.

7) Politics: It’s a good diversion when I don’t want to thinkabout my problems. And it makes me realize there are people who are more confused about life than I am.

8) Blue Bell Ice Cream: I read somewhere that too much sugarcan impair the brain’s ability to make enough serotonin. That’s okay. Refer back to #2 and #3.

9) My children: For making me laugh, making me cry, forteaching me about patience and for giving me three really good reasons to get out of bed on the days I don't feel like it.

10) Football: An even better diversion than politics. Only whenmy team loses, I have to refer back to #2.

I know it’s been a while since I last blogged, but I haven’thad much to say. Happy Thanksgiving, and feel free to share what you’rethankful for, especially if you deal with mental illness.

Boredom is no cure for depression

2011-11-03T20:49:00.001-05:00

There is a vacuum in my mind.

It is a space that feels this relentless urge to latch onto something, good or bad, real or imagined.

Lately, I have felt a senseof boredom at work, not finding my work to be stimulating enough. It’s not thatI don’t have work to do. I do. And I do it. It just isn’t very exciting at themoment.

My wife counsels me to justtry and enjoy it when things are less hectic, but that is easier said than donefor me.

That vacuum in my brain,when not filled with something interesting or exciting, can cause depressionand anxiety.

If the vacuum in my mind isnot occupied with something stimulating, the ruminations start. And nothing canstop them.

The problem with boredom anddepression is that even though we know being actively engaged insomething—whether it’s our work or play—would make us feel better, we oftendon’t feel like expending energy….the one thing that probably would make usless anxious and depressed.

I wonder how many others whosuffer from depression and anxiety are worrywarts like me, their minds alwayssearching for something to be preoccupied with?

Please share yourexperiences or your thoughts about boredom and depression. Maybe someone caneven enlighten me on being more “mindful” and just accepting the ebb and flowof life as it comes.

Sharing always helps, andreading your thoughts might cure my boredom.

Massage can help relieve depression

2011-10-25T15:58:00.004-05:00

Don’t look now, but I’ve hadat least three good days in a row. Somebody call Guiness.

I’m not sure who gets thecredit. My talk therapist or my massage therapist?

I went into the spa a fewdays ago with heavy shoulders and a sore back. As those who suffer fromdepression know, it’s not just an in-your-head problem. Depression hurts.Physically.

As I always do, I emergedfrom the spa feeling like a bear that just awoke from hibernation—rested,rejuvenated and hungry…hungrier for life too.

While massage may not be acure for depression or anxiety, it sure does help manage the symptoms. It’s expensive, yes. But canwe put a price tag on our mental health?

While the science doesn’tsuggest massage is a miracle cure for depression, there are studies likethis one that show it sure helps. I always go in with heavy shoulders butcome out feeling like a champ.

They say our thoughts controlour feelings, but that’s easier said than done for many of us. I’ve found thatwhen my body feels better, say from depression or exercise, it’s easier to tamethe torturous negative thoughts that sometimes push me to the edge of sanity and bring on bouts of depression.

I’d love to hear from you ifyou’ve found massage to be helpful. If you’ve tried it and it didn’t help, I’dsuggest a new massage therapist.

So give it a shot. Massageaway that nagging anxiety—even if only for a little while.

Anxiety: Depression’s Evil Twin

2011-10-17T21:06:00.000-05:00

Some times I have to reverse engineer a bad day to figureout how my anxiety gets the best of me.

Today was a tough day. My oldest child is six years awayfrom college and yet I had a near panic attack worrying about how to pay forher college tuition. I worried about how we are going to pay for braces for myyoungest two...not to mention theircollege tuition.

I worried about what my family would do if something happensto me. I have insurance, but is it enough?

Today was not unlike most Mondays, actually. I don’t dotransitions well—and I’m not talking about my writing style.

The transition from the weekend to the work week is always astruggle. The transition from home to work in the morning and then work back tohome at night is hard some days, too.

Change causes anxiety for me. And as I’ve written before, myproblems controlling anxiety only aggravate my depression.

My doctor just today decided to increase my dosage ofAbilify, because the progress I’ve made since some really dark days this summerhas stalled.

(That paragraph is a good example of a bad transition).

