Wednesday, October 21, 2009

And, just like that ...

For much of the day, I said to myself and to a couple of people, "I wish I could just get better." Not only was it difficult to do more than the ADLs, anything that looked like creativity was stuck way off shore, barely visible at the horizon.
In the late afternoon, I get an email from a list that shares information about technical writing and related jobs. It's a short-term training job in Worcester, presenting a variety of web topics to hospital employees. It's a perfect match for the kinds of things that I've been doing. Within minutes, I quickly reviewed my resume, made a few changes, and sent it along.
I'm sure that the hiring manager will be inundated with responses, so I'm not expecting a quick response or even an acknowledgment. It was just good to take a chance and trust that the process will lead me to the next place.
Sure, I've thought about what it would be like to have to go to work on a regular schedule, complete projects on time, and all that. As I said, I have to trust the process. The interviewing loop (if I even get there) will show me more of what's needed and more about my capabilities. I'll have plenty of time to learn about my rights regarding any accommodations that I might need. There are a few areas where I'll have to be a quick study (search engine optimizations, server logs for a particular content management system, and the like), but there are also other areas where I know the material as well as anyone might.
Just as hard things can show up unexpectedly, taking control of one's life, so, too, maybe, good things can behave similarly. We've plenty of time to figure it all out. I take that back. We don't have to figure it all out. We just have to figure out enough to move forward.

Sunday, October 11, 2009


I have some friends who use labels to characterize and summarize their behaviors. ("Oh, that's my OCD kicking up again.) The labels can be diagnoses, astrological signs, regional descriptors (I'm just a Yankee and so ...), birth order, or any of a number of things. The labels are useful because they quickly package a set of attributes into a manageable chunk. They're unhelpful because the labels might have only a 60% fit; the other 40% has to be discarded as irrelevant.
We're often coached in therapy to refer to ourselves as people with mental illnesses, not as mentally ill people. I am a person with depression; I'm not a depressive.
Further, as we know, the diagnosis of depression includes a very broad array of symptoms. When we take screening tests, the results are often reported as "If you answered 'Yes' on five of seven, 13 of 19, " or somesuch.
And even if we arrive at a diagnosis based on the presentation of enough symptoms at enough severity, that doesn't typically get us very close to identifying a cause. Depressive symptoms are serious enough that they warrant treatment, irrespective of the cause. (As we know, left untreated, depression can be life-threatening.) Finding treatments that work (i.e., relieve symptoms) can take a lot of time and experimentation.
[Another time, I'll explore what seem to be the two camps of treatment - medical vs. behavioral. There's a lot of interesting science coming out in both areas.]
So what? Well, I backed into these ideas as the result of an old theme, that revealing one's depression is a great conversation stopper. I've had the chance to reconnect with several friends from long ago. When they ask what I'm doing these days, I try to calibrate my response. If they were work acquaintances, I say that I'm retired. I might say that I've retired for medical reasons, leaving the topic open. If I knew them well, I will often go into a fairly brief description of leaving work, receiving treatment for depression, and living now. Some people will respond with an "I'm sorry that that has happened to you." Others might related their own experiences or that of family or friends.
Often as not, the response is crickets.
That's led to reflection on how we present ourselves to friends, family, and others. Most people, I believe, are prepared to hear that everything's fine. They may not be prepared to hear about some complicated hardship. Nevertheless, to present myself in the camp of everything-is-fine is not fair to me or to the relationship.
As a result, I wind up missing these old friends more after I've made the contact than before.
One final wrinkle that helps little: we generally use the word identity to describe how we define something or someone. In mathematics, however, an Identity describes the behavior of the integers 0 or 1. If you add 0 to any number, you get the original number. If you multiple 1 by any number, you get the original number. See how much that helps?

