On drinking and depression

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

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

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

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

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

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

I once quit cold turkey once with no professional help but lapsed back into the same old patterns nearly a year later. Then my depression got worse than ever, and the abuse of alcohol became as bad as it had been in college.

Even though this is an anonymous blog, allow me a little room for rationalization here. I was never a Bloody Mary in the morning or bottle in the desk guy. But I was a prolific binge drinker. 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 feel better. Only worse. My first therapist equated it to pouring gasoline on a fire. It’s simple, really. Alcohol is a depressant. Depressed people, umm, I should say people like me that I can relate to, probably don’t need more depressants.

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

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

The signs of major depression were there

The signs were there. This is what my journal said one day last spring, about four months before I slipped into a painful, debilitating depression.

Not doing well today/this week. Dejected. Tired. Trouble getting 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. My focus is inconsistent. Am I ADD too? When I start spiraling down, I can’t seem to stop it.

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

I was going through a stressful episode at work. Like a lot of anxious people, my therapist astutely observed, I attract the anxiety of others 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 to the 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 four months later?

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

I’m reading a book about co-dependency, which is a broader term than I had previously thought. It’s called “Codependent No More” by Melodie Beatty. Codependency is about more than being an enabler. It’s about learning self-care and, sigh, self-love. That’s not easy for men.

When I entered a partial hospitalization program last summer, I learned some techniques through group therapy. We studied the Crisis Survival Strategies  by Marsha Linehan at the University if Washington. An expert on borderline personality disorder (which I don’t have unless you count when it’s questionable whether  I have apersonality when I’m really depressed), Marsha also writes about how to distract 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 you love.  Or just say something thoughtful to somebody you work with.

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

Emotions. Watch a movie or listen to music that will change your 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 a while. Take a break from your worries. (Maybe pull up jerryseinfeld.com. He now puts up bits every day that are “fantastic,” as Jerry might say).

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

Sensations: This one sounds nutty if you’ve never been in therapy. 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 know these 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 of self-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

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.