Tuesday, November 30, 2004

Humiliation (the second wave) - losing control

After having mostly recovered from my first bout of depression I was again gaining in confidence in myself and felt that I had overcome most of the humiliation from my first depressive episode. I was still wary about who knew about my depression, because I still felt embarrassed about this information and was not confident that people would treat me fairly, but otherwise I thought I had recovered in that area. This, as it turned out, was only somewhat accurate. I had come to terms with the fact that a person who was depressed in the way that I had been was as incapable of living life productively because of their impaired mental capacities as an athlete would be incapable of competing with impaired physical abilities (eg. a broken leg or other injury). I no longer felt humiliated to be ill which was a relief. It was also fairly easy not to be when I was mostly recovered and had a rapidly progressing career. But as it turned out I had overestimated the extent of my recovery and I was soon facing a major depressive episode again. With little notice I was again stripped of my dignity and suffered awful humiliation from this malevolent and pernicious disease.

On the eve of my second episode of major depression, as on the eve of my first bout of depression, I was getting on top of my life and succeeding in the things I was putting my mind and effort to. I had recently continued my promotion through the company I was working for and now ran a workforce planning and reporting department of 10 people. My home life was going superbly as well as I had recently welcomed the birth of my firstborn daughter into the family.

Just before the depression hit me again I was due to take a couple of weeks leave at the beach with my newly extended family. I was feeling a bit run down at the time but I had been quite busy with work and the new baby that I thought it was nothing out of the ordinary. However, towards the end of the two weeks leave it became apparent that I wasn't being refreshed by the holiday and the first recognisable signs of depression became apparent to me.

On return to work I was determined not to succumb to depression in the way that I had the first time. It was too aware of the symptoms for it to sneak up on me and give me my illness by a thousand cuts. The way I fought to remain at work and involved in life I will tell at another time. Let me simply say that I was wiser for having had depression before and I fought it with every ounce of strength and guile I could possibly muster. Ultimately it was to no avail.

I had been back at work for a few weeks when I was no longer able do my job. During that time I quickly went to the doctors and returned to medication and kept fighting through the symptoms hoping to be stable enough to continue working. However, I was soon so severely debilitated by the disease that I could not even clear out my email inbox and assign routine tasks to my staff. I had no choice but to take time off. All this occured within a few weeks of returning to work. I again sought my doctor to consult on my prognosis. It was too difficult to tell what the likely outcome was to be so I felt I had to let my boss know of my situation and the prospect of having an extended period of illness. And this I did whilst on my first batch of leave. This just gutted me. I was as distraught from confronting the fact of my illness as I was with informing my boss.

In this early phase of my depression my whole world seemed to be on the brink of falling apart so I determined I would fight this situation to the best of my capacity - and so I did. It was not easy. The realisation that I was potentially not fit for work for the long term, the fact that I felt like I was letting down my boss who had put so much faith in me, the fact that I was unable to lead my team of workers through diffuclt phases of transition in my department all ensured that I began to feel like a failure. This was only compounded by me no longer being able to live up to the standards that I expected from my staff in that period. It was a greulling time healthwise, mentally, and emotionally and I was again placed in a vicious fight for the survival of my soul against depression.

After a few trials of work (interspersed with sick leave), and as symptoms worsened, it became apparent that I was not going to be able to return to work full time - but I would not accept this. Throughout this period everybody at work knew that I was ill. It was impossible to hide it. I came into work looking like a living corpse. As far as I was concerned I was going to work for as long as I was able to fight it out. In the end I was fighting an obviously insurmountable battle that through sheer force of will and habit I had not yet relinquished fighting. After about three months of fighting full time work (interspersed with sick leave) I was walking past a meeting room where a colleague of mine was just leaving. He immediately pulled me into the vacated room and told me to go home because it was not worth doing to myself or my family what my illness and work required and that the business would go on without me. Knowing he was right, and really just needing someone to say it was ok to be sick and not work, I took his advice for which I am extremely grateful (some time later I went and thanked this colleague and he told me that while we were talking in that room, apart from looking as green around the gills as could be, I had been leaning up against the wall on an angle so severe he thought I might topple over at anytime - I had absolutely no idea).

