Friday, September 28, 2007

I Don't Recall

If you were called to testify in a criminal or civil case, your attorney might counsel you to say, "I don't recall." It's a good tactic, if you want to avoid divulging potentially incriminating information, because no one can prove that you do indeed have memory of an event or conversation. Of course, if you do recall and it's proven, then you might find yourself subject to charges of perjury.

I could truly not recall where I parked my car on Tuesday. When I came out of the library, I remembered that I had parked near the side door, but my car wasn't in the space I remembered. I walked up one row and down another and back up the third row. There were only three. I was sure that I had parked on the first row. Now I was beginning to worry that someone had stolen my car. I wondered, though, why anyone would be dumb enough to steal a 2002 Saturn. As I continued my search, I happened to look at my hand, and I saw then that I was holding the keys to my Nissan.

That's when I recalled that I had not driven the Saturn, but had instead driven the Nissan Versa. What a relief!! You say, "Why, everybody has done that." If that was the only problem that I had with my memory, then I wouldn't be concerned. The truth is, I frequently have problems remembering things, like my anniversary, to zip my pants, my supervisor's name. My short-term memory is awful, my intermediate is bad, and my long-term memory is best. I can easily recall how my wife used to serve me coffee in bed when we were newly-weds, even though I'm no longer pampered that way. I can't remember exactly when she stopped loving me, but it was probably within a month or so after we married. Now I have to make my own coffee.

One of the symptoms of depression is difficulty remembering things. You can't remember when your dentist appointment is, so you write it on the calendar, and then you forget to look at the calendar. Did you take your medicine or not? A pill box might help you to keep track of your medications, if only you could remember to put your pills in the box. You might forget to check to see what's in the pill container. You ask, "Did I pay those bills? Did I remember to write the check down in the check book? Did I put a stamp on the envelope?"

As I said, my long-term memory is actually pretty good. I not only remember faces, but I also remember the way people walk, even years later. I remember that I was in Gulfport, Mississippi in 1968 when I first heard Otis Redding sing "Sittin' On The Dock Of The Bay." I haven't forgotten the many stories that my Dad told me as a child. I can recall the teacher who gave me a spanking in the fifth grade. I can name all of the girls I've ever kissed. Both of them.

Sadly and embarrassingly, I forget names. It only takes me about 60 seconds. I do remember a preacher admitting to having the same problem. He might have been depressed. Unfortunately, when his elderly mother would bring him face-to-face with a former acquaintance, she would tell them, "He doesn't remember you." And of course he didn't, so he would stand there with a blazing red face.

The number of things that I forget would bog down Craig's List. Now I know why. According to an article by Daniel Pendick, "Depression leaves few corners of the mind unscathed. Among the more conspicuous of the casualties is memory. Memory is but one of a suite of higher or "executive" brain functions hobbled by depression. In addition to being forgetful, a person suffering from major depression may have trouble initiating tasks, making decisions, planning future actions, or organizing thoughts." To those of us who struggle with chronic depression, all of that sounds distinctly familiar.

Dr. Constantine Lyketsos, director of neuropsychiatry at the Johns Hopkins School of Medicine, explains that due to ongoing depression there is a "loss of coordination between working, short-term, and long-term memory." The forms of memory act as a series of bins. According to Lyketsos, the working memory bin keeps track of events (like eating a cookie) as they happen, but only for a very brief time. An exciting or more important event might be passed from the working memory into the short-term memory bin, where we store memories for minutes or hours. Over time, some items in that bin will be transferred on to the long-term memory, where they will reside for a lifetime.

Dr. Lyketsos states that a depressed person may be too inattentive and unfocused to file passing events into short-term memory. That explains my almost immediate loss of names. He believes that it isn't so much that the depressed person has forgotten, but that the memory was never stored in the first place. There is some scientific evidence, though, that treating depression with medication and/or therapy, can help reduce memory problems.

