Thursday, November 30, 2006

You Deserve Better Than Hope

Hope implies that we have a chance, even a small one, of getting what we hope for.
Hope is a funny construct - it can pull people out of the pits of despair, giving them the power to survive and succeed, but when dashed it can shatter a soul.

Hope is a passive, yet passionate, state.

Hope does not lead to action. In many cases it is a substitute for action.

Hope is somewhat optimistic, and largely dangerous.

If you're emotionally vulnerable and have a desire for a better turn of events, I don't think hope is the best way to go. Yes, there is a chance that things will turn out as you hope they will. But only a chance.

Because hope doesn't do the work, and for a depressed person it just becomes an excuse.

"Nothing ever goes right for me. I should just give up."

If I hope to win the lottery and don't buy a ticket, whose fault is that? That one might be too obvious. If I apply for a job, and hope I get it, but I never call to follow up on the application, whose fault is that? The hiring manager's? Mine, maybe?

It's really easy to be passive about life when you've got the thousand-pound weight of depression on your soul. You hope for good things to happen, but you expect those hopes to be dashed. When they are, you can easily confirm your suspicion that your life sucks, your luck is terrible, the Universe is against you, and you smell funny.

Okay, that last one is just your imagination, unless you have another issue.

But actually that last one is just like the rest of them - they're all things that you can change, but only when you stop being passive about them!

Hope is a dream killer. Sure, sometimes things work out as we hoped they would. But then we are robbed of the satisfaction of accomplishing them, because they just . . . happened. And if those good things didn't happen through our actions, then we have not learned how to make them happen again. Dreams that come true through the random action of the Universe don't turn into phenomenal stories of personal transformation any more often than single-celled organisms evolve into sentient primates with language and culture.

I'll let you look up the odds on that for yourself.

If you feel the need to hope for an outcome, do yourself a favor and find out what it would take to get yourself there. Does it seem too big a goal? No worries. Find a smaller goal, one that you can achieve, that will move you closer. Is your goal to be free of depression? Maybe the best goal you can achieve for yourself is calling a counseling center. Doesn't seem like much, but if you make that call, you have taken action. You are teaching yourself that you refuse to allow yourself to drift aimlessly through life. You are empowered to make decisions that will affect your fate.

Personal responsibility is washed away by hope; hoping absolves us the obligation for our own lives.

Don't let depression suck you down into that hole where you believe all that claptrap about not having power. You do. And you can start using it as soon as you realize that there are much better tools out there than hope. Platinum Author

Tuesday, November 28, 2006

Postpartum Depression

I'm not a woman, so until a friend gave birth I really never gave any thought to postpartum depression. I've never experienced the massive hormonal changes that a woman's body is put through, and that are a significant factor in these cases. But this site had some really interesting things to say.

"Some women don’t tell anyone about their symptoms because they feel embarrassed, ashamed, or guilty about feeling depressed when they are supposed to be happy. " Hmm, that sounds familiar . . . I guess postpartum depression might have some different causes, but it's the same evil monkey on your back regardless. The extra twist of guilt that comes because you have brought a new life into the world and feel bad is a nice touch.

"Some researchers have found that depression during pregnancy can raise the risk of delivering an underweight baby or a premature infant." In case there is anyone left on the planet that doesn't get it yet, depression is a disease that has physical symptoms. "It's all in your head" is a fine and dandy way to minimize it unless you consider the fact that your head, your brain, is the controlling force in every aspect of your life. Your body is affected by depression. Your spirit certainly so. And if you a bringing a new life into the world, its very survival can be affected by depression. It's not about guilt or shame. If you had cancer and you were pregnant you would take care not to let the treatments harm your child. If you had HIV you would take pains to minimize the risk of your child getting the disease. If you are sick and pregnant, or become sick while pregnant, you need to get treatment, for your child's sake as well as your own.

"Postpartum depression can affect a mother’s ability to parent. She may lack energy, have trouble concentrating, be irritable, and not be able to meet her child’s needs for love and affection." This just adds to the cascading failure that depression feeds. If you're limited in your energy and motivation to parent, you know it. It causes guilt, which feeds the depression.

Many women experience massive mood swings in the days following a birth. Anyone who knows a woman who is about to give birth or has just done so needs to be especially aware of her state of mind, so that it can be quickly determined if those hormonal changes have set into motion a longer term problem.

