Friday, 21 August 2015

What is Major Depressive Disorder? - Part 4

Image by tpsdave

In my last post, I hoped to bring to your mind the cumulative effect that the symptoms of Major Depressive Disorder have on the sufferer. Each and every day, for most of each day, he or she (from now on, I'll just say he) is battered by a multitude of mental and physical affects that just wear a person down. To the sufferer, there doesn't seem to be a reason for this, which serves to create frustration and confusion worsening the overall impact.

Whereas my last post tried to explain the effects from the view of an MDD sufferer, this post strives to be more objective. Consequently, while much of what follows is largely repetition, my aim is to comment on each symptom independently.

While Major Depressive Disorder seems to begin with mood - that is, after all, the first symptom described in the definition - it really begins with the brain. Neuroscience tells us that our brains have zones that regulate appetite, sleep, mood, pain, memory, and all other facets of our being. Some zones are special in that they are designed to monitor and regulate other zones, but all of them communicate with each other.

Image source unknown
We all have these zones. We all have a prefrontal cortex, the thinking part of the brain, and we all have a limbic system, the feeling part. The location of these areas of the brain tells us that the limbic system is the older of the two. As our prehistoric ancestors developed larger and more rational brains, the prefrontal cortex evolved to manage the limbic system, giving us an ability to balance emotion and rationality.

In some of us, however, the communication between these two zones is faulty. The prefrontal cortex, the thinking brain, doesn't regulate the limbic system, the feeling brain, in its designed way. In essence, thinking no longer regulates mood, mood regulates thinking. This fault in our brains is the behind-the-scenes of Major Depressive Disorder. It gives us an insight into why Mood is so dominant in the definition and in the sufferer's experience.

So, we begin with mood. Every day, for most of the day, the MDD sufferer feels sad. It's not feeling sad, in the traditional sense. Usually, when we talk of someone being sad, we can point to a cause and can reasonably expect him to regain an emotional balance over time. Sadness, then, tends to have both cause and closure.

For a depressed person, this is not the case. The sadness does not have any readily discernable cause, nor does it have any closure. It persists, and persists, and persists, no matter what is done to get out of it. Further, for many sufferers what they experience isn't truly sadness, it's numbness. There's an emptiness where there should be emotion. For others, an emotion is felt by its absence, not its presence. No matter the case, though, it's clearly more than what we commonly mean when we think of sad.

The definition of MDD presents an alternative affect of mood, the loss of the ability to perceive or experience joy. People can laugh and cry and celebrate all around the MDD sufferer, and he is indifferent to it. This indifference creates a disconnect, a distance between the depressed person and the world around him. Activities that were once enjoyed have lost their lustre. They have become uninteresting. And this lack of interest spreads throughout his world, infecting his job, relationships, and social connections.

In either circumstance, the first effort is to try to think a way out of the problem. But this doesn't work, because the connection between the thinking brain and the feeling brain is faulty. The sufferer doesn't know this. All that's known to him is that there's no reason to feel as he does. He'll try to fix things but can't.

Image by SnapwireSnaps
By themselves, these two primary symptoms are distressing. Consider all the joys the world brings to life: the laughter of children; the play of the wind on leaves and chimes; the warmth of a companion; the sharing of friendships. Now consider a life that is unable, for no apparent reason, to leave glumness behind or see this joy and participate in it. Consider how empty that life must seem. Consider how painful this must be.

You can see how, in these circumstances, the depressed person can experience a loss of energy, a reduction in vitality. If nothing brings him joy, if nothing breaks through the gloom, every small thing feels difficult and becomes draining. He is listless and unmotivated. He will feel guilty, wondering what is wrong with him. With guilt comes annoyance at himself for not being able to shake the mood off. Annoyance brings irritation and negative self-talk.

You can also appreciate how this depressed mood or inability to find joy can harm someone's thinking. Indecisiveness, confusion, irritability all seem to flow from the general ideas of "what's the point?", "it isn't going to make a difference", "it just doesn't matter". Moreover, because of increased fatigue, his thinking ability and his body have both slowed down. Plans can take an eternity to reach and another eternity to implement. In fact, so much energy is taken to plan or act, that neither reaches completion. He becomes paralyzed with his inability to plan or do. This too will foster guilt and shame.

His sleep suffers. On many occasions, sleep is denied him because his mind will not rest. He will consider, and reject, permutation after permutation, in an effort to think his way out of the problem. The racing thoughts will include denigration and shame. On other occasions, he sleeps non-stop, but he doesn't rest. The internal dialogue remains on a sub-conscious level infecting dreams. Either way, both the body and the mind are fatigued. With this fatigue will come increased impatience and irritability. He will lash out at friends, family and co-workers. His social relationships will suffer.

Issues with weight and appetite seem obvious in these circumstances. By doing less, fewer calories are burned. Body fat and weight grow. Alternatively, there's no motivation or energy to cook, or eat, and weight plummets. In either circumstance, bouts of guilt at the weight gain or weight loss may cause binge eating or binge dieting to compensate. Both cause growth in negative self- image.

