Chatting With Depression

I like to have short talks with Depression when it is hanging around. We’ve been together for a while so chats are easy.

I can say, “It’s a tough day,” and Depression will usually answer, “I know, but tomorrow will be better.” I capitalize Depression when I’m talking about the one that hangs out with me occasionally.

Often Depression will tell me about others she visits. (I describe her as a she because I prefer that; call yours whatever you wish. Just be respectful. She is when she knows you understand her, or him, or it.)

My Depression knows I want to hear about others who have found the right medications and, when necessary, the correct psychotherapy to go along with it. If they have not, they suffer needlessly in most cases, and Depression’s cousins, named depression, are with them.

The depression family needs to work on its names; I know they are confusing but maybe they will change one day. In the meantime, they have to deal with us, either as “friends” when their name is capitalized or “not friends” when it isn’t.

My Depression and I became buddies when modern antidepressants were invented, in the 1980s I think. Before then I had relied on good psychotherapy but it had its limits. If severe depression moved in, therapy wasn’t enough. It always helped but it couldn’t compete against that awful mood at its worst.

I tried a couple of new antidepressants when they came out, but they had too many side effects. Nonetheless I felt better. I knew something else would come along. And one did; it was Prozac. My dear friend Paddy Bowman likes to tell people, “I knew Bebe before Prozac and after it. After is better.”

Talk about miracle drugs! Prozac made me feel the way I was born to feel. That gave depression enough of a break that I could get to know her better, and she became Depression.

For her, it was a graduation. Most depressions have to start with people who say things like, “I don’t’ like medicine.” Or they may say, “I don’t want to go to doctors.”

If depressions do their best there, and try really hard, they finally get to have a capitalized name and work with people like me who struggled to find help and did. It is a huge accomplishment for them.

And I do know there are people who don’t have depression. They may have other moods that cause them problems, like anxiety or fear. The problems are many, but so are the solutions if people will only look. And anxiety can become Anxiety, etc. And then there are the rare people who were born without troublesome moods. Hooray for them! Talk about good genes.

Back to Prozac. Other people have told me it doesn’t work for them, nor does Effexor. Both of those help me immensely, but each person has a certain chemistry and she or he has to discover which medication will work. I take my medications one at a time, and right now I’m in my Effexor phase.

A warning here for anyone who hasn’t found the correct medicine: you may have to try several before you find the one or more that help. No one said it was easy, but living with depression is far, far worse than having Depression you can talk to.

Another warning: many doctors tend to recommend the antidepressant most recently recommended to them by a visiting drug salesperson. If you see lots of signs about that drug around the office, or lots of signs about other antidepressants, change doctors.

That is a warning it hurts to give. I typically recommend psychiatrists but some of them do the same thing. If you live in a large enough city, ask around for recommendations for a doctor who understands antidepressants. If you do not succeed, prepare to fight with your doctor and do that if you need to. You deserve medication that works.

Now for the part of this post that is hardest to write. I will tell you about depression that could not be stopped, a depression that almost did me in. I call it “killer depression” because I made several suicide attempts when I had it.

I’ll begin with the easiest part. It wasn’t the depression family at work here. I had a benign brain tumor, a meningioma. It was in the left frontal part of my brain, which is where emotions like depression live.

For a long time, I thought that my antidepressants no longer worked. I became sicker and sicker. No psychiatrist could tell me why I wanted to end my life. And I saw several psychiatrists.

Finally I found a psychiatrist who had a good idea about what was going on. He ordered an MRI of my brain in early 2002, when I was in the mental health section of a Mobile, Ala. hospital.

A neurologist who read the scan came into my room to tell me I had a brain tumor. I was terrified by that news but he told me not to worry. It could not possibly have caused the depression that was ruining my life. Not possibly.

I pulled myself together and tried to keep living, but I also tried again and again to kill myself. My blessing was that, as I got crazier, and I got very crazy, my attempts were just as nutty.

Four years later, I was in another psychiatric hospital, this time in Las Vegas. The psychiatrist who was taking care of me then was, and I put this as kindly as possible, incompetent. It never occurred to him to order a brain MRI.

I had disintegrated so badly that he diagnosed me with dementia. Imagine that. Imagine being demented.

I had all the symptoms. I could not put a sentence together. I could not think through a sentence. I could not sit up. I was incontinent. I was hungry and I was dirty.

I was dying.

And I would have died if a neurologist, this time a good one, had not visited me. He said he looked at me and knew I needed a neurosurgeon. He transferred me to a “real” hospital where the tumor was removed.

I woke up as myself. I had my mind and my humor back. It was a miracle, but it should never have happened.

I had to learn to walk again and I had to learn every thing I could about the years I “missed” when I was so ill. I had to try to recreate the life that had slipped by.

But I was Bebe again. I could go back into talks with Depression as I worked my way through what had happened to me.

I will write about this and other problems with my two benign brain tumors again. My second one was removed last year. There were problems with that one, too, but I was not surprised by it.