Monday, November 27, 2006

Depression Stinks

This blog is about the depths that we can sink to.

It is about the heights that we can reach.

It is about the powerlessness that we may feel.

It is about the control we can take.

Depression incites suicidal feelings because it erodes hope and happiness. It causes physical pain, emotional instability and spiritual barrenness. It attacks us on every level of our being, and must be treated on all levels as well.

It is understandable that some of us are without hope, that some of us believe that there will never be an end to the blackness. That's what depression does, it undermines our very ability to fight it.

I am not convinced that hope comes in a bottle, be it prescribed or self-selected. It is not placed neatly on an altar, nor is it asking us to lie back on a couch and share feelings from our childhood. Hope must blend these things, in a recipe as unique as the person who suffers from this disease.

This post, and this blog, is dedicated to the countless thousands who believe that hope has abandoned them in the darkness.

Maybe it's the fur?

RemedyFind has an extensive amount of information on depression, ranging from details on the various kinds of depression, to a regular newsletter on new research, to an extensive list of treatments rated by members. Only the top ten best-rated treatments with at least one hundred ratings are displayed on the front page, but the complete list is really quite instructive. Sortable alphabetically, by average rating or number of ratings, it goes through so many options that I realize I have a lot more research to do just to understand them all. For example, I did not know that a gluten-free diet has been proposed for treating depression. Apparently none of the RemedyFind members have tried it yet, but it's interesting to see that an alternative like that, or contraceptives, or even just reading blogs and email newsletters are included as potential alternatives.

I think some of the therapies that have not yet been sufficiently evaluated to be included in the top ten are quite instructive. Only 36 members have tried prayer, and it scores an 8.1. More amazing still is the emotional support of pets, scoring an impressive 8.9 with 63 votes in. I'm going to keep an eye on the list to see how those two, in particular, do as more ratings come in. I've spoken a bit about prayer already, so I'm going to speculate a bit about pets, in particular mammals, since that's where my own experience lies.

I have had cats as companions all my life. They are incredibly empathic creatures, sensitive to your moods and able to sense when you're about to go to the bathroom, settling on your lap just moments before the pressure in your bladder builds to a climax. Granted, they have a sadistic sense of humor, but they also use this sensitivity to know when you need to be reminded of the nature of love. I have only had one dog, but he and the others I have known have made it obvious that, although they may be slightly less sensitive to the shifting moods of the human, they are even moreso a vehicle of unconditional love. Love is, in my opinion, the vital tool that pets wield, both innocently and adeptly.

Your pet does not judge you if you can't get out of bed one day. Their eyes do not accuse if you forget their birthday. They don't laugh at you when you try and fail, or give up without trying. This raw emotion of love that they project is in its most primitive form, unrefined by the nuance of human behavior. It is easy to understand, and it is easy to accept that there are no motivations for it. If depression has led to anhedonia then that love may be the first form of pleasure the victim is again able to feel. In turn, the victim will be more likely to take care of basic tasks, such as feeding, walking, and litter cleaning, for the pet than they are for themselves in some cases.

Feeling love. Completing basic tasks. For some serious sufferers, this marks amazing progress.

Other animals, rodents and fish and reptiles, probably can achieve similar results. However, insidious as it is, depression can turn that love into responsibility, and responsibility into guilt. There is no magic bullet, but the right pet can make a wonderful impact.

Irony of Prayer

Prayer is a powerful tool for healing, whether it is physical, emotional, or spiritual damage that must be repaired. In the case of depression, what better treatment option can there be but prayer?

Of course, prayer requires faith, which is generally rooted in hope. Depression attacks that hope as thoroughly as leukemia attacks white blood cells. If you're deep in the black pit, there is very little chance that you have any belief in God, by any name. Your pain is so complete that you no longer feel it, and your hope has been replaced, if you're lucky, with a desire to subsist and survive in the dark world you have created for yourself.

Mr. Bloch suggests having others do the praying for you as well as trying it yourself. This is an excellent suggestion, because it removes the victim from the onerous task of having any hope. I never had that idea when I was myself depressed, since that's the nature of the disease. I will expand on his list of services if I find more and varied ones.

Sunday, November 26, 2006

Ketamine No Quick Answer

Ketamine is a veterinary anesthetic that has been used recreationally for at least ten years. Early research suggests that it could have the ability to address all the symptoms of depression, with the effects being felt in hours, rather than the weeks it can often take with traditional antidepressant medications.

