I'm beginning to think my depression has a lot longer cycle than I had ever considered. I think the cycle may be a 2 year one - at least. Up until now I hadn't considered anything but a solar year, but with this last years experience, well it's not just the amount of light I'm being exposed to that keeps me out of a Clinical Depression. Last winter I avoided a deep depression I thought, by getting up at dawn every morning and flinging open the curtains on my easterly facing, big bay windows. According to some studies, getting a specific amount of sunlight can help prevent major depression.
But this fall as the the length of the days steadily shorten, I found myself in the most intense depression I had experienced in long time. Using all the tricks I have learned over the years, especially in the last year, I have so far avoided the most debilitating of depressions, known as Clinical Depression. This is an ongoing struggle at this time and I'm using every trick I know to keep treading water so to speak.
Writing out my personal coping mechanisms is a part of the process; I hope reading this will help others dealing with depression as well.
Coping with Depression
(click on headings to shunt down)
Awareness of the disease - ending denial about depression
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For those who don't know what Clinical Depression is, acording to the Toronto based Centre for Addiction and Mental Health (camh), Clinical Depression is "..a sad, despairing mood that persists beyond two weeks and impairs a person’s performance at work, at school or in social relationships."
My experience of the thing is characterized by lethargy, including long periods of sleeping. I once spent a month in bed: that means getting up to eat and shit and back to bed. Never going out of the house, except maybe to the closest store to get food - if necessary. You'd be surprised how long one can last on the food in one's cuboards if you're slowly starving - and not burning much protein.
I've learned to cope with my depression over the years through diet, exercise and awareness of the disease. I use this self knowledge to help me recognize the symptoms and cope with them, and consciously negate them. I have a great will to live, and a lot of things I want to accomplish before my time is up. That coupled with the end of the denial about my condition has helped me dismiss all kinds of extraneous data and focus on coping with the short term characteristics of the disease - and avoid the most disabling part of depression - a Major Depression, also known as a Clinical Depression.
One of the main fixes for me, has been being aware of what I consume.
Diet: The Bad
If I drink alcohol I know there will be a four day recovery cycle that is predictable:
Day one is characterized by lethargy and reduced mental capabilities. I usually sleep the entire day (18-24 hours).
I believe my liver and kidneys have been over whelmed by the rush of sugars and carbohydrates in the alcohol. This particular body is in a period of slow recovery, processing the remaining sugars and the toxins that were produced in the rush of sugars that the kidneys couldn't process. These "spilled" sugars affect several different organs, that in turn cause diminished function in several other associated organs. The liver and kidneys are slow in processing proteins necessary to repair damaged organs, and at the same time, sugars needed to sustain normal body functioning. The digestive tract is slow in extracting needed elements in the process due to a deficit of key amino-acids coming from overwhelmed kidneys. Unprocessed sugars that the liver cannot process are "spilling" to the liver from the kidneys, causing long term liver damage.
But the body is an amazing dialectical machine; the Cerebellum slows specific processing to match the capabilities of different organs in the system to receive elements at appropriate times - to get the job done as efficiently as possible, and as soon as possible.
On day two, physical reductions in capability take centre stage.
Day two is characterized by incontinence. Stool is diarrhea or very close to it; colour is yellow. Just below the rib cage on both sides, just forward of centre bisect - towards the front - is a dull aching pain. It's hard to know what's going on. Large amounts of gas in the intestines? If the pain was further towards my back I would think it was the kidneys, but there is no pain there. It could be that the pressure caused by too much gas in the intestines is pressing on the swollen kidneys - which are in the same area, just behind the intestines, towards the back.
I believe there's lots of good stuff in the under processed stool, but the body couldn't deal with it due to the high volume of sugars and carbohydrates, which caused the kidneys to prioritize the synthesis of all kinds of elements that the other organs need to do their work, and the blood stream as well which supplies oxygen and glucose to every part of the body. The kidneys can only hold so much sugar and then they're forced to dump it to other organs which then have to deal with it as a poison. Muscles apparently play a huge role in this processing. As a cycle courier I was able to drink ridiculous amounts of alcohol every night and burn off the poisons by noon the next work day (about 40 km of cycling).
Image from Wikipedia article "Kidney": File:Gray1120-kidneys.png
On the third day depression is the main symptom.
I consider this a 'withdrawal-from-sugar' depression, or hypoglycemia. Coupled with an imbalance in amino-acids and a lack of proteins, this creates low brain function.
