Another Day of Feeling Bad

square848It’s the damn wind again, a Santa Ana blowing off the mountain and against my door. Combined with the heat, it gives me a headache and a stiff feeling all over my body. Plus I have been sneezing.

At first I mistook this for a depression. Friends counseled me to seek out some sunlight. As soon as I went out the door, though, pollen blew up my nose. This disabused me of my theory and I went inside to take some Tylenol for my headache.

Daylight Savings Time certainly doesn’t help.

Bipolar brings on the worry that I am seeing the signs of an imminent mood swing. A cold, the flu, or allergy attacks in their early stages cause me to worry that I am sinking. Then I get a clue as the symptoms worsen and I let go of my dread.

The dog feels the effects, too. He has been pacing nervously up and down the hall, his claws clicking on the wood laminate flooring. I get up from time to time to join him and he follows me. This is the madness of the foehn, the agitation that the drop in air pressure here in the valley brings from the mountains. I hate this part of March and wait impatiently for it to just go away.

How Positive Thinking Poisons Bipolar Disorder

square839When you are depressed, society forces you to lie. The American cult of Positive Thinking demands that we do not speak ever about our unhappy experiences or moods. If you live in Europe and someone asks you how you are, it is perfectly fine to say “Well, I didn’t get a good night’s sleep last night” or “I’m a bit down today”. Here in America, you are expected to say “Good” or “Everything’s all right.” If you stray even as far as saying “Fine” or “OK”, the alarm bells in the questioner’s head go off. This is not satisfactory. This suggests creeping negativism and negativism, the Positive Thinker believes, must be ever and always avoided and suppressed.

If you tell the truth, you find yourself saddled with guilt. Other people don’t want to hear about your bad day. They might mock you, call you a “downer”, or tell you to “cheer up and get with the program.” Your bad mood is a burden to others: they don’t like the suggestion that they have to spend a little time listening to you or that they might be a contributing cause. So you say that you are doing well. In summary, you feel guilt for having ruined their day when the reality is that they have ruined yours with their insensitive expectations of a life free from “negative people”.

Your feelings count. Avoid the Positive Thinkers because they are poison. Find people who are real. They have good ears and just hearts.

The Brain is a Dark Country

square789The brain is a dark country. I travel there alone, lurching over its high roads and through its scourging vales. I believe that what happens to us is only a small part of our moods. The rest is a geology set down when we were in the womb, shaped by the fidgetings of life.

At times, I don’t like my own mind. I tell my therapist that this came from this and that caused this other thing. I despair because blame for my condition does not incite cure.

Depression Finds References Everywhere

square776Sorry for my absence. I got word a few weeks ago that my mother had a [[glioblastoma]] growing in her head and had only a few weeks to live. Since then, I have been swinging from depression to mania and back again, with a day or two here and there where I feel neither condition. When I feel [[hypomanic]], I feel curiously happy though without reference to anything in the world. Depression, of course, finds references everywhere.

So I am waiting, scanning negatives, cleaning out boxes. I don’t know how much longer this will go on.

The Talent of Depression

square756I’m surrounded by people who tell me that everyone has a talent. Years of aptitude testing followed by generous explorations into various careers and skills have led me to the conclusion that my special genius is for being depressed about 10% to 90% of the day, depending on whether I have taken my medications, exercised, and beaten myself up. I know the slough with all its sinks and murky places well. The leeches who live here find their way into every crevice, drawing not happiness but energy from me. I seek relief by reading, walking the dog, or tweeting. Sustained effort is required to pound the quivering mudflats into stillness. Every now and then, when I believe that I have bested it, an gray egret pierces me in my sleep and I wake to despond.

I tell you. It’s a gift.

The Soul as Hamburger Meat

square739Imagine a soft, gray rock domed and striated like a hamburger bun. No life here, you think, then you notice the blue gray beady eyes blink. It opens its maw and takes you in, chewing toothlessly on your chest. Paralysis prevents you from crying. Oh save my soul, oh save my soul, oh save my soul, you murmur but the dire suspicion that you don’t have one overwhelms you.

A few days ago, I had a conversation with my therapist. It amounted to this: I believe with good evidence that I am a good person. Many years ago, when the mania swamped my common sense, I rushed into impulse buying and sudden, unthinking action. I’m calm now, doing my best to be kind. Irritability electrocutes this kindness at times, but mostly I remember my etiquette. But I don’t think I am likable and I find the world perverse on this score.

