I awoke this morning with an aching emptiness, as I knew this was a day that I was going to take a much harder look at myself, without the crutch of abusive substances.
What's been a little disturbing lately is my glass of wine in late afternoon, after my day is pretty much done. It's never been a problem, nor even a daily habit, but I've noticed this past week or so that the time I pour it has been inching up by a half-hour or so, and yesterday I poured a small amount at about 2:30 p.m. instead of my usual 4 p.m. or after.
While my intake has remained the same, this earlier start is scaring me, as it should, and when I went to sleep last night, I promised myself that today, no matter how well I'd be able to resist the clutches of pain medication, smoking and now wine, I would at least take a hard look at my feelings, and the best mirrors I've got are my private journal and this blog.
What's so interesting about these promises we make to ourselves is that most of the time they're half-hearted, something we say to make ourselves feel better for the moment, but never really put into action. But then there are those occasions when we know we mean it, and that's when life can get scary indeed.
Even before I began journal writing today, my anxiety level was up, almost as a type of wall to prevent me from this little trip into the unknown. But I stuck to my guns, made a cup of coffee, watched the last few minutes of a Sopranos rerun (no matter how bad things are, I have to see what Tony is up to), did not light up a smoke, and began writing.
I wish I could say that some startling insight was uncovered, but instead, what became as plain as day was that the pain in my jaw is still holding on with a fierce grip, and I literally felt sadness wash over me like a wave.
Somehow, in recent months, I've been distracted from the pain by family drama, by new freelance writing assignments, by trips to the shore to help my parents, and, of course, by pain medication.
When I told my doctor last week that I was taking way too much Vicodin, he switched me to MSContin, which is morphine sulphate in pill form. While that may somehow sound more dangerous in terms of addiction, for me it's a better choice in that I actually take less medication yet get better pain control. And I don't get the mood lift I was getting from the Vicodin, which, to be honest, is something I've come to miss.
With MSContin, the medication is released slowly over the course of 8 hours, so there's no rush, and therefore no quick and easy escape from the pain and sadness of my condition.
When I just sat with my feelings this morning, not having any deadlines looming or any particular place to be, there was a stillness there, a lack of motivation of any kind, which was in such stark contrast to just yesterday morning, when I felt like I had the world on a string, making all kinds of plans for a type of playday as a reward for meeting a big deadline--first to ride my bike, then to paint at my studio.
Those plans changed, of course, when I took that first sip of wine at 2:30, and interest in anything else simply and quickly waned. I cursed my behavior, vowing to do better today, and indeed I have. I've had one dose of medication and one cigarette, and it's now nearing 2 p.m. And I've made plans to meet a friend in about a half-hour.
But the pain in my face has me reaching--that feeling of wanting to grab something, anything, that will make me feel better, that will quell the loneliness that comes with chronic pain and constant disappointment.
At this particular moment, I suppose I need to just have faith, not in God, per se, but in the realization that in resisting the reach, I will feel better overall--maybe not now, but perhaps tomorrow, or the next day. That's hard to see in the moments of deep sorrow or wrenching pain, or in the throes of an addiction spell. When the latter occurs, it feels like every cell in my body is screaming for relief, and turning a deaf ear for the five minutes or so it takes for a craving to pass can feel like a lifetime.
I talked to a friend about faith earlier today, and I can see that I haven't lost it--it's just changed shape. When I pray now, I don't use the word God anymore, as it's attached to just too much baggage from my Catholic upbringing.
I pray to the "Universal Spirit" instead, which when I shorten it to the letters "U" and "S," spells "us." And that's something I can get with indeed.
All this misery has made me feel the love of others and within myself in ways I never have before, and as I said to my friend this morning, in terms of faith, love is enough. I don't need to pray to some great being in the sky, but I do need to pray to whatever the mysterious source is of all this deep compassion. When I pray to this universal spirit of love, I feel it, and I feel it for me in particular.
That's new.
***************************
Showing posts with label depression. Show all posts
Showing posts with label depression. Show all posts
Thursday, August 06, 2009
Tuesday, April 21, 2009
Understanding Suicide
During the past few weeks or so, I've noticed that on some mornings, I've been waking in a state of depression, which is a bit alarming as I know all too well just how devastating a full-blown clinical depression can be.