Image by johnhain
The MDD sufferer loses all self-esteem. He is filled with guilt and shame and a growing sense of worthlessness. Unknowingly, everything around him that validates the guilt, justifies the shame, confirms his worthlessness, is absorbed, adding to the feeling. He feels guilt even if it isn't his fault. He feels shame even when there's nothing to be ashamed about. He feels worthless despite all evidence to the contrary. Increasingly, he engages in an internal dialogue of negative self-talk and external actions of self-abuse.

Negative thinking patterns have become the norm. A day, filled with both positive and negative events, seems to be nothing but a bad day. The depressed person does not see, cannot see, the positives. He also cannot feel positive emotions. He has become numb or, at best, feels the emotion by proxy, by its absence and through the eyes of others.

Practicing emotion by proxy allows the sufferer to don a mask or normality. He always wears this mask. No-one can see who he truly is because he is unworthy of compassion or empathy. In his eyes, if they saw the true him, they would see that he's a fake, that there's something wrong with him, and that he's undeserving. In addition, he remembers how he lashed out and is ashamed. He believes that he cannot be forgiven and convinces himself that this thought, is fact.

Isolation becomes commonplace. It takes too much effort to socialize. It's easier to just stay at home. But this generates its own guilt and shame adding to the sense of worthlessness. While alone, the guilt and shame, the inability to figure out what's causing all this, increases the volume and frequency of negative self-talk and self-abuse. The depressed person will try to shame himself into action, and shame himself again for not being able to act. In fact, everything becomes an occasion to shame himself. He will belittle himself in ways he would never belittle anyone else. He's worthless, he deserves it.

Consider how it must be to live in such a quagmire. To suffer without cause, to endure without respite. The definition of Major Depressive Disorder tells us that two weeks of this life is too much. Sadly, a typical episode of MDD lasts from six to nine MONTHS. If a person has had multiple bouts of MDD, without treatment or failed treatment, episodes can last YEARS. Consider that: at the bottom end of the typical depressive episode, six months, the sufferer is bombarded with this bleakness every day, for most of the day, for over 180 consecutive days, over 4,000 hours.

It's no wonder that the final symptom has such attraction. It offers an end to the suffering. Just as emotion is experienced by its absence, so suicide attracts, not because he wants to die, but because it will end the pain. It is the end of pain, not death, that is sought.

Image by Unsplash
The danger of Major Depressive Disorder lies in how each symptom acts in concert with the others to create a downward spiral into an existence filled with gloom, despondency, increasing emptiness, increasing numbness. Experiencing all of this, concurrently, takes its toll on the sufferer. The toll is both psychological and physical. The toll can be deadly.

The World Health Organization has stated that depression is the leading cause, worldwide, of living with a disability. The numbers tell us that one in five women, and one in ten men, will experience at least one depressive episode in their lives. The numbers also tell us that one episode, if untreated, will lead to another and that each subsequent episode will last longer and the fall will be deeper. The group at greatest risk? - unattached, older, white males.

All of this doom and gloom can seem to present a hopeless picture. However, not all who suffer will attempt suicide (yet the majority of those who attempt suicide do suffer). More importantly, there is a way out. My journey is proof of that. Beginning with the next post, I will present the other side of the equation: how the sufferer can find a way out.

Please refer to this page about medical advice.


Thursday, 20 August 2015

What is Major Depressive Disorder? - Part 3

Image by LogoStudioHamburg
A short time ago I quoted the definition of Major Depressive Disorder (see here). When you read it, you see that the definition of MDD relies on two factors: (1) the simultaneous presence of multiple symptoms; and, (2) a duration of time over which these simultaneous symptoms are experienced nearly all day every day.

When you read the symptoms, you're probably struck by how vague they are: depressed mood (sadness) most of the day, nearly every day; diminished interest in pleasure most of the day, nearly every day; weight loss or weight gain of more than five percent in a month or a change in appetite nearly every day; insomnia or hypersomnia nearly every day causing psychomotor retardation (slowed down movements and thinking); fatigue nearly every day; feelings of worthlessness nearly every day; diminished ability to think or concentrate nearly every day; and recurrent thoughts of death or suicide.

But within that vagueness is a lurking danger. Notice the repetition of the phrases "most of the day" and "nearly every day". Notice the multiple mentions of slowed thinking and the multiple suggestions of slowed or reduced activity. Weight gain, or loss, is rapid and excessive. You either sleep too much or too little, again to an extreme degree - nearly every day.

In short, your mind and your body are slowing down, day by day by day, as they become deeper enmeshed in a depressed state. You are listless. Every small task or decision seems like a mountain to climb. Everything is a challenge; something as simple as getting out of bed can be overwhelming. You're indecisive, unsure of what to do and, if you do something, you're sure that somehow you'll screw it up and then you beat yourself up for not completing the task perfectly.

You don't understand why you're paralyzed by such simple things. You believe that there's nothing wrong with you and you try to work and think your way through it. And when this doesn't work - and it can't because you're body and mind are slowed - the negative self-talk begins. You talk to yourself in ways that you'd never talk to anyone else, heaping vile abuse on yourself. In time, you come to loathe yourself, deeming yourself to be worthless.