In searching around for information on anxiety anddepression tonight, I found some helpful informationon depression and anxiety from the AnxietyDisorders Association of America. It explains that depression and anxietydisorders are different, but some of the symptoms are the same. They includenervousness, irritability, sleeping issues and problems and troubleconcentrating. Sound familiar? Does to me.

I have never been diagnosed with an anxiety disorder, but I don’tneed to be. I know it’s a problem.

So how do I reverse engineer my day? Looking back, I realizeI should have done something helpful when the negative thoughts occurred. Ishould have written down an action item, like figuring out a way to set aside alittle additional money for the kids’ college funds. Then I should have stoppedworrying about it.

If you are like me, that’s easier to say than it is to do.

Fighting depression like pulling weeds

2011-10-12T11:34:00.002-05:00

I hatepulling weeds. And the flower bed in front of my house is full of them.

Theworst part? They’re all tangled up with the jasmine we had planted as groundcover.

The hopewas the jasmine would eventually strangle the life out of the weeds, but thathasn’t happened.

It lookslike we’ll have to do it the hard way—one weed at a time.

That gotme to thinking. It’s a lot like my depression and anxiety.

Fightingdepression and anxiety is like pulling weeds. It’s hard work. Now, it’s easy torip the top off the weeds, just like it’s easy to obfuscate, scratch thesurface or dodge the real issues with our therapists. The hard part is gettingdown to the root of the problem.

Dump-trucktalk therapy, in which we just spend an hour jabbering about our week and howwe feel, is sort of like ripping off the tops of those weeds. It doesn’t reallyfix the problem. It’s only going to come back.

We candump our feelings on somebody else, but until we figure out how to stop beingso anxious, how to stop the negative thinking, it just comes back. And likethey say about addiction, it will only come back stronger if we don’t kill thelion.

It’smuch harder, so hard I haven’t done it successfully yet, to get to theroot of depression. We can take meds, which I do, we can exercise, which Idon’t do often enough, and we can spend money and time with our therapists. Andyet we can still be depressed and frustrated.

I guesswe have to just be patient, keep pulling one weed at a time.

Successful recovery, as I view it in mymind’s eye, looks like a well-manicured garden. It’s just not easy to get there.

Thank you, Bono and Simba

2011-10-08T10:47:00.000-05:00

Music and movies can be mood changers for me.

This was a tough week. Anxiety and depressiongot the best of me for the most part during Mental Illness Awareness Week,which ends today. Thank goodness. I am quite clearly aware of my mentalillness.

But Friday was different, and I have Bono tothank. Bono, Bruce Springsteen and The Lion King in 3D.

Those of us who suffer from mental illness needsomething to help elevate our mood when we fall into the rut of depression. Onetrick I learned in a partial hospitalization program this summer was the powerof music to change mood.

So I signed up for satellite radio in my carand on my computer at work. With the click of a mouse at work, I can listen toBeethoven or the The Beatles, The Counting Crows or Tchaikovsky. I can climb into The Loft and mellow out with some contemporaryeclectic tunes or slide into the Coffee House and soak up a groovy acoustictune.

I can listen to music to change my mood.

http://musicofireland.blogspot.com/

After a four-day losing streak, I won thebattle on Friday. My day started with Bono belting out “Beautiful Day” on theway to work. I was almost surprised to find myself strumming along with TheEdge on my steering wheel. Was that purejoy just now? Wonders never cease.

As this informativearticle points out, the connection between music and mood isn’t new.Ancient philosophers knew that music could change their mood, even kings inancient times used music to relieve stress. We see music used all the time toelevate mood or relax us. My favorite college football team uses rousing musicblaring over video highlights to whip the crowd into a frenzy before every homegame. And it works every time.

My Friday ended with an uplifting trip to themovies for “Lion King” in 3D with one of my children. Such is the Circle ofLife for those of us with depression. The circle will take me to a low again atsome point, I know. Not today, though.

Music and movies can change my mood, but I haveto be careful.

If I’m feeling depressed, “Terms of Endearment”may not be a great choice for a Friday night flick. When I want to feel better,I change the channel when sad ballads come on my radio. I turn it up whenupbeat tunes come on.

So thank you, Bono and Simba. Friday actuallyfelt like Friday should feel.

Why can't I just let me be?