Obviously, I'm struggling deeply with the wear of chronic physical pain, and my brain chemistry is starting to give way, just like it did five years ago when an infection, which I thought had been cured two years earlier after 18 months of agony, took up residency in my jaw and face again (and has been there ever since).
As any hope for a cure seemed so hopeless back then, I slowly began to sink into a hole so black, so absolute, that all roads seemed to point to just one solution if I was ever going to get out of pain, and that solution was suicide. This led to a stint in the local hospital's psych ward, and then a few weeks later, admission to a psychiatric hospital.
With all of the physical complications I've endured as a result of this blood disorder, frequently spending weeks in the hospital at a time, I can say with absolute certainty that nothing--nothing--is as painful as a major clinical depression. And nothing, it seems, is as misunderstood by so many, particularly when it's accompanied by suicidal ideation.
For most people, suicide is unthinkable, so when a loved one takes his or her own life, we can get lost in a state of confusion and anger. I recall reading a book by a psychiatrist a few years ago who'd lost both of his sons in a 13-month period--one was a six-year-old who'd died of cancer and the other was a teenage boy who'd killed himself.
What was shocking, aside from the obvious tragedy of losing two children in such a short amount of time, was that the doctor talked little about his teenager, saying only that suicide was the ultimate "selfish" act, and he chose instead to write about his six-year-old, as the younger boy's ordeal was most likely easier to understand. The boy was, in a sense, an innocent victim of his disease, unlike his "selfish" brother who took his own life.
I remember feeling such shock that this esteemed psychiatrist, of all people, didn't understand the fatal power of depression.
A few years ago, I was hired as a freelance medical editor for a few months, and I was lucky enough to edit tons of the latest materials about depression and suicide. Perhaps what's most misunderstood about clinical depression is that it's not just a state of malaise or of feeling blue; it's a medical disease that if left untreated will only worsen throughout one's lifetime.
In the same way that Type II diabetics cannot absorb their own insulin, when clinical depression occurs, receptors in the brain close, and a person can no longer absorb their own serotonin.
Why this shutdown happens is still a mystery. Take, for example, a set of twins, both raised by the same parents in the same circumstances. In response to a tragedy, one twin will go through a normal grief period while the other will go into a major depression, and no one knows why. All that's known is that a person simply cannot function without serotonin, and the act of suicide is simply a way to get out of excruciating psychic pain.
In my own case, before I got depressed, I was going through one of the happiest periods of my life. For years I'd worked to get myself to a place where I'd perfectly balanced my work life (freelance writing and editing) and my creative life (songwriting and painting), and felt more inspired and joyous than I had in years.
This is what made the sudden return of chronic pain so devastating, and what ultimately made my receptors close to the very chemical so necessary to live.
It's hard to describe suicidal depression, but essentially, it's a loss of control over our own emotional state. Ordinarily, when one is down or feeling blue, there are things that can lift the spirit, like inspirational readings, listening to music, and talking with others. But when one is clinically depressed, absolutely nothing works to lift the darkness, and slowly the will to live can begin to erode.
In the same way one in chronic pain can lose hope that anything will ever change, the depressed patient also loses hope for a cure, and a battle surfaces between our primal will to survive and an aching desire to no longer feel this hell on earth.
In that sense, the act of suicide is the fatal outcome of a deadly disease, not a moral choice by the patient. Far from being selfish or cowardly, when a depressed patient reaches the decision to end his or her own life, nothing is more harrowing or frightening, because there's the realization that pain has overrode the fundamental desire to live. It's hard to imagine that anything in life could be that painful, but unfortunately, these states exist, and the last thing we should do is judge someone in this unthinkable quandary.
In my own case, I knew that I'd reached the limits of my endurance five years ago when I awoke one morning and felt no love whatsoever for anyone in my life anymore (even my mom), as every emotion had become eclipsed by pain. I was shocked at this revelation, because I knew the things that had been keeping me alive--namely the desire to not hurt anyone in my family--were no longer operating. I intuitively knew that I had about 24 hours left to live, and so I called a suicide hotline, which in turn called an ambulance for me, even though my local hospital is just two blocks away.