Sunday, September 13, 2009

Got lucky

No, not in that way.
Last night, my wife and I had a date night. We dressed up a bit and went to dinner at a favorite Thai restaurant. The place opened last December and has been very successful, so we went early to eat without having to wait or hurry.
We'd worked hard during the afternoon, attending to some long overdue chores inside and outside the house. As a result, we were hungry. We shared an appetizer platter before order our entrees. My wife likes a chicken and squash dinner. Most of the time, I've ordered the Massman curry with chicken or beef. This night, however, I selected the panang curry. It was delicious. I think that the regular recipe was supplemented with a bit of anise, a sweet licorice aftertaste.
About one in the morning, I woke with a pretty bad headache. I got up, went downstairs, and, while waiting for the ibuprofen to kick in, I put an ice pack atop my head. The cold felt very good.
A short while later, I looked up the recipe for panang curry and learned that it's made with fish sauce, which is a fermented product. Fermentation produces a chemical called tyramine. For someone, such as yours truly, who is taking an MAO-I antidepressant, tyramine can be deadly. I was fortunate that the amount of fish sauce in the dinner was small enough to produce just a bad headache.
The menu description didn't mention fish sauce:

Panang Curry Choice of chicken, beef or pork in Panang curry with string bean, carrots, basil leaves and kaffir limes leaves.
Had I known, of course, I wouldn't have ordered it. Now I know.
A big part of the problem is that I didn't think to ask what was in the curry. Other curries, Thai and south Asian, have been fine - delicious and safe. It's not that I didn't know, but that I thought that I knew.
I got lucky.

Wednesday, August 26, 2009

Depression's Evolutionary Roots: Scientific American

Depression's Evolutionary Roots: Scientific American:

"When one considers all the evidence, depression seems less like a disorder where the brain is operating in a haphazard way, or malfunctioning. Instead, depression seems more like the vertebrate eye—an intricate, highly organized piece of machinery that performs a specific function."
The latest in the depression-must-mean-something meme.
I wish I could believe it. I wish that the periods of depression, when nothing moves and all is dull, were leading to better insights about life's problems, mine or the greater good. My experience has been, however, is that I'm not capable of much thought during those times. I don't, as the article suggests, ruminate on topics that require deep and sustained concentration. No, my time is usually spent staring at the opposite wall, my focus about six inches before I reach the wall, so nothing is clear and less is important.
"Laboratory experiments indicate that depressed people are better at solving social dilemmas by better analysis of the costs and benefits of the different options that they might take."
Maybe, and I'm not being too snarky here, we ought to move into laboratories. What I've seen out here, in my life and the lives of nearly all people with severe depression, is that depression wrecks relationships and drives people into repeated episodes of bad and/or self-destructive behavior, often in an effort to find relief from depression.
I commend the article's author for trying to identify something good that can come out of depression. I don't rule it out. I just know that I don't want to go back there, no matter how my analytical skills might improve.

Saturday, August 15, 2009

Several more clips about insomnia

  • The No Wake Zone
    "There’s accumulating scientific and historical evidence that human beings, like many of our mammalian cousins, weren’t meant to follow what we consider a “normal” wake-sleep pattern of two strictly segregated blocks of time—16 uninterrupted hours awake, 8 uninterrupted hours asleep."
  • Sleep Patterns In Children And Teenagers Could Indicate Risk For Depression
    "adolescents with a familial risk for depression but without a depression diagnosis experienced shorter REM latency, meaning they reached the REM stage more quickly. Those adolescents were more likely to develop depression by the end of the five-year study period than those who reached REM sleep later in the cycle."
  • Bedfellows: Insomnia and Depression | Psychology Today
    But it may be that insomnia is more than just a symptom of depression. It may in fact unleash the mood disorder. If sleep researcher Michael Perlis, Ph.D., is right, insomnia may be an early harbinger of depression. His longitudinal studies show that it appears to precede episodes of depression by about five weeks.

  • Gene May Determine How Much Sleep You Need : NPR
    "A team of researchers has found a genetic mutation that appears to allow some people to get by on less sleep than others. The team found the unusual mutation in a mother and daughter pair who appear to sleep less."

Thursday, August 13, 2009

Why You Should Hate the Idea of Applying for Disability Beneifts

Why You Should Hate the Idea of Applying for Disability Beneifts: "In my view, clients who hate the concept of disability are my best clients."