Take for example the case of one person I know. We’re sitting next to a young man with cerebral palsy. A young girl sees him and asks us what’s wrong with them. My companion says “Aren’t you glad that you aren’t like that?”

This person is loved by all except me. This person enjoys the world. Friends call to see how this person is doing all the time. Loneliness is not their curse.

I have only Lynn who loves me. And while I love the world, I am mostly alone in it for the many hours of the day.

My therapist says that the experience of this other person should give me heart. If this mean human being can find friends, so can I. But I retorted “If the world is filled with such people, how can I trust anyone?”

I do my best to be a good listener. But I have found that the blessing for this are many people who do not know how to listen in return. The legions come and give me advice. I cover my head with my hands and wish to cry. The other good people of the world have no time for me. I know it is not because I am bad. It is because I am not likable, not even hamburger meat to them.

The Health Care Reform That Has Yet to Happen

square726A plague is sweeping the nation. Three out of four Americans suffer from it. It is virulent and contagious. It destroys living tissue and bone. Bacteria at the point of infection inject their poisons into the bloodstream, exporting the destruction to other parts of the body. [[Cardiovascular disease]], [[joint problems]], [[pancreatic cancer]], [[diabetes]], [[asthma]], [[osteoporosis]], and even [[Alzheimer’s disease]] have been associated with it. Yet normal insurance does not cover its treatment. It was not part of health care reform. Most Americans are covered only to the tune of a couple of thousand dollars a year or less.

Bacterial plaque of the mouth is vile.1 Most people think it only causes [[caries]] or [[gingivitis]]. But recent studies show that the bacteria dump their waste products into the blood stream — a phenomenon called bacterima — causing problems in other parts of your body. If left untreated, the acids and other waste products will erode the bone of your mouth. This cannot be replaced. You will lose your teeth and if the condition is serious enough, you won’t be able to replace them with dentures or other dental appliances.

Healthy, mentally stable people think it is a simple matter to keep your mouth clean. Consider the third of the population who suffer from major [[depression]] though. When you twirl and fall into the morass as I did, you see your mouth as a hopeless cause. Why brush? Why floss? The commercials all say that your teeth must be white.2 You look into the mirror and fail to see the brilliant flash that advertising and employers say must be there. Even professional polishing fails to brighten your grimace. As conditions worsen, the costs of repairing the damage increase. It becomes more difficult to chew. Your jaw aches. So you give up.

Clearly, this is yet another symptom of the psychiatric disorder. But despite the broader health implications of the [[biofilm]], insurance companies and the public in general view dental care as cosmetic — about as important a medical concern as shaving or getting a haircut.

Insurance treats your mouth as an alien camper in your body. If you turn your lungs into a cancerous sac by smoking, your costs are covered to $750,000. If you become addicted to alcohol or other drugs, your rehabilitation is paid for. But most people are covered only to the tune of $1,500 or less each year. Beyond that low bar you have to pay out of your own pocket.

Do you see the discrepancy? Diseases caused by smoking and alcohol are equally caused by a lack of self control, yet they are covered. You can get your oxygen paid under Medicare3 and a heart bypass covered under most insurance, but there’s nothing out there for a dental implant if you need it. It cost me $40,000 to fix my mouth. Most of this came from my family and a large contribution by my Quaker meeting’s sharing fund. It has taken us years to recover from my melancholy-induced negligence.

In 2008, Congress mandated mental health parity. This meant that my bipolar disorder — which had indirectly caused my dental disaster — was now covered. Barring changes by this Republican Congress, regular care for this life-threatening condition of mine was now possible.

Given the wider damage wreaked by bacterima, it’s about time that there was parity for dental work.

  1. Plaque occurs in layers. It looks like a thick off-white goo. As it builds up, the most destructive bacteria migrate to the bottom where they exist in an environment that is without air, light, or food. The longer you don’t brush your teeth, the thicker these colonies will be. And it is important to brush regularly: the bacteria growth or [[Pellicle_(dental)|pellicle]] can reestablish itself in only twenty minutes! []
  2. Their natural color is yellow. []
  3. At least for now []

The Scary Guy Defense

square715A friend of mine who is a mental health professional in Germany and I often watch a certain social media site for signs of distress among the denizens. Recently, I dropped her a note about one fellow who struck me as being on the proverbial roller coaster. She shuddered when she checked him out and told me that she was sure that he was going to be explosive.