However, the hallucinatory properties of this drug have to be considered before any serious look at it as a treatment option could take place. And considering how easily depressed persons self-medicate with any number of substances, it would be counterproductive to prescribe a drug that already has a history of being abused. Even though it appears to be treating the actual symptoms, not just inducing euphoria, the frustrating truth is that it would be too easy to turn a blind eye to "Special K" as a fun drug and doom many depression victims to a life of more drug dependence instead of more freedom from pain.

Seems like a cruel joke, but it really isn't. If ketamine had "instant relief" properties with no obvious dangers, it would be fast-tracked through the approval process, with drug companies rubbing their hands together with glee at the thought of being able to sell it at a much higher price, since the potential market would be expanded from house cats in need of surgery to a large percentage of the human population. Media reports would herald it as the cure we've all been waiting for. Much fanfare would ensue.

Drugs, however, have a strange habit of hiding some of their side effects for months, even years. Fast track research didn't benefit the users of Vioxx. Better to not allow large companies to quickly capitalize on the desire for hope, and make sure they do their homework. The last thing we want is to cause more harm than good.

Male Fertility Affected by Treatment

Two case studies suggest that certain serotonin reuptake inhibitors may reduce sperm motility. My first thought was, "do these guys need another, literal kick in the jimmy?" But in truth, I doubt it would make a whole helluva a lot of difference to them.

Antidepressants frequently inhibit sexual desire. Depression itself is more likely to inhibit any desire to do anything about that sexual desire. Social interaction is almost completely beyond your abilities, and masturbation, if you can be bothered, often leaves you feeling worse than you did before you started. It's sometimes the price a victim chooses to pay, give up a meaningful sex life for a chance at a meaningful life.

This case study suggests that under certain circumstances, it's possible that one would lose the ability to have children by treating their depression. To some, the idea of being without children would easily overpower the SSRI that they were using in treatment. The disease would key into that primordial instinct, propagate the species, and use it to overcome the drugs. For others, the desire to procreate has already been satisfied, or is already compromised by other factors, such as a vasectomy, vow of chastity, sexual orientation, or erectile dysfunction. If the victim has already made peace with not having children in the future, it is possible that a treatment which had this side effect wouldn't be such a bad thing. However, depression is a wily foe, and it's not unheard for someone that has had a vasectomy, for example, to be suddenly hit by a wave of depression upon hearing that their depression medication is rendering them infertile. Such is the insidious power of this disease, which is why it can never be treated as if it were a merely physical disease.

Saturday, November 25, 2006

It Sneaks Up

What are the early warning signs of depression?

Not as easy question to answer.

For starters, the early signs of depression are entirely internal. Lack of motivation. Lack of pleasure. Lack of focus. Maybe lack of sleep. So if you don't share your life with an incredibly astute and empathic person, nobody else is going to have a snowball's chance in Hell of noticing.

Secondly, symptoms of depression are incremental, and creeping. They build like the lengthening darkness builds after the summer solstice: gradually, naturally, so that it doesn't seem for quite some time that anything is different. We are creatures of routine and habit, so it's easier to believe that nothing has changed by subconsciously adapting to these new circumstances than it is to identify a problem and change to resolve it. Change causes pain, right now. Depression also causes pain, but not right away, and since you can build up a tolerance, it doesn't seem so bad. It's easier to ignore it, deny it, forget it.

Of course, that's the amazing thing about depression: it works within the psychic immune system to maintain its own invisibility. It uses our own adaptiveness to hide the destruction that it's wreaking for as long as it can. If and when it's noticed, there's very little chance that the victim can do anything on their own to fix the problem.

When I was first diagnosed as having depression, in my early twenties, I was able to trace the symptoms back over ten years. I didn't know what it was and I didn't get concerned, because it happened so organically I just assumed it was life unfolding in the ordinary way.

The next time I succumbed to its darkness I again tricked myself. I should have known what it was and actively worked to abolish it, but it managed to slide into my spirit and insinuate itself into my life, again without my noticing. We are a prideful and stubborn creature, and we don't like to admit weakness. Depression masks itself as a weakness, so we hide it rather than treat it like the disease that it is. We accept the social stigma at face value and cluck over the sadness of it, rather than recognize it as a strategy of a willful, malevolent disease that will do whatever it takes to inculcate itself into our lives.