You start to isolate. In the beginning, you do this so you don't "bum out" friends or family. You feel guilty about this. In time, you just don't care; after all, no-one wants to be with someone so worthless anyway.

So you close into yourself. You feel more and more empty, more and more numb. And you tire. And you lose hope.


Image by John D. using Pablo by Buffer.com
Therein lies the danger. Experiencing all of these things, each and every day, practically the entirety of each and every day, is exhausting in ways that only those who have suffered depressive episodes can comprehend. Each day is both a mental and physical struggle. You struggle to think, to decide, You struggle to sleep or stay awake. Some days you don't eat, you can't eat, and others you binge on comfort foods, eating more than you should because you have not eaten for a while. The struggle robs your life of all joy, fatigues you to the point where you cannot get any rest. And the numbness consumes.

Sadness is too inadequate a word to describe this state. Depression, another word, is also inadequate. Tell someone you have cancer, and they will nod and sympathize and express regrets. Tell someone you are depressed, and they'll ask for the reasons why, tell you to "get over it already", tell you about their deprerssion and why it's really no big deal. And inside you both agree and disagree and a new bout of self-abuse begins.

This is your life, 24 X 7. You loathe yourself. You are empty. You have lost all hope. You are in constant pain. You see no way out of the pain. Thoughts of suicide creep in. And with the constant pain, the exhaustion, the numbness, the never-ending despair, it seems to offer a solution.

So re-read the definition.  Read between the lines. Take the words to an extreme. See the depths before you. Dwell on them. And then you might have an inkling of what it means to live with Major Depressive Disorder. Maybe then you'll appreciate just how deadly it is.

Please refer to this page about medical advice.



Wednesday, 19 August 2015

What is Major Depressive Disorder? - Part 2

Image by narciso1
In my last post (see here), I quoted the definition of Major Depressive Disorder. My plan was, and remains, to discuss this definition by commenting on its two key elements: the multiplicity of symptoms and the duration of them. My research had been completed, my notes were ready, my plan was in place, and yet - nothing. Why this nothing?

Simply put, my inactivity is caused by the lingering effects of my MDD. Even though I have recovered significantly over this past year, I continue to experience symptoms of Major Depressive Disorder - depressed mood, diminished interest, fatigue, feelings of worthlessness and guilt, and diminished ability to think or concentrate. Admittedly, the impact of these symptoms is less pronounced than they were a year ago, but they continue to make themselves known. They are a reminder that my recovery, while both positive and uplifting, is incomplete. My journey to recovery continues.

So, even though my preparations for the follow-up posts were complete, the actual task of writing the final text proved to be elusive. My thoughts were scattered, my interest was iffy, and feelings of inadequacy popped up.

Additionally, I have an anniversary of sorts coming up. It has been almost a year since my suicide attempt. While I believe that my writing has helped me to exorcise that demon, I do know that the depth of my depressive episode causes me be consciously cautious in considering plans for the future. I have no doubt that there is also a subconscious effect.

I'm not, however, the same person that I was nearly twelve months ago. My self-improvement efforts, my research, my active involvement in therapy, my self-work at home, my writing, my medication, and my new-found hope, have worked together to give me the tools I need to cope. Moreover, I now have a willingness to accept my limitations and seek help before it is too late. I know where I was last year and I know that it's a place I never want to revisit.

My acceptance isn't restricted to recognizing my limitations. It extends to how I view Major Depressive Disorder. I know longer see myself as depressed. That word doesn't fully convey what I, and millions of others, go through. It has a commonality of meaning that trivializes the pain and incapacity that we live with. I now accept that I live with a disability, Major Depressive Disorder, and that this disability means that I will, from time to time, undergo depressive episodes. I am not my illness, but I accept that it is, as it has been since my teenage years, a component of my life.

By accepting this fact, and by applying the tools I've acquired, I'm a more balanced person than I was last year.

And I am better for it.

Please refer to this page about medical advice.



Wednesday, 12 August 2015

What is Major Depressive Disorder? - Part 1

INTRODUCTORY REMARKS


I began this blog by presenting a three-part series that I called "Another Group of Three" (Part 1, Part 2, Part 3). My aim was to outline three key aspects of my personality that operated together, in multiplicity, leading to my suicide attempt.

Major Depressive Disorder (MDD) is, by itself, dangerously debilitating if not diagnosed and treated; however, in my case it was coupled with constant exhaustion caused by my sleep apnea (which itself can cause depression) and my natural tendency to retreat into myself. The net result was an amplification of negative effects. To my thinking, it is analogous to the results of mixing alcohol with a sedative. Each operates on its own as a depressor thereby lowering brain stimuli. In combination, their depressive effect is multiplied perhaps causing this lowering of brain stimuli to become fatal. I may be overreaching, but it makes sense to me.

Thus far my blog's focus has been about the debilitating effect that MDD has had on me, my downward spiral into the Black, my resultant suicide attempt, and my journey through recovery. The posts I have written are very personal to me. Yet, while the personal nature of the debilitations of MDD foster a deepening disconnect from the world, creating a despairing loneliness in you, it is also true that there is a commonality of experience in all sufferers worldwide.

This post, then, is the first in a new series in which I will discuss Major Depressive Disorder in a more objective way.