That's how bad I was; I couldn't even walk this short distance, as every ounce of energy was going into just staying alive and not swallowing the bottle of pills that offered permanent relief.
In time (four agonizing weeks or so), the antidepressants began to work, but not everyone is so lucky, particularly those who've struggled with depression repeatedly in their lives. Studies have shown that clinical depression actually damages the brain, and if left untreated, the illness only gets worse throughout one's lifetime. As the years roll by, the depressions become more frequent, more severe, and require less stimulus to set them off. That's why intervention with medication as soon as possible is so paramount to healing.
Studies have also shown that antidepressants can actually have a curative effect, meaning that if the first depression is treated with medication and therapy, the likelihood of it happening again decreases sharply.
Of course, there are those patients who use a suicide attempt as a cry for help, or as a means to get attention, and some of them do end up dying. But for the patient who is suffering from severe and extended clinical depression, suicide is nothing more than a way out of a type of pain that can never really be put into words.
I've heard it said that suicide is "a permanent solution to a temporary problem," but this isn't quite accurate, at least in terms of a major clinical depression. For some, the problem is debilitating and lifelong, and for these patients, suicide is the means to finally rest, even at the cost of life itself.
***************************
Obviously, I'm struggling deeply with the wear of chronic physical pain, and my brain chemistry is starting to give way, just like it did five years ago when an infection, which I thought had been cured two years earlier after 18 months of agony, took up residency in my jaw and face again (and has been there ever since).
As any hope for a cure seemed so hopeless back then, I slowly began to sink into a hole so black, so absolute, that all roads seemed to point to just one solution if I was ever going to get out of pain, and that solution was suicide. This led to a stint in the local hospital's psych ward, and then a few weeks later, admission to a psychiatric hospital.
With all of the physical complications I've endured as a result of this blood disorder, frequently spending weeks in the hospital at a time, I can say with absolute certainty that nothing--nothing--is as painful as a major clinical depression. And nothing, it seems, is as misunderstood by so many, particularly when it's accompanied by suicidal ideation.
For most people, suicide is unthinkable, so when a loved one takes his or her own life, we can get lost in a state of confusion and anger. I recall reading a book by a psychiatrist a few years ago who'd lost both of his sons in a 13-month period--one was a six-year-old who'd died of cancer and the other was a teenage boy who'd killed himself.
What was shocking, aside from the obvious tragedy of losing two children in such a short amount of time, was that the doctor talked little about his teenager, saying only that suicide was the ultimate "selfish" act, and he chose instead to write about his six-year-old, as the younger boy's ordeal was most likely easier to understand. The boy was, in a sense, an innocent victim of his disease, unlike his "selfish" brother who took his own life.
I remember feeling such shock that this esteemed psychiatrist, of all people, didn't understand the fatal power of depression.
A few years ago, I was hired as a freelance medical editor for a few months, and I was lucky enough to edit tons of the latest materials about depression and suicide. Perhaps what's most misunderstood about clinical depression is that it's not just a state of malaise or of feeling blue; it's a medical disease that if left untreated will only worsen throughout one's lifetime.
In the same way that Type II diabetics cannot absorb their own insulin, when clinical depression occurs, receptors in the brain close, and a person can no longer absorb their own serotonin.
Why this shutdown happens is still a mystery. Take, for example, a set of twins, both raised by the same parents in the same circumstances. In response to a tragedy, one twin will go through a normal grief period while the other will go into a major depression, and no one knows why. All that's known is that a person simply cannot function without serotonin, and the act of suicide is simply a way to get out of excruciating psychic pain.
In my own case, before I got depressed, I was going through one of the happiest periods of my life. For years I'd worked to get myself to a place where I'd perfectly balanced my work life (freelance writing and editing) and my creative life (songwriting and painting), and felt more inspired and joyous than I had in years.
This is what made the sudden return of chronic pain so devastating, and what ultimately made my receptors close to the very chemical so necessary to live.
It's hard to describe suicidal depression, but essentially, it's a loss of control over our own emotional state. Ordinarily, when one is down or feeling blue, there are things that can lift the spirit, like inspirational readings, listening to music, and talking with others. But when one is clinically depressed, absolutely nothing works to lift the darkness, and slowly the will to live can begin to erode.