I called my boss immediately and informed her I was just far too sick to work. I remained composed on the phone but as soon as my call finished I broke down and cried. I was exhausted from the illness, I was exhausted from the battle, I was exhausted from the worry - I was simply done, I could not go on. My world was imploding in on me and there was nothing more I could do about it except to stand and watch one degradation after another.

During this phase of my health dilemmas my workplace was as accommodating as could be. For another three months they held my position open, reduced my role to half time, and worked on a return to work plan with me. As soon as I raised my hours and role towards full time work I was unable to cope (and I was not all that effective during my part time work either). Things eventually were brought to a head and I resigned without pressure from my workplace. This decision I took in the best interests of myself and my family but ultimately I think it was in the best interest of my workplace as well. They had offered to provide a comparable role on my return to full health but this was perhaps more legal obligation than than benefit for them. I ultimately knew that if my depression was to pass I would find some means to productively employ my talents.

The humiliation I faced during my second episode of depression was more horrid than my first. The above catalogue of incidents is not the half of it but a small selection of the lowlights. The countless meetings with my boss and HR were just as awful. Each time it was a reminder to me that I was incapable of doing my job. I was being carried through one of the many company processes/policies to the letter and I just felt like a uselss passenger. There was meant to be some kind of dignity behind these procedures but I think in reality it is only in form because some things can never reach and deal with human frailty in a satisfactory way.
Apart from the humiliation of facing workplace processess designed to protect me, and an obvoius loss of capacity and prestige, I also had to face what was important to me personally. I had a reputation to lose, financial assets to lose, and a family dependant on me that I kept letting down. As these things were slipping ever further from my grasp there is no way I can properly describe how I felt. What I can say is that the whole of my being and psyche were impacted in an extraordinary way. I felt totally emasculated as a man and, as my health worsened, I felt on the verge of being totally dehumanised - and I think for a portion of time I was because I had lost total control of my life.

Sunday, November 28, 2004

Update - A return to health and looking forward

I haven't given a decent update for a few days so I thought I'd turn my hand to that today. I have begun the second part of my trilogy on humiliation and am about half way through it. I was flagging in my concentration to remember and process the events surrounding the beginning of my second major depressive episode that I needed to give it a break. So I have decided to reflect more easily on what's been happening over the last week.

In many ways it's just been the usual week for me with one exception - its been my best week healthwise since I have come down with this second episode of depression. Whilst I have had more productive weeks when I was still working full time with my depression my health has not been better. I've wisened up as to how I push myself when feeling 'depressed' so that I don't exacerbate my symptoms and due to this policy I have had a very full and busy week but I have also only had two half days where I needed to crash a bit and recouperate. I just paced myself when I was feeling a bit 'depressed'. I honestly can't describe how fantastic it is to feel energetic and alive again.

With this renewed vigour I have been more aggressively considering how my future is to be structured in terms of work and career. I have had good feedback from my existing client based on the work I have done for him so far. He has made his final downpayment on the current contract I have with him (which means I have completely met the financial goals I set for my business to December) and he even asked me to become more involved with his business at a management level as per some of our prior discussions.

I have been writing quite a bit lately as well and have been developing concepts for books and plays that I can publish. In the last couple of weeks I have decided on four children's books that have particular merit in their concept and I am determined to write them over the Christmas break. I have also begun to develop a concept for a play about depression that I think will also have some merit - but I am less certain of this. I have a few friends that I can bounce this idea off and refine or change if necessary. But I am enthused at the possibilities in this area at the moment.

Either way, the question hanging over me at the moment is whether the writing I am doing is a distraction to the management work I have begun or whether it is something I can do alongside it. I am definitely committed to developing a business relationship as far as I can with my existing client and have been considering quite seriously whether I will stop at one client and write or attempt to develop my client base to my business models number of four or five and not write. There is not time in the day to do both well so a decision is definitely pending.

I am getting excited just being able to consider these possibilities again. I am adamant that even if I decide early which way to jump that I won't rush in to it and overwhelm myself so greatly that I will again fall ill. In all this planning I still have to consider my role in the family. I will not extend myself in a way that compromises the stability that is finally being found in my home, a stability that is prevailing even with the depression and its negative impacts.