I must stress that I am not a mental health professional. Should you require the help of a mental health professional, contact your family doctor immediately or go to your nearest hospital or walk-in clinic. IF YOU HAVE SUICIDAL THOUGHTS, PLEASE CALL 9-1-1 IMMEDIATELY AND SEEK THE HELP YOU ARE SO DESERVING OF. You are more worthy than you appreciate and you deserve the opportunity to heal.

MAJOR DEPRESSIVE DISORDER (from DSM-5)


When diagnosing a mental disorder, mental health professionals refer to a standard classification system called The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. The current edition, DSM-5, defines Major Depressive Disorder as follows:


  • A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

    • 1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
    • 2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).
    • 3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5 percent of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
    • 4. Insomnia or hypersomnia nearly every day. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
    • 5. Fatigue or loss of energy nearly every day.
    • 6. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
    • 7. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
    • 8. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

  • B. The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning.

  • C. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).


The key elements of Major Depressive Disorder are, therefore, duration, impairment in functioning over the entire duration, a lack of a physiological or general medical cause, and the presence of five (or more) affects throughout the entire duration which must include either depressed mood or loss of interest or pleasure.

Over the next few posts, I will explore these elements of MDD. I will also bring to your attention resources that may help you better understand MDD or, if you are a sufferer of the disorder, resources that may simply help you.

I remind you that I am not a mental health professional. I live with Major Depressive Disorder and, from time to time, I experience depressive episodes. The most recent depressive episode brought me to the brink of death and prompted my reaching out for help. My own research, the guidance and lessons shared by fellow-sufferers, the compassion of therapists, and so much more, have all inspired me to share what I have learned with you. It is information, it is not a diagnosis.

Please refer to this page for more on medical advice.


Wednesday, 10 June 2015

An Unexpected Tangent

Image "smile" by K.L.
Today I received a text message from my son which led to an unexpected diversion in my writing. He sent:

I have a project for you. I'm making a poetry anthology in English class and I'm supposed to include 4 poems from other people, whether it be from online or from someone I know. I was wondering you and your great grasp of the English language could right a poem for me. The theme is cities if you're interested.

Now I first had to put aside any desire to correct my son's grammar (it being a text message, I made an allowance). Then I had to chuckle at the thought that his assignment meant a "project for [me]". Smiling, I took about ten seconds or so and, using my "great grasp of the English language", I concocted this little gem:

They scurry here,
They scurry there,
They scurry, scurry
Everywhere.

They go up high,
They go down low,
There is no telling
Where else they go.

The sky above them,
It is so dense;
To live in smog
Just makes no sense.

And with no earth
Beneath their feet,
They look so lost
So incomplete.

For those lost ones
We must take pity.
It's not their fault
They're in the City.

Not a literary classic by any means, but it's silliness brings a smile to my face.

And it feels so good to be able to smile

Monday, 8 June 2015

My Cry for Help

Image "Help!" by Lydia
Let me be clear, my suicide attempt was not a cry for help. It was a surrender, a complete abdication of my will to live.

My cry for help came on September 3, 2014. It came after.

I knew that my life was being saved on September 2; however, my brain, addled by the effects of the drugs I'd taken, denied me the ability to fully comprehend what this meant. In retrospect, this created a wonderfully serendipitous mental silence. The incessant negativity of my inner voice was stilled giving my battered psyche the opportunity to rest that had been denied for so long.

For hours, I drifted in and out of consciousness, steeped in the stimulus, the life, of the emergency room, gifted with this stillness of mind. The seeds of hope and of the will to live took root and, when the effect of the drugs wore off in the wee hours of September 3, my thoughts had clarity, a clarity grown from the strength within these seeds, the strength that The Black had sought to suffocate.

This brought its own terror: after trying so determinedly to kill myself, how do I now face life?

That is when I cried out for help.

Wednesday, 3 June 2015

The End Is The Beginning

Image "Urban Hope" by Twitter.com/mattwi1s0n
September 2, 2014, is the day when the rest of my life began. I didn't expect this. I expected it to be the day on which I died.

At some point that day, in the midst of a drug-induced haze, I sent an email to my parents asking them to make sure my son was taken care of. Typically, any email to my parents would languish for a number of days before I received a reply. But the email of September 2, 2014 was different. It was read immediately and acted upon immediately. As I slid into the oblivion I sought, my parents dropped everything they were doing and rushed to my apartment. They tried to revive me and ultimately called 911. They saved my life even though I believed it was unworthy of being saved.

The police, EMTs and hospital staff did their jobs with ruthless efficiency. They didn't care why I'd tried to kill myself. They simply did what they were trained to do and saved me from myself. They forced me to walk. They forced tubes down my throat and filled my digestive system with charcoal. Then, when I was moved from the emergency department to a room, they placed a guard at my bedside.

And something unexpected happened. At the end of all the efforts made by my parents, the police, EMTs and hospital staff, I discovered two things I'd thought forever lost: hope and a desire to live.

Image by PublicDomainPictures
I can't express how shocking this was. After months of Black, after months of suicidal thoughts, after acting to kill myself and still my pain, I saw a small flicker of light in the once suffocating gloom. In opening myself to death, in welcoming it and asking it to bring an end to my suffering, I found Life and choice.