In the same way one in chronic pain can lose hope that anything will ever change, the depressed patient also loses hope for a cure, and a battle surfaces between our primal will to survive and an aching desire to no longer feel this hell on earth.
In that sense, the act of suicide is the fatal outcome of a deadly disease, not a moral choice by the patient. Far from being selfish or cowardly, when a depressed patient reaches the decision to end his or her own life, nothing is more harrowing or frightening, because there's the realization that pain has overrode the fundamental desire to live. It's hard to imagine that anything in life could be that painful, but unfortunately, these states exist, and the last thing we should do is judge someone in this unthinkable quandary.
In my own case, I knew that I'd reached the limits of my endurance five years ago when I awoke one morning and felt no love whatsoever for anyone in my life anymore (even my mom), as every emotion had become eclipsed by pain. I was shocked at this revelation, because I knew the things that had been keeping me alive--namely the desire to not hurt anyone in my family--were no longer operating. I intuitively knew that I had about 24 hours left to live, and so I called a suicide hotline, which in turn called an ambulance for me, even though my local hospital is just two blocks away.
That's how bad I was; I couldn't even walk this short distance, as every ounce of energy was going into just staying alive and not swallowing the bottle of pills that offered permanent relief.
In time (four agonizing weeks or so), the antidepressants began to work, but not everyone is so lucky, particularly those who've struggled with depression repeatedly in their lives. Studies have shown that clinical depression actually damages the brain, and if left untreated, the illness only gets worse throughout one's lifetime. As the years roll by, the depressions become more frequent, more severe, and require less stimulus to set them off. That's why intervention with medication as soon as possible is so paramount to healing.
Studies have also shown that antidepressants can actually have a curative effect, meaning that if the first depression is treated with medication and therapy, the likelihood of it happening again decreases sharply.
Of course, there are those patients who use a suicide attempt as a cry for help, or as a means to get attention, and some of them do end up dying. But for the patient who is suffering from severe and extended clinical depression, suicide is nothing more than a way out of a type of pain that can never really be put into words.
I've heard it said that suicide is "a permanent solution to a temporary problem," but this isn't quite accurate, at least in terms of a major clinical depression. For some, the problem is debilitating and lifelong, and for these patients, suicide is the means to finally rest, even at the cost of life itself.
***************************
Saturday, December 13, 2008
The Limits Of Everything
It's Saturday now. It's taken me two days to absorb the consultation at the Hackensack Pain Clinic, where after a long discussion about the details of my health history, I was told I would most likely be in pain for the rest of my life.
While I was told about treatments that might help--a change in medications, injection therapy (which most likely wouldn't work as this has gone on too long), and a type of brain surgery where a device is implanted to re-route the pain signals--the words that echo are the ones that sounded so final. This condition will never heal on its own, as what I'm experiencing now is something akin to phantom limb pain. The source of the pain is long gone; what is firing now are essentially memories of it.
The pain has been worsening in the last month or two, which has made me careless, as I've been smoking again, albeit one or two here and there. Still, it doesn't help matters any.
The doctor I saw was perhaps the most empathetic doctor I've ever seen. He gave me the bad news first and let me cry in a fit of shock at hearing words I wasn't expecting. I might have had an easier time hearing I was going to die than hearing I would be feeling this pain for the remaining decades of my life.
He actually made that point to me--that I was still a relatively young person who had a lot of life yet to live, and therefore something like this motor cortex stimulation (the brain...er...procedure) should be something seriously considered.
I woke up feeling just so sick this morning from all the pills I've been taking, and just so sad, as if a grey mist was circling my entire room. Of course, it might have been the dust build-up, as I can't bring myself to clean anything right now. My poor cat is acting as the dust mop. As she rolls around the floor, her fur picks up all kinds of debris. She knows something is up.
My friends in recovery are so concerned about the effect of this news on my addiction, but addiction right now seems like the least of my concerns. Whatever it takes to get me through the day is what I'll take, addiction be damned.
I'm trying my hardest to move forward. I saw a chiropractor yesterday, and will continue to see him for trigger point therapy; I've made an appointment with my old acupuncturist for Monday; and I've made an appointment with the neurosurgeon recommended by the pain doctor for Wednesday.