2011-10-05T21:09:00.000-05:00

Being married to me must be exhausting, I told my wife.

No, she said, being you must be exhausting.

Sometimes it is.

The subtle mood swings. The nagging anxiety. The utter inability to just be... Itis all so damn tiring sometimes.

My moods can swing like a heavy pendulum from happy todepressed, content to crazy, in a morning, much less in a week.

My current meds are working, for the most part. Beaten down and gaunt from the weight loss, I crawledout of the darkest, deepest and most dangerous depression of my life thissummer.

Those fleeting impulses to say to hell with it all are fewerand farther between now, but consistent contentment eludes me still.

I am restless. They say Abilify can make you feel that way.But it may have saved me, so what to do? Flush the pills down the toilet and riskslipping back down that slippery slope into a pool of misery?

No! I can’t do that. I have to stay the course. I have totry again tomorrow. I have to do all the things my therapist is telling me todo but for some reason I don’t.

I have to remember my job is just a job. It’s what I do, notwho I am.

I have to try harder to stop the negative thoughts when theystart.

I have to go back to giving five minutes at the start of eachday to my Higher Power and asking Him for help.

I have to learn to just be.

Oh, how I wish it were thatsimple.

Why doesn't mental illness have a color?

2011-10-03T18:32:00.001-05:00

When I strolled down the driveway this morning to pick up mynewspaper, I was surprised. Surprised because it (my newspaper, not the driveway) was pink.

It didn’t take long for me to realize the state’s largestnewspaper was pink in recognition of Breast Cancer Awareness Month. It’s a goodthing. The paper was chock full of stories about cancer survivors, cancerresearch, cancer prevention and more.

But it got me to thinking. How many people have a clue thatOct. 3-8 is also Mental Illness Awareness Week? How many blue newspapers were published today in honor of the week? Probably not many.

While cancer gets the headlines, mental illness is every bitas much of a public health crisis. Only it’s a silent killer. The stigma aroundsuicide, depression and other mental illnesses is so great that I’m too much ofa chicken to publish this blog under my real name.

That’s sad.

So in honor of Mental Illness Awareness Week, I thought I’ddo my part. Hereis a brochure from the National Alliance on Mental Illness on depression that might help you.

Major Depressive Disorder has been a hard fact of life forme for six or seven years. That’s since I was diagnosed. My issues actuallydate back to college and even, I realize now, back to my adolescence.

Like way too many boys and men, I suffered in silence forfar too long. I didn’t get help because I wasn’t sure I needed it. I was too scared or too ignorant to ask for help.

I am far from an expert, but now I know the symptoms, evenif I still fail to realize I’ve slipped into the deep, dark pit of depression until I’vehit rock bottom. I hit rock bottom this summer, and it was pure misery.

If you think you might be depressed, help is available. Here is some more great information from NAMI on what depression is exactly.

If you’re having a bad day, you may not be depressed. But ifyou can’t remember the last time you had a good month, I’d recommend talking toa professional. Folks who know a lot more about it than I do say psychotherapy— ascary sounding but basic term that means talk therapy—is a good place to start.You may or may not need medicine.

Since starting this blog, I’ve noticed there can be fiercedebate about whether drug-free treatment of depression really works. I wouldsay it depends on your circumstances, your family history and, probably, yourbrain chemistry.

The specific type of talk therapy that I havefound helpful is cognitive therapy. It’s basically learning to change the way wethink. There all kinds of techniques that a therapist or psychiatrist can teachyou.

One of the techniques I use when my mind starts racing isthe Stop Sign Technique. To stop the negative thought patters that sometimesresult in near full-blown panic attacks, I close my eyes andenvision a literal STOP sign in exquisite detail. Its color. Its shape. Theletters S-T-O-P and what they look like. It helps. Sometimes, anyway.

For many of us, talk therapy alone isn’t enough. It isdifficult if not impossible for me to imagine life without medicine at thispoint. Maybe that day will come, it just won’t come anytime soon.

A good place to start is to get educated. Talk to yourprimary doctor if you might be depressed. Ask—demand if you have to—a referralto a therapist or a psychiatrist, or maybe both. It may be the best phone callyou ever make.

If you are like me, your family will thank you for it.

I plan to blog a couple of times this week in recognition ofMental Illness Awareness Week.

