Depression Feels Like....

There are some things that all of us who have mood disorders share in common. Still, everyone's experience with depression is unique to them. Perhaps similar to, but not the same as anyone else's.

A little history. This has been a health issue for me since I was 15 years old (perhaps earlier). Unfortunately, I didn't know why I felt as I did. In fact, I thought that everyone had the same feelings that I did. Often, chronic clinical depression becomes a state of mind that feels "normal" to the person who suffers from it. They've never known any other way of life.

I remember the first time that a doctor ever asked me if I was depressed. I was 31 years old. I had started having migraine headaches, and had been referred for tests. The first doctor that I saw said, "Are you depressed?" I replied, "No," mainly because I didn't know what depression was supposed to feel like. Remember, this was the only state I had ever known. I was puzzled as to why he had asked me that question, but I didn't pursue it any further.

When I was 38, I was preaching for a church in New Mexico and I started having difficulty thinking and focusing on my work. My short-term memory was shot. I was frustrated and began to have anxiety attacks. I would stand in the pulpit and struggle for the right words. There was a car-sized chunk of lead sitting on my chest and I couldn't catch my breath. Oddly, the members of the church didn't notice any problems. Finally, I was so deeply depressed that I resigned and moved to Tulsa, OK to be near family. Of course, there's more to the story, but I wanted you to see how serious the problem had become.

Today, I know all about my type of mental illness. It has become a constant and familiar companion. I can easily recognize the signs when I begin another slide to the bottom of the pit. Usually, fatigue first comes on. My brain seems incapable of thought and it's hard for me to comprehend what I'm reading. I have difficulty concentrating and am easily distracted. My wife notices that I'm no longer joking or talking much. Laughter leaves the house. There's no interest in things that usually excite me. Socializing becomes painful and I try to isolate myself, even at church. I find myself staring at my computer monitor and I can't remember what I was doing.

Even simple arithmetic becomes almost impossible for me to comprehend. I want to sleep all of the time, but I know that I can't. That frustrates me. Irritation boils up unexpectedly. I become less affectionate. There is a tight feeling in my forehead. One of the first clues I get is that my eye-lids become swollen and my eyes close to a squint. A look in the mirror shows that I'm depressed. I feel hopeless and helpless. My self-esteem flees and I feel guilty because of the hardship that my illness causes. That familiar inner voice whispers, "Here we go again. Get ready for the fall."

Other than that, life is pretty good. Things do get better, eventually.

Ask someone for their personal story and be a good listener.

["I'm so low I could do a ten minute free-fall off the edge of a dime."]

How To Recognize Depression

Sunday, a friend of mine asked me how I had been feeling. When I told him that I had been doing much better for the last two months, he said, "I can't imagine what it would be like to be depressed all of the time."

That's a good thing. I wish that no one ever experienced those feelings. The truth is, though, that some do. One in five people will have to deal with major clinical depression. Unfortunately, many of those persons and those who are close to them will never know that they are depressed. Consequently, they will go untreated, and may suffer needlessly for many years.

Not all depression is treatable. That has been my experience. I, like some others, have treatment-resistent depression. That's another problem altogether.

Abraham Lincoln once wrote, "I am now the most miserable man living. If what I feel were equally distributed to the whole human family, there would not be one cheerful face on the earth. Whether I shall ever be better I can not tell; I awfully forbode I shall not. To remain as I am is impossible; I must die or be better, it appears to me." Neither he nor I would wish this condition on our worst enemies.

Before anyone can be treated, they must first be diagnosed. A preliminary diagnosis can sometimes be done personally. If you or anyone you know has the symptoms of depression, then get to a doctor immediately and tell him/her what the problem is.

Characteristics of Depression

01-Depression is a whole-life illness. It involves your body, mood, thoughts and behavior.

02-You may have problems with thinking clearly, concentration and decision making.

03-You might have short-term memory problems. It's not the same as "senior moments."

04-There can be a loss of motivation and lethargy expressed as procrastination.

05-You lose interest in formally enjoyable activities or hobbies.

06-There may be extreme fatigue, loss of energy and slow body movements.

07-Usually there is either a loss of appetite or a craving for carbohydrates and sweets.

08-You may feel chronic aches and pains or a sense of numbness and insensitivity.

09-You can be anxious, worried or nervous.

10-Self-criticism or criticism of others is typical of depression.

11-Anger or irritability is frequently expressed.

12-Your outlook on life is mostly negative or pessimistic. You feel hopeless and helpless.

13-There is usually a desire to withdraw socially, losing even the enjoyment of the company of people you care about.

14-You may experience a loss of libido.

15-Other signs are: crying, sleepiness, neglect of hygiene, guilt, and loss of self-esteem

Knowledge of this illness is an imperative. It is the first step in treatment. Read everything you can about depression. Then talk to a medical professional.