Therefore, we can safely conclude that a good treatment plan can address many of the difficulties we experience with depression, including poor memory function.

Through the years, my wife has frequently complained about my poor memory, especially when I forget what she said to me or don't remember to complete an important task. My only defense has been to say, "Honey, I just didn't recall."

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

Friday, September 21, 2007

High And Low

Finding a good therapist is a little like finding a good pet. Sometimes, it's "dog-gone" hard. It would be nice if we could just tune in to Dr. Phil everyday, and he would counsel us through the T.V. in our living room, but finding someone that we can work with is just not that easy. Therapists are like auto mechanics, some are skilled and trustworthy, and some are not.

So, how can we find a qualified person to help us adapt to a life of depression? We might begin by understanding the types of therapists that are available.


01-Psychologists-Licensed practicing psychologists are specifically trained in the mind and behavior as well as diagnosis, assessment and treatment of mental, emotional, and behavioral disorders. The treatment provided is often called "talk therapy." **Not all psychologists believe that chronic depression is a result of a chemical imbalance, and they may attempt to persuade you to give up your medication. Ask them for their views on this issue.

02-Social Workers-C.S.W.s usually have earned at least a Master's Degree, and they also receive training in the prevention, diagnosis, and treatment of the above-named disorders. Their goal is to maintain physical, psychological, and social functioning.

03-Psychiatrists prescribe medication. They have the background and experience to understand how the body and the mind as a whole react when psychiatric medication is used to affect brain chemistry. Psychiatrists, as a rule, do not engage in psychotherapy.

04-Marriage and Family Therapists-These counselors have at least a Masters Degree, and have specialized training in the area of family dynamics and therapy.

05-Other mental health professionals might include Certified Counselors, Religious Counselors, and Psychiatric Nurses or Nurse Practitioners.

Locating a good therapist is most likely accomplished (a) through word of mouth, (b) professional referral, (c) church counselors, (d) support groups, or (e) the Yellow Pages. The most reliable sources are friends, family or acquaintances who have actually worked with a particular therapist.

Questions To Ask
01-What is your professional training and degree?

02-How much experience have you had with my particular mood disorder?

03-What theoretical school of thought do you follow?

04-How long are the sessions, and what is the charge per session?

05-Will you accept my insurance? Do you have a payment plan? Are your fees based on a sliding scale?

06-Have you ever been in therapy yourself? For how long?

07-Is it possible to reach you after hours for an emergency?

08-What can I expect from you and what do you expect from me in counseling?

09-How long will I need to be in therapy?

10-Are there other types of treatments for my problem that you would recommend?

11-How do you decide when therapy is done? Are you goal-oriented?

12-Do you take the lead in a session, or do you expect the client to take the lead?

13-Do you tend to focus on what has happened in the past, or on what is happening in the present?

14-What should I do if I feel that therapy is not helping me?

15-Is there a charge for the initial "get-acquainted" counseling session?

Unfortunately, many of us are unable to pay for the type of therapeutic counseling that we need or desire. Personally, that has been a little frustrating to me. I'm sure that I would benefit from therapy, as do almost all people who have chronic mood disorders, but many of us don't have the funds or insurance to get the help we need. This is a frequent complaint among support group members.

If you are able, seek out a qualified therapist who can be another asset in the treatment of your mood disorder. Taking advantage of every resource available is the best approach to controlling and living with depression.

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

Friday, September 14, 2007

Have Some Fun

I've been pretty depressed this week, so I think it's time to have some fun. The following is written by an unknown author, and is an example of my own personal brand of twisted humor.

NOTE: To those of you who are not from the United States, this article is a type of things that make Americans laugh. It is often described as "dry" wit. Its appeal is that it is so outrageous that it is funny. Do not take any of the statements as being meant seriously.

How To Get Ahead In Life

01-As I let go of my feelings of guilt, I am in touch with my inner sociopath.

02-I have the power to channel my imagination into ever-soaring levels of suspicion.