I do not want you to be surprised if your depression or your anxiety or other emotions that cause you huge problems are not the moods themselves. But start with the moods. Do as I did. Follow each avenue, beginning with doctors. Take medications, even if you have to experiment until you find the right one.

If all else fails, do research on illnesses or disorders that can cause symptoms like yours. Then go to the doctors who treat those.

I have to say that you will probably find that you have a mood disorder. You will survive it and you will survive it happily if you do the things you should.

And I hope that you will not have a major illness. You cannot imagine how much I hope that.

Vestibular Rehabilitation

I went to my neurologist and mentioned that I was occasionally dizzy. He did an in-office test that made me very, very dizzy. As I lay there feeling miserable, he stopped back by the office to tell me I had a vestibular problem.

Embarrassed that I didn't know the word "vestibular," I came home and looked it up. Well, it means "inner ear." Talk about relief. I was sure it was a part of the brain I hadn't heard of, one that would cause worse problems than I and others I've heard about have had. 

Now if you learned "vestibular" when you were five years old, don't tell me. I kept telling myself I should know it, but...

Anyway, now I know it. 

The neurologist told me I would need to see a physical therapist, but first he gave me a prescription to help with the dizziness. If you've been dizzy,you have probably taken Meclizine. It did wonders for me. After a couple of days I felt much better and then I wasn't dizzy at all.

So I swanned into the physical therapist's lab sure that she would give me simple exercises. First she had me do a few things, such as looking at several things by just moving my head with my eyes open.  I could not do it. My eyes went in every direction.

Then she held something in front of me that I was to look at while moving my head. Couldn't do that either. My eyes went on journeys that time, too.

Before long, I was dizzy and nauseated again. So she gave me exercises that were exactly the things that had just made me feel lousy again. This is "vestibular rehabilitation," she said. And she added that I had to do them several times a day.

Since I left her office, I have imagined the minuscule parts of my inner ear running laps and lifting weights. I hope it's working. I'm not doing my routine nearly as frequently as I should.

But I have a few days before I have to go back to her lab again. Surely in that time I'll make up for the time I'm missing now. At least I hope so. I hate for the parts of my inner ear to have to keep up their vigorous exercises. 

They Will Not Take Care of You

Do not kid yourself when you are in a hospital, a rehab center, a nursing home or any similar place: They Will Not Take Care of You.

I have been in hospitals and rehab centers more than once. In each case I thought I would be safe. In most, I was not. There were good staff members but there were also awful ones. The extent you could take care of yourself depended on how sane or coherent you were.

Once I was in a psychiatric hospital. I was horribly depressed. Words could not begin to describe it. I got sicker and sicker and finally the stupid psychiatrist who put me there decided I had full dementia. 

Yes, I know I used the adjective “stupid.”

The staff people there were horrible. As I got worse, so did they. They had treated us with contempt before; as I became helpless, they just ignored me. I am sure they treated other disturbed patients the same way. One nurse had responsibility for an entire floor; the rest of the staff were aides who did not want to deal with sick people.If you did not need the nurse, you did not see her.

Think of that. The aides did not want to deal with sick people. Yes, it was a psychiatric hospital but several people I knew before I became incoherent were also physically sick. 

I would have died from what the psychiatrist called dementia, but I did not have that. In a moment of good fortune, my doctor saw a neurologist walk into the hospital. He asked him to look me over to confirm that I was demented. 

In one of my luckiest moments, the neurologist immediately saw what was wrong with me.  He sent me to a “real” hospital where a neurosurgeon removed a meningioma, a benign tumor, from my brain in an emergency operation. The meningioma had caused the pressure that drove my depression over several years, which ended in dementia-like symptoms.

That episode was not my only encounter with terrible staff people. I was in a rehab center near my home recently after another meningioma operation. For the second time, I had to learn to walk again.

This was an instructive time because when I entered the center I was a bit off-center, to put it mildly. I felt as if I was fine but I did things like falling out of wheel chairs. And, occasionally, I would say things that didn’t make sense.

That gave the hostile aides a chance. I learned quickly how mean they could be. Luckily, I was usually OK and could call them on it. Soon those people avoided my room, and I made friends with the pleasant staff members.

And that was not all I’ve been through. I’ll stop listing specific instances but they have been way too numerous.

Why am I starting this blog with this story? I want to let you all know that you must be aware of what is going on around you. You must be aware of what can happen if you lose the ability to speak up for yourself. You must be sure you have a family member or close friend who will take care of you.

I know that is not always possible, but you must try. And I’ll close with a story that I think makes my point better than anything I’ve lived through.

I have often believed that people with a whole lot of money can buy the best care. That is not always true.

A wealthy friend of mine has a severely demented relative who is in a very expensive nursing facility. I was sure she was getting the best care. But when I spoke with my friend not long ago, he said hated the days he or other relatives couldn’t get there.

He is sure that the woman they love is left wet and possibly unfed if they aren’t present.

I guess the lesson in this is that money certainly helps but it doesn’t guarantee perfection. Very poor people or very rich people may be in settings where they are correctly cared for. The rest of us have to take care of ourselves as well as we can.