Thursday, November 25, 2004

Humiliation - the first crescendo

Being a fairly proud and defiant person I had never been prone to feelings of humiliation. If ever I was socially maligned (or abused) as a young adult or teen I would invariably provide the most suitably venomous retort within my command and typically hit the mark with skill and finesse. As I grew into adulthood I would tend to hold my tongue more, hold my head higher, square my shoulders more broadly, and take with dignity the slurs sent my way. Interestingly I noticed that this latter approach had no less impact on any protagonist as the most venomous and hurtful retort of my youth. I think I simply began to figure that any maliciousness or ignorance exhibited by a person (including myself) was a discredit to the proponent moreso than the recipient so I changed my ways.

If I ever committed my own social faux pas, and became conscious of the fact, I would only be satisfied if I had done all in my power to appease the injured - which usually was accepted and done with quickly. I would not be prone to dwell on the matter beyond that and did not shrink back from getting back on with life mindful, but unconcerned, of the former situation. In short, I wasn't quite bullet proof on the matter, but I certainly was not predisposed to travelling through life with a temper of disgrace or shame even if I had done something silly.

So as I began to realise that I had depression, come to terms with its symptoms, and then attempt to understand and allow for the symptoms' impact on my personality and activity, I was completely unready for the feelings (which were more a state of mind, or a distortion of my soul, than an emotion) that soon overpowered me with guilt and shame. It was initially a kind of embarrassment on steroids but it soon degenerated into a feeling of self-abasement and disgrace that encompassed my whole life and being. I felt awful because of the depression and I felt even worse because of the humiliation of my soul and being.

I began to take on a self awareness of embarrassment when I began to have the symptoms of depression and not know what caused them. I was critical on myself about being lazy and undisciplined so that when I was confronted, usually by my wife, on my state of living before I was diagnosed with depression (of which the symptoms involved not moving out of the house more than a couple of times a week, wasting my time on the computer, and a steady disengagement from my social networks) I felt embarrassed about being a bad person and a poor husband and felt embarrassed about simply wasting my life away. Typically I was a driven and productive person so this change of lifestyle impacted me to a fair extent. I think I was saved more embarrassment due to having declining powers of cognition and concentration so that towards the time of diagnosis I was unable to think much about how I was living although I was in a constant state of sever agitation and frustration.

On being diagnosed with depression much of the embarrassment I had felt disappeared pretty quickly. I realised that I was not as 'bad' as I had thought and that there was a real explanation for what was impacting my life. I felt very uncertain about what the immediate future held but I knew what was wrong and that was sufficient for the moment after several months of decline.

After this initial period of embarrassment I again fell into the same state but for another reason. I was being treated with anti-depressants and I wanted to act contrary to my symptoms wherever possible so I started to attending low key social occasions wherever possible (family gatherings and occasionally meeting my most intimate friends only). In doing this I felt extremely awkward. It wasn't a social phobia at all it was just that the depression had so impacted my mind and concentration I was unable to socialise properly with other people and I was reluctant to tell them of my illness. These two factors embarrassed me a good deal. It's hard to say in this period whether it was the illness itself or my reaction to its symptoms that caused the most embarrassment but in some sense it didn't matter as either way I felt dreadful. I had some small feelings of guilt and shame at this time about not being a useful or productive person but this was far less so than the more immediate embarrassment I was feeling at the time.

I still remember quite vividly the first time I went out with other people after I was diagnosed with depression. It was a celebration for mine and my brother’s birthdays (my 29th, his 25th). I had only just been diagnosed with depression about a week before and nobody except my wife and I knew what was going on. I was desperate to cancel and not face my family (besides which I just felt totally dreadful anyway) and only got to the restaurant due to the patient encouragement of my wife. I walked into the restaurant like an invalid. The whole evening seemed to drift by like a dream. I sat in one spot and didn't move all night. I hardly said a word to anybody. I could hardly be less enthused if I had tried and I felt like I was attending my own funeral rather than my birthday. Attempts by family to converse with me were utterly painful for both parties as my mind was still very agitated and the last thing it wanted to do was hold a conversation. At the end of the night I had fudged my way through the evening but that was about all I had successfully done. I felt dreadful because of depression and felt equally awful because I was unable to socialise as normal and I was too embarrassed to tell them about my depression in the first place (as if it was a sign of weakness or something like that).