My hope is it helps someone, even if it’s just ONE.

On drinking and depression

2011-09-29T15:34:00.001-05:00

So this is the blog that might scare away men I’m hoping tohelp. Not a popular subject. Depression and alcohol.

The bottom line? A lot of one can lead to a lot of theother. Depression can make you want to drink more. And drinking more can leadto more severe depression.

It’s not cool to lectureothers or say "here’s what you need to do." Therapists and AA folks call that cross-talk. You’resupposed to say “I can relate to that because….”

So here’s how I’ll start. I canrelate to the intractable problem of alcohol and depression. I drank enoughbeer in college to float a barge. I drank enough beer after college to drown a dragon. Only the alcohol never killed thedragon. It only made him angrier.

I kept on drinking, and drank evenmore when the first real tests of my life came. The loss of a loved one. Thestress of owning a business. The stress of parenthood and trying to be a goodhusband, good career guy and good father at the same time.

The worse it got, the more Idrank. The more pain I suffered, the more I tried to dull it with alcohol. Iwas quite clearly self-medicating, only this medicine has horrendous side effects.Hangovers. Even more anxiety. The inability to concentrate. The obsession overwhen the next drink can be consumed.

I once quit cold turkey once withno professional help but lapsed back into the same old patterns nearly a yearlater. Then my depression got worse than ever, and the abuse of alcohol becameas bad as it had been in college.

Even though this is an anonymousblog, allow me a little room for rationalization here. I was never a BloodyMary in the morning or bottle in the desk guy. But I was a prolific bingedrinker. After Katy Perry-like Friday nights, I’d be hung over until Wednesday.And then I’d start again on Thursday with heavy drinking.

And it never, ever made me feelbetter. Only worse. My first therapist equated it to pouring gasoline on afire. It’s simple, really. Alcohol is a depressant. Depressed people, umm, Ishould say people like me that I can relate to, probably don’t need moredepressants.

If you want to read a great blogabout depression and alcohol, which is the chicken and which is the egg, check this one out. If you wantto read some scholarly articles about alcohol and depression, clickon this link.

Praise God, alcohol abuse is not aproblem for me right now. Not today at least. We’ll see about tomorrow.

The signs of major depression were there

2011-09-27T12:51:00.000-05:00

The signs were there. This is what my journal said one daylast spring, about four months before I slipped into a painful, debilitatingdepression.

Not doing well today/this week. Dejected. Tired. Troublegetting to sleep. Frustrated. Stressed. Racing thoughts won’t stop. I want to quit my job and get my life back. Reality is I can’t or won’t.

Anxiety is high. Not getting everything done at work. Myfocus is inconsistent. Am I ADD too? When I start spiraling down, I can’t seemto stop it.

That’s what I wrote on March 30, 2011. When I saw mytherapist that day, her advice was simple:Get through this crisis!

I was going through a stressful episode at work. Like a lotof anxious people, my therapist astutely observed, I attract the anxiety ofothers around me like a magnet. If they are anxious, I pull in their anxiety.

My therapist also told me to gently bring my mind back tothe reality that my job is no different than others. Everybody has stress. It may feel like it, but it's not literally a dragon that I must slay or face a terrible death. It’s a job!

So what went wrong? Why did it all come crashing down fourmonths later?

I am still trying to figure that out with the help of newmedicine, more therapy and some self-reflection.

I’m reading a book about co-dependency, which is a broaderterm than I had previously thought. It’s called “Codependent NoMore” by Melodie Beatty. Codependency is about more than being an enabler. It’sabout learning self-care and, sigh, self-love. That’s not easy for men.

When I entered a partial hospitalization program last summer, I learnedsome techniques through group therapy. We studied the Crisis SurvivalStrategies by Marsha Linehan at the University if Washington. Anexpert on borderline personality disorder (which I don’t have unless you countwhen it’s questionable whether I have apersonality when I’m really depressed), Marsha also writes about how todistract ourselves when we feel threatened by a mental health crisis.

Her handy way to remember the steps is “a wise man ACCEPTS.”The acronym goes like this:

Activities: Exercise.Do a hobby. Clean. Attend an event. Call or visit a friend. (You get the idea).

Contributing: Volunteer. Do something nice for somebody youlove. Or just say something thoughtfulto somebody you work with.