All this causes me to look back at my own behavior when I was in extremis. The world looks as if it is always about to teeter and dump you and anyone close by into a pit. Some people find this fascinating. They hover around you, watching you as you rant and rave about your unsteadiness and the threat the world poses toward you. They are often nice people, kind people. You think they don’t know you, they can’t possibly know you. And their proximity adds to your sense of [[Koyaanitsqatsi]].1

They laugh at your jokes. They find you interesting. The edge of an episode cleaves your consciousness. You are beginning to repeat yourself. What can you do to right things again so that you can resume stability? The problem, your troubled mind jumps to conclude without reasoning, is that you are dangerous. So you have to show them that you are genuinely and truly mad. You launch into what is called the Scary Guy Defense.

Thanks to your mania or mixed state, you have already emitted a series of cues that suggest you are losing it. You raise your voice. You shake. You wave your arms. Words pour out of your mouth at an erratic pace. The lids of your eyes roll back and the orbits bulge out. The euphoria squares your shoulders and tenses every muscle sliding across every bone in your body. A terrible strength props you up. And it seems fit to exaggerate these symptoms because you want people to run away, because nothing scares you more than the prospect of your body flipping blindly about and striking one of the gentle ones. You pull on a monster mask because you don’t want to hurt anyone.2

  1. In Hopi: “crazy life, life in turmoil, life out of balance, life disintegrating, a state of life that calls for another way of living” []
  2. One time I got into an email exchange with a Berkeley student who shared my interest in [[Stephen Sondheim]]. With each long letter, I felt encroached upon. So I suggested she come down to Palo Alto to have a threesome with my wife. It worked. She never contacted me again. []

Arguing with the God Within

square705Near the end of Ingmar Bergman’s classic [[Winter Light]], the troubled minister who is the film’s main character, can’t decide whether to hold the 3 o’clock service or not. His day has been especially depressing because he gave counseling to a parishioner who subsequently committed suicide that very afternoon, he fought with his mistress, and he has the flu. The church sexton, a disabled survivor of a railroad accident, talks to him about the part of the Gospels which he has been reading, the Passion.

Jesus, the sexton reasons, didn’t suffer all that much on the cross. Why, the janitor goes on, he personally suffered more pain in his life than the four hours that afflicted Jesus and his pain was probably much worse. No, the [[crucifixion]] is not the most important segment of the Passion. Think of the [[Garden of Gethsemane]], he says. The [[Last Supper]] is done. The disciples who have accompanied him have no clue about what is about to happen, so they go to sleep. Jesus is all alone, so he kneels down to pray. And what does God the Father say to him? Nothing. God is silent. And that, the sexton reasons, is the most terrible ordeal that Jesus endures.

Agnostic that I am, I still value the Gospels as a guide for understanding the suffering that is happening in my life. But what I would give for a silent God at times! In the void, my depressions fill the emptiness with the voice that is the worst of the Old Testament combined with Catholic guilt. I call this my inner god — a false god to be certain — because its primary purpose is to torment me. My illness exists, according to this voice, for the purpose of punishing me. But therapist after therapist has asked me What have I done that is so terrible that I deserve this constant hammering at my self-esteem? I can throw out a number of things, but they are all trivial compared to the actions of some of my peers who feel no shame for what they wreak against others1 Surely there should come a place where my penance is over? But no matter what amends I make, the god inside me continues to berate me and declare me worthless.

One reason why I value my manias is that they shut down this voice entirely. Only my own ideations occupy me — obsessively. My thoughts race from project to project, propounding desperate philosophies that enthrall me more than [[methamphetamine]]. The evil god, the blasphemer against my happiness is put to death and does not rise again until I crash. Then for more than forty days at a stretch, the god assaults me with shame.

For the depressed and the anxious, the silence of God is a scream.

This post is in response to Day 9 of the Health Activist Writers Challenge: “Health Activist Choice

  1. Do you hear me, [[Newt Gingrich]]? []

Vitamin D and the Cold Blue Funks

square699My endocrinologist tapped a few keys and brought up my latest bloodwork. She pursed her lips as she scanned the numbers. My [[triglycerides]] were too high, so she upped my [[Lipofen]]. Everything else was within proper balances. Except at the bottom of her study: my [[Vitamin D]] levels were excruciatingly low.

I asked her what that meant.

“We don’t know a lot about how it works,” she admitted. “We do know that when it is low you can feel tired and depressed.” I had just confessed to these symptoms a few minutes before, so the result explained the torment of my winter.

Some people, she explained, had trouble producing enough Vitamin D from sunlight. The amount that they use to fortify milk didn’t suffice. I spent the winter taking walk after walk in the bright sunlight, but I wasn’t producing.