President Lincoln's hard-won wisdom was expressed in a letter to Mary Speed, written September 27, 1841. He wrote: "A tendency to melancholy...let it be observed, is a misfortune, not a fault."

Don't be an obstacle to someone's recovery. Be tender, understanding, sympathetic and helpful.

["I'm so low I could do a ten minute free-fall off the edge of a dime."]

Precious Memories

The church occasionally sings a song titled Precious Memories. Lazy days and idle moments often lead to gentle thoughts of our personal precious memories. This last week I was in Tulsa over the Thanksgiving holiday. While there, I decided to call an old friend whom I had not seen in about sixteen years. She and I worked together at a law firm. Our jobs required that we spend long hours in each others company and we developed a good relationship. When I heard her voice, it was as though all of those years had rolled back to the times when we had so much fun working together. I consider those days to be "precious memories."

People outside of the mood disorder "club" might think that we seldom have any good times. Some might believe that our lives are so filled with the problems of our illness, that any memory we hold would be a bad one. I am happy to report that that is not the case.

Some time ago, I was looking through our family photos, and I said to my wife, "We've had a lot of fun over the years, haven't we Honey?" She agreed. When I was depressed, life looked pretty dark. It seemed as though I would never see a good day again. Since I was fifteen, I can't remember any year that I didn't experience a period of major depression. Sometimes it lasted weeks, sometimes months and occasionally an entire year.

Teresa and I have been married almost 32 years. I was depressed every year, which was hard on her, but we still managed to have a lot of fun. We raised two wonderful sons and a sweet foster daughter. We traveled extensively through OK, TX, CA, NM, AZ, CO, AR, MO, NV, UT, WY, LA, MS, TN, GA, NC, KY, MT, ID and WA. We made our home in 8 of those states.

We visited 11 national parks, many national monuments and recreation areas. We went hiking, climbing, caving, skiing, trail-riding, touring, swimming, metal-detecting, gold-panning, biking and other things too numerous to mention. We met literally thousands of the most wonderful people in the world. Most importantly, we stayed in love and remained married.

Yes, in spite of my periods of depression, I would say that we have many precious memories. That's the point that I want to make to those of you who struggle with mood disorders. If you take the time to think about it, you will discover that you also can remember some wonderful times (days?) in your lives.

The things you do today create the memories of tomorrow. Make an effort to bless someones life.

[I'm so low I could do a ten minute free-fall off the edge of a dime."]

Bipolar Disorder: Type Two Hypomania

The average person hasn't heard much about Type Two Bipolar Disorder, but there are some significant differences between the two types.

While Type I has a manic phase characterized by extreme behavior, Type II has what is called hypomania, hypo meaning "low." The minimum requirement for diagnosis is four days.

Characteristics

01-Can exhibit any of the behaviors of Type I, but at a "hypo" level.

02-Because of this, it can go undiagnosed by medical professionals and unnoticed by associates of the patient.

03-Sometimes, due to the stepped-up energy, it is seen as a good thing.

04-Irritability

05-Animated speech

06-Increased self-confidence

07-Goal setting, list-making and multiple projects which are often uncompleted

08-Focused on doing research of some type

09-Rapid-fire ideas (many of which are good)

10-Hypomanic episodes can be quite enjoyable to the person experiencing them, therefore there is a tendency to refuse medication or do anything that might stop the episode.

It is important to note that hypomania/Type II disorder typically has a much more severe depressive phase. Persons with Type II Bipolar Disorder are more likely to commit suicide than people with Type I disorder.

During my teen and early adult years, I manifested the manic behaviors of Type I disorder. I required little sleep (sometimes 3 hours), was angry and violent, hypersexual, extremely energetic, and I had difficulty focusing attention and was easily distracted. During that phase of my life I was addicted to alcohol, unable to concentrate on school work, infrequently completed projects, job hopped and very often engaged in risk-taking behaviors.

After age 27 though, my manic phase began to change. I attribute this completely to my becoming a Christian. This new life-style, especially cessation of drinking alcohol, gradually changed the chemistry of my brain. A psychiatrist once told me that this metamorphosis was rare, but that I had obviously undergone a change. In fact, this same psychiatrist said that she believed that I would have been dead by now, if I had not become a Christian. I think she's probably right.

My hypomanic phase is so subtle that it is usually indiscernible by anyone other than my wife. She knows me best. To others I might just seem to be in an extremely good mood and energetic. This subtlety is what makes hypomania difficult to diagnose by any medical professional who doesn't have enough experience with mood disorders.

Many doctors treat only the depression presented and that creates some long-term problems for people who have Bipolar Disorder. If only the depression is treated (with an antidepressant), and no mood-stabilizing medication is added to the regimen, then each depressive phase will be worse than the one preceding. This is what happened to me, and I will discuss this more in my next blog.