Day three is the most important day in the recovery from the hyper-glycemic binge (my body chemistry on beer). The hypo-glycemic depression and lack of mental acuity can lead to bad decisions about diet (like drinking again - or gorging on sweets), that can lead to another depression cycle. This can cause psychological effects that make it even harder to break the cycle. If I don't pop up out of the day three depression I lose faith in my prescriptions and that leads to a general malaise - which can lead to a clinical depression.
Day four I note thinking is back. I experience the easy synthesis of ideas. I'm happy, I want to create. Body pain is gone. I have no desire to head back to the bottle.
At one point in my life I used to drink everyday, but the physical and mental price I have to pay now as this body ages are not worth the high and the social ease that it affords. I'm happier now alone, writing, than being the maverick social animal I can be while drinking. Being a leader in a group, or just a part of a group, used to be paramount to me; but being a leader amongst regulars at a bar, or on "the drinking team with the baseball problem", in other words, a leader amongst alcoholics, is like being the captain of the Titanic. I was going down fast.
This was a conscious decision on my part and it's all wrapped up in my understanding of my physiology and my identity. When one gets older, what others in extended social groups think of you becomes less important. I'm happy and confident in who I am, I don't any longer require a constant affirmation that I am normal - I know I'm normal - and unique at the same time.
So, the above is an example of how I avoid depression through diet. Specifically things I avoid consuming, and if I do consume them, understanding their side effects on me, and developing personal ways of coping with those effects. Depressants (like alcohol and marijuana) seem to effect my mood worse than amphetamines, like the double-double coffee and tea I like to consume - a lot of.
Diet: The Good
Also there are things I need to include in my diet to maintain balance. In this personal health model, the good functioning of my brain seems to be central to avoiding a Clinical Depression. The best way I've found to do this, as I've said above, is to regulate the stuff I consume.
Plenty of water
Dehydration can lead to an all over body discomfort, an aching of all the muscles. Also, dehydration can cause swelling of the brain. Swelling of the brain is a known cause of brain dysfunction. In acute dehydration individuals end up making bad decisions which often lead to their deaths. In extreme dehydration the body dies as a result of the brain ceasing function - due to swelling.
In the case of our cultures addiction to caffeine, even though caffeine gives me that mental boost (and I love it for that), sustained slight dehydration leads to being perpetually not on my 'A' game. Stupid is as stupid does, over time adds up to just stupid.
Coffee and tea are diuretics, they cause dehydration of every cell in the body; so, I try to drink equal volumes of water as coffee/tea (I also do this when I drink alcohol, which is also a diuretic). This is only a rule of thumb I use to try and stay properly hydrated. I probably don't drink exactly equal volumes, but there is always a glass of water beside my coffee cup.
Good food in
A balanced diet of proteins, carbohydrates (both and roots and grain), and vegetables and fruits is very important for me. Most people in this culture eat too much protein and carbohydrates in relation to the amount of greens and fruits. Root vegetables seem to have key ingredients that grain carbohydrates do not; potatoes carrots, and parsnips are my favourite and are really important - but grains also have elements the body needs, individuals should determine a balance of some of each through the week. Leafy stuff also needs to a big part of my dinner plate. I try to go for 1/2 green stuff 1/4 carbohydrates and 1/4 meat.
Avoid processed foods!
The processing of food in large industrial factories seems to remove essential ingredients that the body needs to process stuff. Scientists still don't understand the complexities of the chemical vista that is the living body, and meanwhile the industrial process requires breaking everything down to essential elements to make the enterprise profitable. This disconnect is causing great stress on the health of individuals - and the health care system as well. Even if processed foods appear to have the correct amounts of each element - determined whether through ones own hard wired cultural bio feed back system, like the taste glands, or the ingredients list - the ingredients one's body needs to process the food may not be present. Thus one slowly starves while feasting. Think about what that's doing to your brains ancient hard wired functioning.
As I said above physical exercise plays a huge role in processing the poisons that result from my consumption of alcohol. Muscles have the ability to break down amino-acids, just like the liver. Amino-acids are integral in the kidneys function of filtering out poisons. They also help the stomach digest, the kidneys and the intestines 'crack' out elements that the rest of the body need in order to function. This freeing of essential elements in food helps every part of the body, it is key to health and wellness, including brain functioning.