Through their efforts to save me, my parents, and then a team of strangers, revealed to me in a most profound way that I was worthy. I can't fully convey just how startling this revelation was. My lack of worth was, to me, a given. To have this fact, this central belief, challenged so categorically was a personal paradigm shift the influence of which continues to this day.

My journey of recovery had begun.

Thursday, 28 May 2015

Not My Best Moment

Image "Coco"  by Andy Rennie
I'd just awakened from an afternoon nap when the doorbell rang. I went to the door, opened it, and stood gawping at the person at the door. Absolutely no thought went through my head and no words went through my mouth. I was in an utterly moronic state. My hair was mussed, my clothes were rumpled and my eyes still had that just awakened look.

At the door was our newspaper girl. She was, not surprisingly, non-plussed by my demeanor. She, very hesitantly, mentioned she "was collecting" and it was only then that I clued in.

I felt so bad. Can you picture it: you're a young girl, dressed for summer, collecting for newspaper delivery. You ring a customer's doorbell, and who should come to answer your ring but a 50-something, dishevelled old man, overweight, mouth hanging open staring at you with a blank imbecility.

I'm shocked she didn't run in terror.

Monday, 25 May 2015

Additional Thoughts on "Another Group of Three - Pt 3"

Image by bykst (pixabay.com)
I was concerned about the effect my post, Another Group of Three - Pt 3, might have on my recovery. To be safe, I reached out to my counsellors and gave them links to the post.

Not surprisingly, they asked questions, good questions, questions that forced me to think. I took a short sabbatical from posting and gave them the consideration they deserved.

One question I was asked focussed on a couple of sentences from that post. I wrote:
I suffer from Major Depressive Disorder. I will always suffer from Major Depressive Disorder. I've known this for many years but tried to ignore it. By ignoring my illness, I set in motion the causal connections that led to September 2, 2014.

On reflection, these remarks attribute to me an understanding about myself that I didn't have, particularly on September 2, 2014. My near-death on that date and the research and therapies and analyses (both professional and self-directed) that followed, helped me to view my past and recognize additional incidents of prolonged depression. So, although I now realize that I've lived with Major Depressive Disorder for decades, this understanding wasn't always the case.

What I did know was that I was moody, someone we Scots would call a "dour bugger". During my teens, I attributed the moodiness to typical teenage mood swings. When I was older, I attributed them to the stresses of post-secondary studies, or shift work, or money problems, or raising a family, or a bad nights sleep. In other words, the same stresses that everyone experiences. Even though I knew I wasn't always so dour, it didn't occur to me to seek a solution for what I didn't realize to be a problem.

Image "Hiding Cat"
by The Next Web Photos
I also knew that there were days, which I called Black Days, where the best thing I could do was stay in my room with a pillow over my eyes and let the mood work itself away. The solitude soothed me and helped me regain balance.

Initially, these Black Days never seemed to stick around for long. They came, and they went. I didn't see them as the harbingers of the larger issue that they clearly were. Over time though, as these things are wont to do, the episodes of The Black grew in frequency, duration and, to my everlasting regret, depth of despair. Again, I see this now. I didn't truly see it then immersed in each cycle as I was.

You see, as I mentioned above, when I was in the midst of an episode there was always some external event (employment instability, marital breakup, financial woes and the like). The setback suggested my grim mood was a natural reaction. Everybody has setbacks, and everybody reacts to them in different ways. But, with time the grimness dissipated and my mood improved. Since The Black went away, I didn't think I needed help.

Now, why did I use the word "truly" above? It's a small concession to a troubling possibility: somewhere deep within myself I knew that these episodes of Black Days were more than a reaction to the typical stresses of life. If this is so, I did, as I wrote in the sentences quoted above, ignore my illness and set in motion the causal events that led to my attempted suicide. But I'm also able to accept that I didn't recognize the real danger of The Black since it was, after all, not uncommon and did go away. So, I may have suspected a larger problem but since it wasn't causing any real harm, I gave it only passing consideration. I didn't, I must stress, think that I was suffering from a mental illness - a mood disorder.

And that is the crux of the matter. By not seeing the danger, it overwhelmed me, exhausted me, pushed me into an existence that was less than living. And it nearly killed me.

Image "La Brea Tar Pits, Los Angeles" by Garrett Ziegler
On September 2, 2014 I learned the true danger of The Black. The Black has infinite patience. The Black is relentless. The Black is unforgiving. The Black is the tar pit of despair, swallowing you whole, surrounding you, suffocating you in its finality, striving never to let you go.

Ultimately, The Black KILLS.

Sunday, 24 May 2015

A Necessary Pause

Image by geralt (pixabay.com)
I've been considering a question raised by my counsellors. After they'd read my last post, Another Group of Three - Pt 3, they asked me if I was re-living my suicide attempt?

I admit I hadn't considered this possibility; however, the importance of the question warranted a thoughtful answer. So I took some time off from posting to consider the motivations behind that post.