Comparison: Compare yourself to others, especially those whoare worse off. (It will remind you that it could be worse and you are probablyquite fortunate).

Emotions. Watch a movie or listen to music that will changeyour emotions for the better. (Don’t watch "Mommy Dearest" if you are depressed.Maybe go with "Old School" or even something lame like "The Sound of Music").

Pushing Away: Push the situation away by leaving it for awhile. Take a break from your worries. (Maybe pull up jerryseinfeld.com. He nowputs up bits every day that are “fantastic,” as Jerry might say).

Thoughts: Count to 10, watch TV (not the news), read, or doanything that will change your thought pattern (Remember our thoughts determineour feelings. Simple but profound truth).

Sensations: This one sounds nutty if you’ve never been intherapy. One proven technique if it’s a really bad day is to clutch a piece of ice.Or squeeze a ball. Or have sex (that one really is on the list, honey).

Maybe one reason I crashed this summer is I didn’t knowthese techniques. They don’t always work, but knowledge is power, and effort,any effort, to change our negative thinking is better than stewing in a pot ofself-pity.

Source: From Skills Training Manual for Treating Borderline Personality Disorder by Marsha Linehan.

The best part of waking up? I’m still not sure

2011-09-25T20:59:00.000-05:00

I’m not a morning person. Never have been. Probably never will be.

I never knew there is a scientific reason that my anxiety seems to be worse in the morning until I did a little research into morning anxiety.

I found this great blog on morning anxiety at The Reality of Anxiety, one of the best blogs out there on mental health. The post is several years old but quite good.

Our bodies naturally produce a stress hormone called cortisol, which was a good thing back when people threw spears at each other and needed a boost of adrenaline to stay alive. It still has its place, such as when my American Express bill arrives in the mail.

Too much morning anxiety, though, only compounds matters. Cortisol levels are already at their highest in the mornings, and when we can’t manage our stress, our adrenal glands keep pumping more of it into our bodies. Morning anxiety creates more anxiety. It can be a vicious cycle.

Here’s what my mornings feel like. I wake up slowly but then quickly begin to worry about my day. That just creates more anxiety. On a good day, I’m okay by 9 or 10 a.m., or my third cup of coffee, whichever comes first. On a bad day, it’s noon or so before I feel “good.”

The inevitable “fight or flight” struggle I have goes something like this. A lot of mornings I don’t want to get out of bed, much less deal with work. Then I start to feel better and realize I can’t flee to Mexico because of my mortgage and the fact that all of my children will eventually need braces. Reality is a great motivator.

By lunch, when I can either work out or at least eat—boosting my blood sugar level at about the same time my cortisol levels are probably evening out—I’m good. Sometimes, I’m even great by 2 p.m. Miracles never cease.

It’s ironic that depression is so often associated with darkness. I actually do better at night, until I start to worry about the next morning.

So what to do? Exercise in the mornings? Not me. I hate exercising until I at least can figure out what day it is.

Pound coffee? Too much makes my heart race and my hands shake.

The simple things help me most. Four square breathing (four deep breaths, holding for four seconds before exhaling for four seconds) and a little devotional time seem to help. At least when I feel like it.

Folgers may have written the best jingle of all times about the best part of waking up. Only I’m still trying to figure out what that is.

Think you are depressed? Man up!

2011-09-23T16:58:00.000-05:00

Smart people who study mental illness say twice as many women suffer from depression than do men.

I find that hard to believe.

Since I began sharing my struggles with depression with close friends, I’m amazed at the number of men who tell me they are probably depressed.

Is the science wrong? Probably not.

Yet could it be that research shows twice as many women experience depression because men are less likely to admit they need help? Probably so.

I’d be interested to see what effect the Great Recession has had on the number of men who suffer from depression. Suicide rates reached an all-time high in 1932, according a Bloomberg article that references an American Journal of Public Health study.

You don’t have to be a history buff to know that was the height of the Great Depression. (That’s a really sad pun). They may have been the most difficult time in American history for men—at least in terms of mental health.

An article published in the Atlanta-Journal Constitution this week said the suicide rate for middle-aged people (ages 45-64) is the highest it has been since 1998.