Soon after this 'party' I returned to my doctors to monitor my progress. He needed to find out more about my family history of mental illness (which certainly didn't make me glow with pride). I now had to tell someone in my family what was going on just to be able to find out what I needed. I chose my father who I knew to be discreet and who hadn't attended my party. He hadn't seen me for several months and was surprised to see me just turn up at his door. Due to the change of expression on my face and the 20kg (44lb) I had added to my weight he hardly recognised me. From memory I just got pretty much straight to the point by telling him I was sick and needed to talk about the history of mental illness in our family. I have hardly felt so degraded as person in my life by confessing my illness at this time. It was a definite low point for me but only continued to decline.

As the relief began to settle from finding out my diagnosis I became more prone to feelings of uselessness, and shame. My medication reduced the agitation of my mind so I had more time to think and reflect on what was happening. I started to feel useless as a person as I was unable to do anything much - and I still believe that this is quite a normal way to feel when looking at what's happening and it was certainly something I was not ready for. It is truly humiliating to a person who is proud and productive and who has a sense of worth in what they are able to do as much as in who they are. And I felt the anguish of this. It was totally humiliating to be asked by someone "how are you today?" because i just felt like crap and was instantly reminded of it. It was totally humiliating having someone ask how uni was going for me or what I was doing at the time because I was doing absolutely nothing and uni was going to the dogs. All these little things that are normal to life had the severest impact on the way I felt about myself and I was more or less in a total state of humiliation until several months later when I had recovered enough to risk taking a job.

I felt that depression was slowly but surely destroying my soul as effectively as it had destroyed the normality of my life at the time. And a key in that process was the building and building of self-degradation and shame that left me in an almost constant state of humiliation.

Humiliation - next time

The upshot of my last post's query has been that I took my meds late and suffered. I was brazenly active again on the Sunday morning and afternoon and only suffered a slow Monday morning. I have been back in the swing all this week - being the real Mr. Mum at home, looking after my daughter, meeting a work deadline, and partying with family and friends over the last two nights (going away party for a mate on Tuesday and a Family birthday party last night). Things are starting to look reasonably optimistic!

Having had good health over much of the last week I am beginning to wonder if I am ever going to be depressed enough again to have enforced time out with little to do but read and write. However I am sure I will push the limit and feel the wrath of this disease some time soon if it doesn't just cycle back and floor me regardlessly.

Since Sunday I have tried to log on here three times to update my blog with reflections on my humiliations in depression but blogger has been out of order at those times. I actually wrote a short entry introducing my humiliating experiences but the blog gremlins despatched of this without a trace. Even today I have been trying to get on for an hour only getting the error message (and I only just thought about writing it in MS word and pasting it later). Oh well, I soon hope to write my trilogy on humiliation as this was a big shock to the system several times throught my depression. I might even try later today when my little girl's sleeping.

Sunday, November 21, 2004

Oooops

I have had to get up so I don't keep my wife awake. Perhaps I did over cook it a bit today? Or it could just mean that I got a little too excited about having such a great day. It could also be because I took my meds about two hours late and the delay has caused this insomnia. Either way ... oooops!

Saturday, November 20, 2004

A normal day (really this time)!

I have finally had a day full of activity without feeling the ill effects of it. Its great to be back (touch wood - *knocking head*). For those who care to know what a full day is it is what I would call something of a normal day if I was healthy. So, my wife was out all day and I took care of my daughter through until tea time. In that time I went and ordered prescription contact lenses, did the grocery shopping, had lunch out at McDonald with my daughter, got home and visited a local garage sale, then did gardening for a couple of hours and went out for a couple of hours in the evening. I finished it off by cooking dinner for my wife (steak and five veg). And I reckon I have done it without burning myself out or winding myself up (ie. hypomanically) - time will tell. It feels great to live normally even for one day.

I recently received some feedback from a mate regarding how bleak this blog was at times and they weren't at all happy. They pointed out that there was hope even in the despair of depression and I should write about that too. Well Rosie - I hope you enjoyed this entry.