My initial motivation was simply to write to my son in an honest and forthright manner and communicate openly to him. He's fully aware of the events described in that last post, albeit less bluntly, knew it was coming and was ready.

A second, equal, motivation was to take pleasure in writing. Writing, like so much else, had been denied me, and I delighted in having recaptured my voice and expressing myself. My choice of words, my choice of images, convey feeling and nuances and life. And I revel in the opportunity.

But these motivations don't answer the question. I had to consider what other motivations might be at play.

I begin by telling you that the short answer to my counsellors' question is Yes. And No.

If you have no personal experience with Major Depressive Disorder, you can't understand just how debilitating it is. Any understanding you think you have is tainted by the common use of the word "depression" to refer to sadness, grief, loss or economic malaise. These meanings, while well-intentioned, perhaps trivialize what I and many, many others suffer. The illness, my illness, Major Depressive Disorder, is so much more than this.

 Image by John D. using Pablo by Buffer.com
So how do I convey this in any meaningful way? I could go on at length and describe incident after incident, like how I did not eat for days because I was unable to go across the street to get bread; or how self-abuse created feelings of shame of such intolerable levels that I isolated myself, hiding in my apartment for months on end; or how I could not reach out to anyone, especially those who loved me, because I was unworthy of that love.

Such lists, while compelling, lose their effect when presented in this way. They become a diatribe of negativity that disguise the underlying malady, my nemesis, the Black. When you are in the midst of an episode of Major Depressive Disorder, all is negativity. All is Black.

To give voice to the nadir of my despair, I used September 2, 2014, the day upon which I chose to die. That day, more than any other, is the exemplar of my plight. Only through showing you how bleak my illness made me can you gain a sense of the extent of my self-imposed horror or the salvation in my recovery.

Yes, I did re-live September 2, 2014. By so doing, I could be honest with myself, my son and all others who may read this letter. Only by being open could I face the truth.

Yet, I didn't re-live that day in the same way. I sought to learn, to find a seed that could teach me, guide me, and lend support to my recovery. This seed I found. I must have because I didn't fall into a new tailspin.

But just in case, after the post I contacted my counsellors and invited them to read it. I wanted to be sure that someone might be concerned. I reached out, one thing I hadn't done before. If nothing else, I'd learned that one lesson.

I looked at September 2, 2014 with open eyes, saw myself, and found comfort in my survival.

Tuesday, 5 May 2015

Another Group of Three - Pt 3

Image "Depression" by Tyler Herbert

Major Depressive Disorder and Me

This is Part 3 of a three-part series. Each post can be read independently of the others; however, if you would like to see the full series, click for Part 1 and Part 2.

On September 2, 2014 I chose to die. A couple of days earlier, I'd went through my apartment gathering all the pills - mostly over the counter medications - I could find. Now I opened an app on my KoboARC and left a note for my son and my family. I scribbled another note to my son in an old notebook and left it in front of my living-room chair. I poured myself a small glass of water. Then I went to bed, lay back, and deliberately, one by one, took each pill with a small sip of water until none were left. In all, I swallowed in excess of thirty-five pills. My research told me I'd taken more than enough pills to kill me. I lay back, closed my eyes, and drifted into oblivion.

At some point, over the prior months and years, my mind, for so long my strongest asset, became my worst enemy. An internal war was raging as I fought against myself. I could not understand why I was so despondent, so lethargic, so lacking in anything. I chastised myself mercilessly, castigating myself with the vilest and most repugnant epithets I could hurl all in an effort to elicit some response, to shock and shame myself into action. When this didn't work, the self-loathing grew culminating in a never-ending spiral of self-denigration within an ever closing world of utter Black.

Shame and self-hate prevented my reaching out. After all, there was nothing visibly wrong with me. Everyone has difficult patches in their lives. I had a son who loved me. I had a family.

 Image by John D. using Pablo by Buffer.com
Yet, despite this, my personal world had shrunk to the Black space that my mind had become. The external world was nothing more than torment, a reminder that there was no reason for my lack of, well, anything. And so the self-blame and denigration grew. The Black that was my mind expanded and, through expansion, my perception of, and interaction with, the world became more and more limited. Physically, and especially mentally, I became fatigued and lived in a state that was beyond numb.

By September 2, my mind had become such a poison to me, had exhausted me so much, that the permanent rest offered by Death - oh how seductive that possibility of permanent peace is when all is Black - was welcome. Better to die than to exist like this. I existed, I didn't Live.

No. That is too simple. There was no analysis, no forethought. There was nothing more than desperation, an urgency to make it all stop, to make it all go away. The seductiveness of Death appealed, not because I thought it through, but because it was an act, and any act had been beyond me for so long. My mind was so Black by then, Death seemed natural. I'd convinced myself I was worthless, and suicide is an expression of this worthlessness.

The notes I left were apologies; but, I wasn't apologizing for killing myself. I was apologizing for being so worthless, for letting down my son by not being the dad he deserved, for letting down my family by not fulfilling the hopes they had for me. Someone so worthless, so filled with Black, so lacking in Life, so filled with self-loathing, had nothing to offer anyone.