May life treat you kindly. Keep your eyes on Jesus.

[I'm so low I could do a ten minute free-fall off the edge of a dime.]

Bipolar Disorder Types One and Two

Many people can remember a lot of discussion some years ago about Manic Depression. In fact, it was a label to "conjure" with. It was spoken of and spoken about as something worse than cancer, diabetes, Parkinsons, Alzheimers, etc., all lumped together. Any one who had Manic Depression was to be feared. They were the really "crazy" people.

There has been some enlightenment since that time. A change in labeling the illness as Bipolar Disorder has helped relieve some of the stigma, and bring about a better understanding of this disease.

There are an estimated 5.7 million American adults who have Bipolar Disorder. They stand somewhat separate from others who have unipolar depression. Bipolar means two extremes. There is the manic (i.e. supercharged) phase and the depressive phase.

People with this disorder swing between feelings of elation and feelings of depression, with somewhat balanced periods in between. That's probably an oversimplification, but it gives us a place to start.

There are two types of Bipolar Disorder (type one & two), with some significant differences. In today's blog, I will attempt to describe the behaviors of the type one illness.

THE MANIC PHASE

01-An unusually high or euphoric mood lasting more than a week.

02-Alternatively, an irritable, angry or impatient mood.

03-Overly critical or complaining.

04-Feeling unusually good about ones self. A belief that ideas, abilities, or plans for changing things are extraordinary or brilliant.

05-Dismissal of others suggestions that anything is wrong.

06-Extremely energetic or alert, even though little or less sleep is needed.

07-A feeling of being special with insights that others fail to have or recognize.

08-Unusually rapid speech.

09-Difficulty focusing attention; distractibility.

10-A markedly increased interest in sex, even with complete strangers.

11-Addiction to alcohol or other drugs.

12-Risktaking behavior. Expensive and/or nonsensical spending, reckless gambling, foolish business ventures, driving too fast, pursuing "on the edge" sports and other life-risking behaviors. They may appear to be fear free.

13-Exhibitionism. Changes in dress, makeup, or appearance to seem more attractive/flamboyant.

14-Restless, driven and agitated.

The above describes the Type 1 manic cycle. In my next blog, I will discuss the hypomanic cycle experienced by those who have Type 2 Bipolar Disorder (which is what I have).

["I'm so low I could do a ten minute free-fall off the edge of a dime."]

Introvert Crash

I've been in a slump for the last two days, primarily because of all the fun I had on Sunday. On that day I went to Bible class, to morning worship, to my wife's office to change clothes, to my part-time job, back home to change clothes, to my friend's farm to entertain a bunch of grade-schoolers, back home to change clothes and on to evening worship. Then back home to "rest."

To an extrovert that sounds like a good day. Lots of action!! Lots of people!! To an introvert like me, it's a recipe for a slump. For years I had noticed that I always had a "Blue Monday," following a Sunday teaching, preaching, counseling, socializing and preaching again.

You would think that for a person who has a depressive disorder, that feeling would be "natural." The odd thing is that this also happened to me when I was feeling really, really good. It wasn't until a year or so ago that I finally had this phenomenon explained to me in a way that made sense.

First, let me explain my lifetime view of my personality. I had always believed that I was "shy" around people and that I wasn't comfortable with being the object of attention. Even though I was a preacher and appeared confident in that role, I still fled to a quiet corner when attending parties or church social events. This is not to say that I wasn't friendly or cordial or attentive toward other people, but I always felt drained after socializing. On Monday, I crashed.

One day, while I was searching for a treasure in a used book store, I found one. I bought and devoured The Introvert Advantage by Psy.D. Marti Olsen Laney. Finally, someone understood and validated my feelings.

Dr. Laney writes, "Introversion is at its root a type of temperament. It is not the same as 'shyness' or having a withdrawn personality. It is also not something that you can change. The strongest distinguishing characteristic of introverts is their energy source: Introverts draw energy from their internal world of ideas, emotions and impressions. They are energy conservers. They can be easily overstimulated by the external world, experiencing the uncomfortable feeling of 'too much.'"

When I read that "They can be easily overstimulated..," I knew that I was on to something. Dr. Laney said, "...they need to limit their social experiences so that they don't get drained. Just being around people can be overstimulating to introverts."

Introverts like to listen more than they like to talk...prefer to share special occasions with just one person or a few close friends...think before they respond or speak...feel anxious about deadlines or pressure to finish something...don't like overstimulating environments (even movies)...feel drained after socializing, even when they enjoy themselves...etc.

I would strongly recommend that both introverts and extroverts read Dr. Laney's book. It is well written, interesting and easily understood. It will absolutely clear up any misconceptions about both personality types.