It's all a bit overwhelming to find myself at this level of pain again, and at this point of despondency. I suppose the question I'm grappling with now is not how much suffering one person can take, but how many times can they take it?
I'm trying to push myself out the door to work on my Christmas card project down at my studio, but I'd so much rather watch television and escape into lives and stories where things always work out.
I'm also trying hard not to feel sorry for myself, but all this trying in every direction is eroding me to the bone.
I just can't go to the recovery rooms anymore. While I'm happy for everyone that God is working in their lives, as many have truly found peace and contentment, I just can't be there right now and listen to it. Instead of finding understanding and fellowship there, I'm finding, well, nothing.
That said, I'm still working with my sponsor, who I love, as I do enjoy the Twelve Steps. But that's about as far as I can go with the recovery folks right now.
While these other therapies the pain doctor spoke of do present some hope, I just can't feel it for some reason. I'm so used to everything going wrong at every turn that I dare not get my hopes up for anything. While I said in a recent post that disappointment hasn't killed me yet, I fear there IS a limit as to how much one can bear.
Just like there are no absolute truths, there are limits to everything, and I've hit the limit of just about everything I can currently think of.
Getting out of this mess will be a miracle indeed.
While I was told about treatments that might help--a change in medications, injection therapy (which most likely wouldn't work as this has gone on too long), and a type of brain surgery where a device is implanted to re-route the pain signals--the words that echo are the ones that sounded so final. This condition will never heal on its own, as what I'm experiencing now is something akin to phantom limb pain. The source of the pain is long gone; what is firing now are essentially memories of it.
The pain has been worsening in the last month or two, which has made me careless, as I've been smoking again, albeit one or two here and there. Still, it doesn't help matters any.
The doctor I saw was perhaps the most empathetic doctor I've ever seen. He gave me the bad news first and let me cry in a fit of shock at hearing words I wasn't expecting. I might have had an easier time hearing I was going to die than hearing I would be feeling this pain for the remaining decades of my life.
He actually made that point to me--that I was still a relatively young person who had a lot of life yet to live, and therefore something like this motor cortex stimulation (the brain...er...procedure) should be something seriously considered.
I woke up feeling just so sick this morning from all the pills I've been taking, and just so sad, as if a grey mist was circling my entire room. Of course, it might have been the dust build-up, as I can't bring myself to clean anything right now. My poor cat is acting as the dust mop. As she rolls around the floor, her fur picks up all kinds of debris. She knows something is up.
My friends in recovery are so concerned about the effect of this news on my addiction, but addiction right now seems like the least of my concerns. Whatever it takes to get me through the day is what I'll take, addiction be damned.
I'm trying my hardest to move forward. I saw a chiropractor yesterday, and will continue to see him for trigger point therapy; I've made an appointment with my old acupuncturist for Monday; and I've made an appointment with the neurosurgeon recommended by the pain doctor for Wednesday.
It's all a bit overwhelming to find myself at this level of pain again, and at this point of despondency. I suppose the question I'm grappling with now is not how much suffering one person can take, but how many times can they take it?
I'm trying to push myself out the door to work on my Christmas card project down at my studio, but I'd so much rather watch television and escape into lives and stories where things always work out.
I'm also trying hard not to feel sorry for myself, but all this trying in every direction is eroding me to the bone.
I just can't go to the recovery rooms anymore. While I'm happy for everyone that God is working in their lives, as many have truly found peace and contentment, I just can't be there right now and listen to it. Instead of finding understanding and fellowship there, I'm finding, well, nothing.
That said, I'm still working with my sponsor, who I love, as I do enjoy the Twelve Steps. But that's about as far as I can go with the recovery folks right now.
While these other therapies the pain doctor spoke of do present some hope, I just can't feel it for some reason. I'm so used to everything going wrong at every turn that I dare not get my hopes up for anything. While I said in a recent post that disappointment hasn't killed me yet, I fear there IS a limit as to how much one can bear.
Just like there are no absolute truths, there are limits to everything, and I've hit the limit of just about everything I can currently think of.
Getting out of this mess will be a miracle indeed.
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