Image by John D. using Pablo by Buffer.com
I survived. Not by choice but by chance. My salvation is that I seized this chance and sought a means to recover and regain self-worth. This blog, this letter to my son, is about this recovery.

And recovery requires a raw honesty. I tried to kill myself. I hurt my son and my family. I have a mood disorder - Major Depressive Disorder. I suffer from Major Depressive Disorder. I will always suffer from Major Depressive Disorder. I've known this for many years but tried to ignore it. By ignoring my illness, I set in motion the causal connections that led to September 2, 2014.

I caused my downfall. Now I'm causing my recovery. This I promise to myself, my son and my family.

This is Part 3 of a three-part series. Each post can be read independently of the others; however, if you would like to see the full series, click for Part 1 and Part 2.

Wednesday, 29 April 2015

A Newbie's Confusion

""Problems, problems..." by Ion Chibzii
I'm very new to this process.  Yes, I've read online diaries and journals and blogs for years, but there's a huge difference between reading and creating one. Many efforts get abandoned. That, by itself, is a testament to just how difficult the creative process can be. And there lies my problem - I just don't see myself as all that creative.

Yes, I've written essays and stories and, gasp, poems for years but I'll be the first to admit that they're quite amateurish. I love the use of language, the effort needed to find just the right nuance of expression to convey an image or a mood, or create a character. I'm often moved, when reading, by wonderful turns of phrase (much to the eternal annoyance of my son who must hear each phrase immediately after I've come across it). Some people have a facility with language that I feel humbled by.

My lack of creativity extends to images. I truly love looking at photographs and paintings and sketches and comics and all other visual arts. I appreciate the effort taken by the artist to capture just the right colour or angle or lighting. I just don't seem to have quite the right "eye" to visualize in this way. I can appreciate, after the fact, but I'm not convinced I can create in quite that way.

To compensate, I seek out images that move me and, I believe, give added depth to the words I type. These images are not mine. They belong to the artist who created them. To see how I respect these artists please read this.

Friday, 24 April 2015

Depression and Death

Image by geralt (pixabay.com)
Depression exists but can best be described by absence. It is the absence of the capacity to laugh or cry. It is the absence of joy or sadness.  You have no ability to feel anything; to think; to plan. It is a numbness that stills. It is a dead weight, beyond despair, that suffocates the mind and exhausts the body. The weight is real, ever-oppressing, draining you of all energy, leaving you listless. It is the absence of colour, the Black quagmire, that penetrates every part of your being reducing self to near nothingness. It is the absence of everything that is you.

Death is the seducer. Within the all, and the nothing, of Depression, Death is your ultimate attempt to salvage a remnant of self. Death does not free you, but it does gift you with end.


Thursday, 23 April 2015

Another Group of Three - Pt 2


Obstructive Sleep Apnea (OSA) and Me

This is Part 2 of a three-part series. Each post can be read independently of the others; however, if you would like to see the full series, click for Part 1 and Part 3.

About 20 years ago, my then girlfriend complained about my snoring. I wasn't all that surprised because I'd sometimes awaken myself from the noise! However, it wasn't the volume (which she described as deafening) that caused her the most concern. She told me that sometimes I was gasping for breath, snorting, almost as if something was choking me.

Admittedly, I thought she was over-reacting but I went to see my doctor anyway. He sent me to an ear, nose and throat specialist, who ordered a slew of scans and tests, diagnosed that I had Obstructive Sleep Apnea (OSA), and operated on me to fix the problem. The snoring went away, the gasping for breath stopped and all was good.

What I didn't know, because I didn't research it, was that the surgery has about a 25-30% success rate. Or, to put it another way, a 70-75% failure rate. I just went about my life, unaware that for the next 20 years the OSA was wreaking havoc with my body and mind.

Image by Habib M’henni
The name tells you that OSA is a sleep disorder. While you're asleep, your muscles relax and something (your palate, tongue or uvula) collapses to create an obstruction in the back of your throat. This causes you to experience an apnea (defined as the cessation of airflow for > 10 seconds). This can happen dozens of times a night without you ever being aware of it. Some people have hundreds of apneas a night.

In my case, each apnea lasts for 18 seconds or more and I experience 70, or more, apneas every hour. In essence, each time I fall asleep, I end up choking myself for a cumulative 20 minutes every hour. I wake up each morning tireder than I was when I went to sleep. Most mornings, I begin my day with a massive headache. Every day is spent in a sluggish haze. My body feels leaden with exhaustion and my thinking is unfocused. My memory is very much hit and miss.

Keep in mind that I wasn't aware that the surgery had failed. The progression of OSA came back gradually. I thought I was tired because of too much work, or dealing with changing shifts, or a bad night's sleep, or too much coffee, or too much stress. So, I developed ways to function including a reliance on notepads. In time, I realized that these methods were becoming less effective. What I didn't know, was why. Sadly, or, fortunately (I truly don't know which it is), it took something quite extreme to answer that why. That will be explored in Part 3 of this series.

The effects of OSA are substantial. There is an increased risk of stroke (the risk to men is increased threefold); type 2 diabetes (48% of type 2 diabetes sufferers have OSA); hypertension; and other ailments, including depression.