The social aspects of playing games in groups is another thing about physical exercise that helps me avoid major depression. Playing team games exercises one's muscles but also one's brain. Sport combines physical, analytical, abstraction abilities, but more importantly, because team sports are often adversarial in structure, it also requires social skills. It's us against them; but you can't kill them, or injure them, there are very specific rules.
Most anthropologists think large group dynamics lead to increased brain size in humans (3X larger than other mammals), which concurrently lead to complex languages. So the size and structure of our brains is a function of social dynamics. Even the large part of the brain devoted to visual functioning (that is also proportionately larger in humans than in other mammals) is also likely a function of the social - as a lot of it seems to be devoted to face recognition, social ordering, recognizing one's place in a social hierarchy.
As well as physical social exercises, I like to write. Writing exercises a whole bunch of different areas of the brain.
Off the top of my head:
Memory - where did I see that before
Spelling - building new memory
Conceptualization - organizing different kinds of thoughts
Synthesis - seeing relationships between different things
Story telling - using cultural artifacts to strengthen the listen-ability, and thus cognition of a story
Ending depression - some anecdotal observations
This is an anecdotal list of stuff - that in the writing - might allow me to see myself better, and possibly be helpful to readers also dealing with depression.
Symptom #1 - Depression as a refuge
Monday, September 20th, 2010
1) Sometimes I use the knowledge that I have a tendency to tip into depression as a defence mechanism - to avoid social situations that I find difficult.
For example, talking to people about real, personal, possibly embarrassing things is too hard for me. I know that we're all the same, but that understanding - even though I absolutely believe it is true - and act on it in all the time, isn't strong enough for me to over ride my defensiveness. During important social moments, when a person is opening up to me and it's time for me to reciprocate, I clam up, and go away inside. By giving up, walking away or changing the subject I'm confirming to myself that I am defective ---> worthless. This leads to depression, which re-enforces the belief that I am defective - a catch-22; a self supporting structure hanging in the air, it's complexity somehow obscuring the fact it is not supported by anything.
The result of my failure in these complex social situations leads to depression, the depressive episode is so frightening and all encompassing that is over shadows and confuses the real issue and any lessons that might be learned.
I realize now through writing it out, that the root of the problem is I am overly defensive. I'm shy. Ironically, I've always known this, it's not something I'm embarrassed by - in fact, in some ways I think it's kind of cute.
Now I can start to tackle the real issue - and that seems a whole lot easier than some deep defect with no name.
And that makes me happy.
Symptom #2 - Anger as a way out
Thursday, September 23rd, 2010
Sometimes in the coarse of a prolonged depression I lash out at inanimate objects. It starts when my motor function seems to be off just a little, everything I touch or reach for tips over or falls to the floor.
(Neuroscientists might want to look at that - could be a way forward in understanding depression ---> Why is motor function related to a feeling of loathing about things?)
So anyway, this 'bull in a china shop syndrome' can lead to a projection, "the universe is against me". This is the height of hedonism, but when I'm in crisis, in a depression that won't abate, where I can't consciously, logically work through what is happening - what other avenue is left?
I'm not saying this is good - that one should let fly and punch walls and smash dishes; this doesn't do any good, the self loathing is just intensified while you try to focus on cleaning up what you've just smashed. AND, in the process - because your mind is elsewhere, and your still uncoordinated - you cut yourself on the glass you're cleaning up! Thus furthering the feeling of self loathing, and confirming the unhealthy projection that the universe is against you.
Fifteen years ago I saw myself going down this path and I didn't like it. I saw it as the beginning of a mechanism which could lead to hitting people; so I taught myself to recognize the adrenaline surge that precedes the violence and to stop what I was doing, breath deep and say to myself, 'stop it, this is bad for you'. That statement became associated with the reduction in adrenaline and a feeling of peace.
I still have those adrenaline surges, but they rarely end with smashing stuff. It's an on-going thing, I'm never cured of it - just happy when I over come each instance.
The only way I've discovered out of this, is talking therapy. I don't mean with a shrink - as I've never been to one - but by talking this stuff through with somebody I really trust, someone in my most intimate social network; lover, family member, best friend. There are factors other than one's conscious mental framework that contribute to depression, it's a many vectored ailment I, and the professionals don't yet understand; research continues. But the cognition of the thing, the sharing, the appreciation that one is not alone, that we all experience these things to one extent or another, and perhaps the addition of a new perspective brought to the symptoms by a trusted someone - all seem to help greatly in getting through these depressive periods.