The only place I’ve ever met men who tried to commit suicide was in a dual diagnosis program for people who suffer from mental illness and/or addiction. The men I know in my personal life that are struggling with what could be diagnosed as depression aren’t suicidal, but they don’t exactly have a sunny outlook, either.

Several male friends of mine have come to me for advice. They’ve asked me if they could be depressed.

Since I’m obviously not a doctor, I tell them to talk to one. But I also urge them not to stop with their primary care doc if they don’t get the help they need. With all due respect to doctors, internists don’t seem to understand mental illness very well. It’s not enough to get on a drug. Therapy is often needed, too.

If your doctor isn’t helping, ask for a referral to a psychologist or psychiatrist, or look one up on your own online. That’s what I did.

It’s normal to get the blues. But if you feel hopeless, exhausted, persistently sad and have lost interest in things that once gave you pleasure, it might be worth your time to check out this FACT SHEET on men and depression. It comes from the National Alliance on Mental Illness.

So guys, if you think you are depressed, man up! You are not alone.

Broken hearts and fragile minds

2011-09-22T17:27:00.000-05:00

I’ve read tons of blogs about depression. The Splintered Mind is one of the best.

His latest post, “On Heartache and Depression,” is a must-read for those of us who suffer from depression, especially those who are also coping with loss.

So what’s the difference between sadness and depression? And how do we know when we are just sad or when we’re depressed and might need help? I’ve been asked that before. Here’s what A Splintered Mind writes about his recent divorce, about the difference between sadness and depression.

Sadness is a response to tragic or disheartening events; Depression is an overwhelming feeling of hopelessness and misery that pulls my heart to the grave. Sadness invites comfort from others; Depression compels me to drive others away.

Brilliant, Splintered Mind. Part of healing, he says, is allowing ourselves to be sad when sad things happen. For me, it’s the death of my father.

Dad, the greatest man I’ve ever known, died two years ago. It took two years for me to slip into the deepest depression I’ve ever experienced. A dark, terrible place I never want to visit again.

Did I go there because I didn’t let myself go where my feelings tried to lead me after Dad’s death? (Note to self: Ask therapist about this next week). And was my depression worse than it would’ve been had I properly grieved two long summers ago?

Splintered Mind further opines about the difference between depression and sadness.

When my thoughts are tainted with hopelessness and dreams of death, I know they are induced by Depression and I fight them off. When I pine for the marriage lost and wish things had turned out differently, or even burst into tears, I know it's a response to the tragedy I'm living through. I allow it to happen.

When sadness threatened to overwhelm for the first two years after my first big loss in life, I didn’t let it happen. I shut down emotionally. I seldom talked about Dad and almost never let myself cry.

Maybe it’s not just sappy therapy speak to say we should let ourselves feel feelings. Smart people who’ve spent a lifetime studying it say our thoughts determine how we feel. So when we think sad things, maybe we should allow ourselves to feel what we’re thinking, to let the tears flow.

Looking back, my recent descent into that dark place was the worst time of my life. Yet while there is still a hole in my heart, those tears were like a salve in my wounded soul. It’s getting better.

So thank you, Splintered Mind. Thank you for reminding me it’s okay to be sad. It might even save my fragile mental health.

Anxiety & Depression: Which is the chicken, which is the egg?

2011-09-21T00:08:00.000-05:00

Before I was old enough to know what stomach acid was, I knew what it felt like.

I was in the fourth grade, best I can remember. The teacher told me the principal wanted to see me...on Monday morning.

That weekend was pure hell. I worried myself sick. What the heck did I do to get in trouble? Would I get paddled? What would my parents do to me when they were called in? Should I confess to a crime I didn't commit?

Those crazy thoughts swirled in my mind and made my stomach churn...all weekend. I barley slept, worrying like hell about what was to come. I didn't know then that the stomach-churning anxiety that tortured me all weekend all came from my thoughts...irrational thoughts.

Then Monday morning came. The principal called me in...to ask if I would do the honor of raising the American flag at school every day for the rest of the year. I nearly wet my pants with joy.

Some 30 years later, I repeat that ritual weekly, if not on a daily basis. I worry like hell about something that has or hasn't happened and probably will never happen...and then I get depressed. It's a slippery slope of misery that makes me wonder. What comes first? The chicken or the egg? The anxiety or the depression?