Not only do I now know myself better, but I also have a greater understanding of my extroverted friends, co-workers and family members.

"Blue Mondays" are natural for me.

["I'm so low that I could do a ten minute free-fall off the edge of a dime." ]

Hug A Veteran!!!

I'm proud to say it. I'm a veteran and I'm from a family of veterans. My father served during WWII, I served in Viet Nam, and my oldest son served during the Gulf War. Even though veterans were encouraged to do so, I didn't wear my ribbons and medals today. I think that I still feel some sadness from the way that service men and women were received during the Viet Nam War. I'm glad to see how America is standing behind its military during the war in Iraq. Again, we will find that some of these vets will be in need of mental health services.

According to the National Alliance On Mental Illness (NAMI), in 2002, more than 700, 000 veterans received mental health services from the VA. I know that there are many who need this medical attention that have not and probably will not get it. Our government, led by President Bush, has made great strides toward removing the stigma of mental illness. This, I believe, will compel Congress to make sure that adequate care is provided for our veterans. This is one area of the budget where there must not be any cutbacks, but increased funds should be made available to the Veterans Administration Hospitals to see that these men and women receive the medical attention that they have earned and deserve.

I would invite every citizen to visit a VA hospital. I have been to three. Most people would be shocked and perhaps shamed to see how broken many of these vets are. Broken. That's the word that frequently comes to my mind whenever I am at one of these facilities. These men and women are often broken in body and sometimes in mind, but they are never broken in spirit. They are proud to have served their country. Most of them, if they had it all to do over, would do it all over again.

I love my country. I love my military brethren. I love the freedom that they have purchased for all of us. God bless America!!

Friends, I hope that you will hold our veterans in high esteem. They deserve to be treated with dignity and respect. Especially when they are broken.

["I'm so low I could do a ten minute free-fall off the edge of a dime."]

Depression: A Sensitive Subject

At this point in time, after struggling with depression for over 42 years, I am able to frankly discuss my illness with anyone who is interested. I'm not sure what it is about my personality that makes that easy for me do. At the same time, I do understand why so many people are unable to be that open.

Our society has placed a stigma on those who experience a mental illness. Fortunately, due to more efforts to educate the public, that is changing. It seems that the people with whom I've talked about these disorders fall into three categories. (1) Those who are ignorant (unknowledgeable) and (2) those who are fearful and (3) those who are compassionate. I've seen many individuals move from the first two categories and into the the third.

The majority of people in the United States (and the world) haven't been given enough information to form a basis for understanding. Consequently, many are fearful of how mental illness might impact their personal world. This results in shunning, criticism, harsh remarks and sometimes abuse being directed toward others who bear the burden of this disease.

That is why some people are reluctant to share their problems openly with others. That is why depression is probably the most untreated illness in America, even though it is often the most treatable. Sufferers are reluctant to discuss this issue with their physicians and their loved ones. Therefore, their health continues to spiral down, and unless their doctor or family is perceptive and asks the right questions, they won't receive the help that they need.

All of us must be willing to face the truth. Depression is a fact of life, just as is high blood-pressure, diabetes, cancer, Alzheimer's disease, Parkinson's, and even death. Therefore, I believe that we need to be as comfortable discussing mental illness as we are any other disease. Probably all of us could move a little closer to understanding and compassion. Don't you agree?

I have a mental illness. And that's an inescapable fact.

["I'm so low, I could do a ten minute free-fall off the edge of a dime."]

Depression Code Phrases and Words

Code Phrases For Depression-I can remember, even as a young man, learning to adopt some of the "code phrases/words" for an explanation of how I felt. This was years before I discovered that there were already clinical descriptions of my illness being used by the medical community. Some of my favorite descriptors for depression were: "I'm so low I could do a 10 minute free-fall off the edge of a dime." "I've been down so long, it looks like up to me." "I'm as low as a snake's belly." And there were others, some of which I've forgotten.

The interesting thing about this period of my life was that I was walking around with full-blown depression and didn't even know it. Millions of people suffer from depression and they are never treated simply because they don't know what their problem truly is. It may well be one of the most under-treated diseases in society.

In my case, I can remember having "black thoughts" and moodiness as early as 15. My best guess is that I probably had a problem before then. This may surprise you, but I was not formally diagnosed as having chronic clinical depression until I was 38 years old. So, for 23 years I didn't receive any help with my illness. Unfortunately, the help I did get worsened the problem.

I want to end today's blog by urging you to read everything that you can get your hands on about depression. You will soon learn that some books are helpful and informative, and some are not. With this illness (and probably any other), you have to remember that Knowledge Is Power. You have to educate yourself because sometimes you will have to educate your medical professional.

["I'm so low, I could do a ten minute freefall off the edge of a dime."]