So the cure was a megadose of the food supplement. It came in an emerald softgel about the size of my little fingernail that I have to ingest once a week.

The role of Vitamin D in depression is not confirmed at this time, but a recent study out of Great Britain suggests that low vitamin D levels are associated with melancholy, “independent of age, sex, social class, physical health status, and season.” This finding remains controversial because other symptoms of Vitamin D deficiency such as heart problems might in themselves lead to depression.

What I can say about this is that since taking Vitamin D, I have begun to smile again — genuine smiles rather than the forced grins that civility demands. The glow of my exercise sessions last beyond an hour or two and it is far less hard to get them started. Other depression sufferers report similar results.

The one thought that troubles me is whether the symptoms of depression that I have felt all these years is nothing more than a symptom of this deficiency. But then there is the question of the mania: This can happen when there is too much Vitamin D in the system. Are my mood stabilizers the wrong treatment? I do not remember changing my habits in advance of the surges of energy. So I shall work with my psychiatrist, remembering that for the bipolar the body is an explosion and a fire that rages and ebbs.

In a Sad Corner of the Multiverse

square690My current reading consists of three books crammed into my Kindle — Styron’s [amazonify]0679736638::text::::The Confessions of Nat Turner[/amazonify], Metaxas’s [amazonify]1595551387::text::::Bonhoeffer[/amazonify], and a curious but apparently true work of physics by Brian Greene called [amazonify]0307265633::text::::The Hidden Reality: Parallel Universes and the Deep Laws of the Cosmos[/amazonify].

I have to admire anyone who wades through piles of scientific papers in an attempt to explain how parallel universes — or taken collectively, a multiverse — arise from taking theoretical physics to its logical extremes. I don’t pretend to understand the math, so I am taking Greene at his word.

The concept shoves me into a place of despair. In its crudest form, consider that there are parallel Milky Ways with parallel earths1. On many of these there is another Joel, perhaps pecking away at his computer like I am, except his history has been different. Due thanks to the Universe issues from my lips that this is not the somewhere he lives on the streets (having never met his wife) or is even dead. But there’s a depressing thought that emerges as I read this and I find myself cursing conditions here.

It is possible, you see, that a new universe comes into existence every minute or so. And from this fruition, come new realities. One of these realities has brought me to a better place than this where I am successful or at least secure in a world where the politics are sane. I make a difference in that world. So why, I ask, did I get stuck in this time stream? Why have I deteriorated alongside the rest of the country? Why don’t I get to travel in a better one and stay there?

The despair grows unbearable when I think: “What if this is the best universe?” Ah, then it is tragedy all the way down.

Fork the multiverse. It’s screwed me.

  1. Anyone who has watched Star Trek knows the theme []

The Paranoid Experience

square689Paranoia burns both as one of the brands of stigma and as a symptom experienced by sufferers of bipolar disorder, major depression, schizoaffective disorder, and schizophrenia. In my experience, the psychosis afflicts me both in mania and in depression, but the feel of it is different in each state of mind.

Manic paranoia is exciting. Roll the tapes for Mission Impossible or The Man from U.N.C.L.E. Imagine me as The Fugitive. The chase is on! The CIA is after me! I’ve got to assume my alias, change my email, check out the window to be sure that no one is watching the house.

One time during the days of the early Gulf War when I was volunteering heavily for PeaceNet, this kind of paranoia had me in its grasp. I was driving with my wife to get my hair cut when I noticed a car in my rear view mirror run a stop light seemingly to avoid losing me. I parked my car, went inside, and sat down. I swear to this day that a man came into the shop after me. He looked at me and then walked out. It had to be the same guy, right? My wife never saw him.

Depressive paranoia is humiliating: It’s a dark, tragic hour. I am all alone and no one wants to hear me while I expose the doom that is about to befall me. Or I think I am radiating a presence that just drives people away so I hide to avoid their soul-crushing gaze.

I can fall into the latter simply by reading the news too much which is dismal enough some days, but in depression I take it a few steps farther and see people specifically out to get me.

I forgot to take my morning meds a couple of days ago — a bad news day — so I was despairing by bedtime. Yesterday, after taking a doubled dose of my antidepressant and getting some treadmill time in at the gym, I feel more realistic about what is happening. But I pay as little attention to the news as possible.

Yet this other feeling — that I have been putting people off and am ultimately responsible for the world’s failures — lingers. Pieces of that may be true, but the depression intensifies the wariness. I may be killing myself — sans gun or knife or poison — with the stress.