My former therapist (she moved to the West Coast) taught me some techniques to deal with the runaway thoughts of negativity and despair. She taught me to take a deep breath, close my eyes and envision a stop sign in intimate detail...the exact color of red, the lettering of the word STOP. It works sometimes, sometimes it doesn't.

My current therapist, who is brilliant at helping me with these cognitive therapy techniques, has encouraged more of the same and taught me to reign in those maddening episodes of anxiety, to gently put the brakes on the runaway train that is my brain—without skidding off the highway. Sometimes it works, sometimes it doesn't.

That's because changing our behavior, our thoughts that control our feelings, isn't easy.

Do you suffer from anxiety? If so, ask for help. For me, the combination of talk therapy, drugs (Abilify, Cymbalta and generic Valium as needed) has helped immensely from that dark, deep pit I felt helplessly trapped in not so long ago.

I am no doctor and no expert. I only know that asking for helping, taking deep breaths and thinking about stop signs is a good start. Maybe if I can keep sharpening those skills, the depressions that come won't be quite so dark, quite so deep and quite so long.

If you don’t feel sexy, go for a walk

2011-09-18T18:28:00.000-05:00

The doctor told me to do two things to cure my depression. 1.Get up and get moving and 2. Tell my wife we need to have more sex.

That was the advice given to me by an internist a couple years ago, when I was mired in the muck of depression.

I came away thinking two things. If you suffer from depression, you need to see a specialist. And second, that doctor has not been married for very long.

Those of us who deal with depression know how hard it is to get off the couch some days, much less run off to Zumba class. They know that depressed people don’t exactly feel sexy. And our significant others sure as hell don’t feel attracted to us when we can barely muster a smile.

I’m learning that doctor isn’t all wrong, though. I remember when walking to the mailbox felt like a victory after a “sick” day in the bed. When I don’t feel like running, a hobby I enjoy when I’m not bluesing, a brisk walk down the street and back relieves the pain of depression, at least for a little while. HERE'S WHY

If I can force myself to go for a run and suffer through the first mile, the payoff can be huge. Exercising seems to do even more for anxiety, providing somewhere for those random running thoughts to escape.

As for sex, well, it’s pretty good for depression, too. Or so I hear.

To Hell and Back

2011-09-14T11:50:00.000-05:00

We were standing atop a mountain, at one of the prettiest places in Georgia, when I grabbed my big brother's arm and fell to my knees.

"I can't do it," I cried out, sobbing.

My children and their cousins were close by, but I couldn't help it. I wept uncontrollably. This was it. The worst moment of my life.

But why?

I have a beautiful wife. Three beautiful children. A great job. So what the hell is wrong with me? Why so much darkness and pain—real, physical, gut-wrenching pain?

I didn't care "why" that day. I only knew that it was time to surrender. Time to declare that depression had defeated me that day. Time to admit that the anxiety, the racing, jumbled thoughts that made my life a nightmare were much too much to bear alone.

We sent my children away that day, one week after the doctor instructed me to turn over my meds to my wife for fear that I might hurt myself.

It would get better. It had to. How could it get any worse?

I leaned on the arms of my family, my wife, brother and mother, and gave up. Right then and there I gave up and told them I couldn't do it alone. I was sick of being sick, so sick of it that I didn't care what the strangers looking on thought. Didn't really even care that my children saw me in such a pathetic, miserable state. I had to get help. For them. For me.

Three days later, I entered a partial hospitalization program in Birmingham, Alabama. New drugs coursing through my blood and pumping chemicals into my brain, I found my bottom. I learned that my thoughts control my feelings.

I learned that my family history wasn't my fault. I felt like Beniah of Biblical times... I had slipped into a snowy pit with a lion for the fight of my life. This time, I would not stop until the lion is dead.

I had lost 30 pounds without really trying. Left one career and started another. Nearly lost my wife, or so I thought.

This time, with God's help, will be different. I will stand up and fight, even when I don't feel like getting out of bed.

Thousands of dollars and numerous therapy sessions later, I am still standing, still fighting. I won't give up.

I am a writer by trade, but writing this blog is the hardest thing I have ever done.

My hope and prayer is this little blog will help someone else. Southern men like me can't admit when we are weak, when we can't do it alone. It's time for that to change.