In the U.S., the economic cost of undiagnosed OSA, from medical costs to treat related illnesses and OSA caused car accidents, is estimated to be well in excess of $10 billion.

Against all of this - the low success rate of surgery; the increased medical risks and associated medical costs; the increased economic cost - is a simple solution. The recommended treatment is a CPAP (continuous positive airway pressure) device. In essence, you wear a mask and inhale mildly pressurized air. The continuous pressure is used to keep your airways open so that no apneas occur.

Yes, I'll wear a mask, and yes, it's attached to a machine. But, given the choice of continuing to choke myself, or not, I'd rather wear the mask. Ultimately, I'm looking forward to a good night's sleep, waking up with no headache and feeling vital throughout the day.

For two wonderfully informative videos on OSA, please view Sleep Apnea Explained Clearly Part 1 and Part 2.

This is Part 2 of a three-part series. Each post can be read independently of the others; however, if you would like to see the full series, click for Part 1 and Part 3.

Sunday, 19 April 2015

Another Group of Three - Pt 1

Image by Rakkar
Introversion and Me

This is Part 1 of a three-part series. Each post can be read independently of the others; however, if you would like to see the full series, click for Part 2 and Part 3.


Years ago, a friend convinced me to complete an MBTI (Myers-Briggs Type Indicator) questionnaire.  Now, even then I knew myself pretty well so I really didn't see the point.  But it was a good friend, so I caved and went ahead.


The results weren't surprising.  In the end, I was typed as INTJ (with the I coming in at 89%) which meant that I was very much an introvert.  This I knew.  I'm the guy who goes to the party and stays in the corner, or goes to the bar and stays at the table.  I hate small-talk (I'm horrible at it) but will gladly sit down with you and have a conversation.  Give me a book, a quiet space and a coffee (or a beer), and I'm in a happy place!

More recently, I read 15 Signs You're An Introvert, Even If You Don't Feel You Are with my son.  He was surprised at how many of these signs (14 out of 15) applied to me.  The odd one out used to apply to me but other factors negated its influence (more on that in another post).

Social events are very stressful to me.  Even though I sit in the corner or stay at the table, the chaos and noise surrounding me can be overwhelming.  My choice to sit back is not being standoffish or aloof but is an attempt to cope with the mass of stimuli coming at me!  At the end of events like these, I need some "me time" to unwind and recharge.  This means I tend to isolate myself and balance the over stimulation with some quiet.

My preference is to be by myself.  I can be by myself in a Timmy's simply by reading an ebook while sipping my coffee and chomping on my donut.  This gives me the best of both worlds - comfortable socializing by limiting the chaos and a personal space that is respected.

FYI, my ideal job, according to various aptitude tests I've been subjected to, is to work in a nice, and very quiet, library!

For more on introversion, please read Susan Cain's wonderful book Quiet: The Power of Introverts in a World That Can’t Stop Talking

http://www.thepowerofintroverts.com/about-the-book/

or Laurie Helgoe's equally as informative Introvert Power

http://www.drlauriehelgoe.com/introvertpower.html


This is Part 1 of a three-part series. Each post can be read independently of the others; however, if you would like to see the full series, click for Part 2 and Part 3.

Friday, 17 April 2015

Why "The Three of Me"?

Source: http://img.artex.mobi/collezioni/img/prodotti-web/
Much to the embarrassment of my son, I take fleeting stabs at creativity. I try to keep these efforts, poor as they usually are, separate from my more businesslike writing (letters, resumes, and the like). Admittedly, the distinction between the two is less about quality (it's all universally inept) and more about privacy.


Initially, I saved my creative efforts in a folder I labelled "Me, Myself, and I". The first of these folders was actually a 3-ring binder that I used in high school, Now, it's been a long time since I was in high school so that binder, and me, have fallen apart, although in different ways.


When I started to write using a desktop computer, I kept the label. After all, it worked. My writing was still quite bad, but nicely organized!


Some months ago a life-changing event took place (more on that in a later post). Now, I research, and work and come to terms with what that event means to my ongoing life. Issues with memory and concentration mean that it's important to have a written record I can refer to. Writing will also let me consolidate my efforts. So, I picked up some notebooks at the Dollar Store and began to write away.


It's critical that I share this with my son. My life-changing event came during a time when so much around him seemed to him to be spiralling out of control. By sharing with him, he could know why my life changed so drastically and verify that this change is a positive one.


You've probably guessed, but my son and I live apart. I’m truly fortunate that we've kept a close bond. Circumstances mean that we don't see each other as often as we'd both like, though when we do, I keep him up-to-date on my goings on. Conversation is great for this, but I'd rather our time is spent on "us" and not "me". I do share my writing, but sadly, since my handwriting’s a mess, he sometimes struggles with it (actually, he laughs at it!). The solution is obvious - type my notes so he can read them without the distraction of my poor handwriting (or my being there).


And this is where a secondary goal crops up. The internet is a wonderful resource and my research led me to many stories that helped me. Sharing how I’ve been helped is a way to give something back.

All of this, plus some prodding from others, led to the creation of this blog. But its private/public nature meant my old folder name wasn’t fully appropriate. So, a small variation and voila, “The Three of Me” is born!