Finding happiness or letting happiness find you

This has been a pretty good stretch - a lot of fun, good energy, and clear thinking. The last couple of days, since my muscle biopsy, have been less so, but, even with the tiredness and discomfort, I'm confident that I'll be back on the right path soon. A year ago, even six months ago, I couldn't have been that confident. It's clear that I'm doing better.

So, what worked? All of it: the ECT treatments last year, the current meds, counseling, loving support from family and friends, time. I needed it all and, with the possible exception of more ECT treatments, I'll continue to need it all. It's easy to get all wrapped around the axle with the dialectic of whether it's mind or medicine that we need. Maybe some folks can get better with one treatment method, but that's not been true for me. It makes it difficult, when there are a lot of variables, to determine which one to tweak when things start going bad again. But, no one said that this was going to be easy.

A few quick notes re the PBS show on Depression

Last night's show, DEPRESSION: Out of the Shadows . PBS, was pretty good. Most of it focused on the suffering that patients feel and how depression can affect the whole family. The most telling part, for me, was when one of the subjects showed all of the prescription medications that he takes daily - anti-depressants, adjunct meds, meds to counteract the side effects of other meds. There's interesting research coming out regarding Area 25, a central part of the brain that appears to affect mood, pleasure, energy, and mental focus.

The follow-on discussion host by Jane Pauley was also good. Of particular note is how anti-depressants alone can have devastating consequences for people, such as Pauley, who have biopolar disorder. Anti-depressants in those cases can trigger even wider mood swings and suicidality.

In all, it was worth watching.

Depression as a conversation stopper

It shouldn't come as a surprise that the topic of depression often leads to a silent, dead end. In the past few months, I've been in touch with some friends and former co-workers. In several cases, when I've explained that I'm out of work due to depression, I've received no response.

As I said, it's not really surprising. The topic of depression breaks a conversation train on a couple of levels. First, it's such an amorphous illness with no tidy set of causes or definitive course of treatment. Sometimes, we're trying to treat the core illness while, at other times, we're trying to ameliorate the symptoms (such as insomnia or myalgia). CBT, ECT, m-o-u-s-e.

Second, when depression is at its ripest, there isn't much else going on. I've worked hard to keep current on a range of topics - technical stuff, politics, world events - but, some days, I've got nothin'. I've been out of work for almost two years and so the technical stuff that I've learned is pretty much in the abstract. I haven't had to create and deliver products with any of that knowledge.

I'm not feeling sorry for myself on this. It is what it is. It's part of the reinvention process - how do I develop new interests and new topics for conversation. I'll let you know how it works out.

‘Mad Pride’ Fights a Stigma - New York Times

This article, ‘Mad Pride’ Fights a Stigma - New York Times, from this past Sunday's paper, is getting a lot of attention among the mental health bloggers. In brief, the article describes a movement among people with mental illness - notably schizophrenia and bipolar disorder - to embrace the word 'mad' as a way doing battle with the stigma associated with their illnesses. This is done, in part, because there's a perception that people with schizophrenia and bipolar disorder are scary. (People with depression, by comparison, are seen as harmless and helpless, if they're seen at all.)

A by-product of the rebellion against the stigma of mental illness is that some folks are moving away from any treatment, medication or therapy, regarding those treatments as an effort by society and medical establishment to tame or tranquilize patients, rendering them, well, harmless and helpless. I've got to say that, while many people have had bad results in their dealings with mental health professionals, I've also seen the absolute disasters and even death that comes to people who can't or won't be treated.

In all, though, it's good to mix it up. Even people whose mental capacities are diminished need to have a voice in their treatment .

Brains of People with Depression Different - Psych Central News

In addition to the key findings of this report, Brains of People with Depression Different - Psych Central News, that people with depression have fewer of the receptors that regulate happiness, there's an interesting note at the end of the article. The researchers are looking for people who are depressed but who are also not taking medication. This is a key problem in many types of medical research - establishing a control group against whom varying treatments can be tested.

Having been through a brief time last fall when I needed to get off of one antidepressant before starting a new one, I can attest that untreated depression is still quite miserable. As interested as I am in the science, I know that I couldn't stand an extended time without treatment.