03-I assume full responsibility for my actions, except the ones that are someone else's fault.

04-I no longer need to punish, deceive or compromise myself, unless I want to stay employed.

05-In some cultures, what I do would be considered normal.

06-Having control over myself is almost as good as having control over others.

07-My intuition nearly makes up for my lack of self-judgment.

08-I honor my personality flaws, for without them I would have no personality at all.

09-I need not suffer in silence while I can moan, whimper and complain.

10-As I learn the innermost secrets of people around me, they reward me for my silence.

11-When someone hurts me, I know that a lawsuit is more gratifying than forgiveness.

12-The first step is to say nice things about myself. The second, to do nice things for myself. The third step is to find someone to buy nice things for me.

13-Blessed are the flexible, for they can tie themselves into knots.

14-Only a lack of imagination saves me from immobilizing myself with imaginary fears.

15-I honor and express all facets of my being, regardless of state and local laws.

16-Today I will gladly share my experience and advice, for there are no sweeter words than "I told you so."

17-Just for today, I will not sit in my living room all day in my underwear browsing the web. Instead, I will move my computer into my bedroom.

18-I am learning that criticism is not nearly as effective as sabotage.

19-Becoming aware of my character defects leads me naturally to the next step of blaming my parents.

20-I am willing to make the mistakes if someone else is willing to learn from them.

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

Friday, September 07, 2007

What Comes Naturally

The natural approach to important aspects of their life is important to some people. On August 7, 2007, Jim Bob and Michelle Duggar welcomed their 17th child into this world. The Duggars have become famous for their "natural" approach to birth control. As Irving Berlin might say, they are just doing "what comes naturally."

One of the complaints that some depressives make about treatment is that prescribed medication is just not natural. For a variety of reasons, they object to taking drugs to alleviate their Bipolar Disorder (BPD) or chronic depression symptoms. The argument often offered is that if they used medications created through the science of man, they might become addicted, but if they used "natural" medicants they would not. In their mind, the use of natural substances would be superior to the use of prescribed medications.

I believe that there are a couple of major flaws in that philosophy. First, it is not consistent with the way that most people actually live. When we get a headache, very few of us take Willow Root tea to ease the pain. We go to our medicine cabinet and grab an aspirin, or other "unnatural" pain reliever. Few of us think about natural treatments when we have a stomach ache, or bad cough, or other similar ailments. Even those who disparage man-made medications seldom rush to the health food store for help with their common illnesses.

Secondly, if we consider that God created every element in the world, then it surely follows that everything is "natural." These elements may have been formulated into a medication created by members of the scientific and medical communities, but the ingredients are still made up of substances which naturally occur. Obviously, you can't create something from nothing.

Now, having said that, I do believe that those of us who are depressives should take advantage of everything that might aid in treatment of our illness, including things that are considered to be more "natural." I have long been a fan of orthomolecular psychiatry (study further), which favors the use of nutritional approaches to the treatment of depressive disorders. This community of psychiatrists, though often criticized by other doctors in their field, believe that nutrients are the building blocks for sound physical and mental health. They contend that a natural treatment should be a complementary approach to healing that supports and nourishes the body and brain, helping to counteract the effects of neurotransmitter malfunction.

Deficiencies in diet often lead to needed supplementation with Omega-3 fatty acids(fish oil), Folate, B vitamins, Zinc, Selenium, vitamin C, Choline, Phenylalanine, 5-HTP and Manganese. A holistically trained physician may offer information about alternative treatments, and a nutritionist can be an important resource.

Personally, I'm willing to do whatever it takes to improve my mental health. I would stand on my head, if it would make me feel less depressed. I believe that those of us who have a mood disorder should take advantage of every thing that might possibly help in the treatment of our illness. I would suggest, though, that we always discuss this approach with our primary psychiatric professional. Even vitamins can be taken in toxic doses.

Naturally, I exercise caution in all medical matters.

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