Antidepressants Do Work In Depression While Evidence For Cognitive Behavioural Therapy Is Poorer Say Experts

For the past few months, there's been a lot of brouhaha about the lack of effectiveness of antidepressants in the treatment of mild to moderate depression. So, not surprisingly, along comes another report that claims that cognitive-behavioral therapy (CBT) is no more effective than other forms of psychological support. (Apparently, in the UK, CBT is commonly prescribed as a first-line treatment for depression.)

AlphaGalileo.Org: Antidepressants Do Work In Depression While Evidence For Cognitive Behavioural Therapy Is Poorer Say Experts

The conclusion is that treatments should be more nuanced - psychotherapy, medications, or other - based on the specifics of a patient's history and condition rather than on the enumeration of symptoms according to standardized questionnaires.

Religious Orientation and Depression « Biotikos

Once again, we're caught in that vexatious spot of confusing causation with correlation. This article summarizes research that tries a) defines two types of religious orientation and b) correlates those orientations to a prevalence of depressive symptoms.

Religious Orientation and Depression « Biotikos: "if people seek future growth and have more personal attachments to their religion, they are less likely to have depression. The results from both studies show that an intrinsic view of religion is related to lower depressive symptoms."

If we're more outwardly focused (confusingly defined as intrinsic), we're less like to have depressive symptoms. If we're inwardly focused in our religious practices (extrinsic), our depressive symptoms are likely to increase. The study doesn't address the possibility that that the religious orientation is caused by, rather than causing, changes in our depressive symptoms.

Sometimes, the pain of depression comes from healing karma

Buddhist Teachings > Lama Zopa Rinpoche > Transforming Depression

... when you wash a dirty piece of cloth, the water becomes black with dirt. You don't see the black dirt as a negative thing since it means the cloth is getting clean. In the same way, when you practice dharma negative karmas can ripen causing you to get sick because you're purifying so much negative karma by practising dharma. So you should rejoice when you get depressed!

Would I be reading this if I wasn't sick?

This page, Depression Cures, provides a list of various homeopathic treatments for depression. I pretty much stopped reading at the one that had me drinking my own urine in a cold shower, but toe-wiggling does sound a bit like one of the meditation techniques that I've used with some success.

My opinion on homeopathy, indeed on a lot of topics, is that finding something that works for you is the most important thing. I am cautious, however, and tend to look for treatment that have a fair bit of peer-reviewed (not peerer-reviewed) science behind them. There are tangential treatments, such as the efficacy of cartoons on mood, that can be safely practiced and are likely to bring relief from symptoms with minimal side-effects. Anything that I might ingest, be it apple-cider vinegar or the aforementioned urine-for-a-treat, ought to have some good science behind it. Combining some homeopathic treatments with other medications can be deadly.

Jolting the brain fights deep depression - CNN.com

Reports about this study are showing up in lots of places recently. Deep-brain stimulation (DBS) is in a place similar to ECT (shock) treatments - very effective in many cases and still quite creepy for all but the most experienced observer.

Jolting the brain fights deep depression - CNN.com: "'Depression is> a physiological disorder, and basically we are regulating the abnormal signals to brain causing the depression,' says Dr. Ali Rezai, director of the Center for Neurological Restoration at the Cleveland Clinic in Ohio."

Sometimes, a cold is just a cold. Sometimes, it has something special.

So, for a week now, I've been laid low with a cold or something more. I've had bronchitis and pneumonia in the past and this feels a bit like those, but not enough for me to call the doctor. I've slept a lot during the day and, generally, at night, too.

The risk comes at the beginning and end of such an illness when we start to think that we can get back to normal (using whatever we consider to be normal these days). The day can start out with good energy and then drop out quickly. While the energy is dropping, I'm still thinking that I can get done the many little things that I've laid out for myself. If I'm not careful, I can start to spiral downward in the frustration. So far, it hasn't been bad. I've felt lousy physically, but my mood has stayed intact. These are the signs of progress that we can celebrate.