I suppose others may feel the same way too so I want to answer the point. While I do wish to show off and celebrate the successes within my battle against depression, and I have done so at every opportunity thus far, I equally wish to communicate the experience of being depressed and the impact it has had on my life and, more importantly, my soul. I feel that this is what I didn't (and perhaps couldn't) understand when I first came down with depression and it was this that impacted me as much as the illness itself. The truth is I barely understood it well at the beginning of the second episode either and so suffered from the illness and in my soul. The point in writing my blog in the way I do (and I do it the way it is on purpose) is to explore and reflect on the impact that depression has had on my life, and my soul, and to perhaps fill a part of the void that others may have in coming to terms with their own depression. As far as I could find out, when it mattered most, there was no resource that directly addressed this for me - or for my loved ones who suffered along with me and perhaps suffered even as much as I did.

If this blog can help me understand better what I've been through it will have served its purpose well enough. If it can help others also to understand their own or their loved ones response to depression then it will have done everything I could have hoped for. Along the way it will look directly at some of the symptoms of depression that I have faced and put that in the context of my life - including the times of hope. But I want most of all for people who read this to understand the deeper impact of depression on my life and my soul - things like enforced unemployment, relationship strain, not getting out of bed, boredom, grief, humiliation, despair, anger, frustration, hate.

As a person I don't particularly like being bleak as it is against my nature. But it is a reality that things can get quite bleak when your world is turned upside down by depression. And it is not only the illness that a depressed person and their family has to deal with it is equally the dramatic effects on lifestyle and it is also the severest of battles to remain in control of your own soul. My experience with depression is that you have to know exactly what you're fighting to fight it well and it is with this in mind I write as I do.

Wednesday, November 17, 2004

Boredom

At the moment the days roll on as previously described. Rested on Sunday. Looked after my daughter and house hold chores on Monday. Took daughter to a birthday party and went out in the late afternoon and evening on Tuesday. Crashed today (Wednesday). I got out of bed at 2.45pm and have taken it easy having only had brunch and watched a video until now.

One of the consequences of this current 'lifestyle', apart from frustration and despondance, is boredom. I am getting better in my mind but there is a lag in my recovery to be able to endure normal activity. So I sit around perfectly conscious in mind, although occasionally a little bit hazy (I write here when it is worse), with a restriction on any activity if I wish to be in control of my active times and moments. I am now experienced enough to sense when I have reached my limit of activity and respond accordingly to this with inactivity. Naturally, this time in my life is fertile ground for boredom.

An otherwise fit body and acute mind being forced to lay inactively is not healthy or welcome and is virtually impossible for me to counteract. I read as often as I can and regularly walk 3-4 times a week for up to an hour at a time. This fills some of my time in a reasonably positive, and potentially helpful, way but this meagre response to inactivity is hardly a panacea for the boredom that is born of my current conditions. So enforced idleness and boredom remains.

It appears that all the ways to remedy my boredom are blocked as they are all necessarily bound closely to productive activity - of which I am hopelessly incapable of sustaining. To increase my activity and ignore my limitations is to act recklessly against my health and family for my short term gratification. So I suffer the boredom and hope that my health recovers sufficiently for me to sweep the idleness away with increased activity. And there have been times, as at the end of August and early September, where I was able to sustain a lifestyle of constant moderate activity and little boredom. But since my mid-September crash I have been unable to regain that level of activity which then busied me sufficiently to ward off that spectre of boredom which haunts me again.

Ongoing boredom is a battle of patience and endurance. It is a battle to ward off those dark thoughts of the soul that still occasionally get the better of me (such as I relayed in my pre-suicidal musings a couple of weeks back). With time on the side of an idle and wandering mind it is easy for it to drift into awful reflections of what your life has become and then with great personal condemnation survey the carnage of your life and loved ones and leap to seemingly obvious self deprecating conclusions. It is both memerising and disheartening to pay it attention yet it so plainly shapes the fabric of each day and week that it is unavoidable to consider your life in anything but this way when idleness is present in such generous measure.

Sunday, November 14, 2004

General update - depression as a cruel taskmaster

"To inflict a suspension of action on a being conscious of posessing the powers of action, and burning for their employment ... to do this, is to invent a torture that might make Phalaris blush for his impotence of cruelty." Charles Robert Maturin

It has been a little while since I have bothered to update this blog so I might just give a brief survey of how things are.

I am recovering steadily but patchily. Wednesday from midday was fairly good. I went out for trivia in the evening and had a good night.

Thursday I was finally able to look after my daughter again for a whole day but suffered in my health as a result of the effort. I was unable to complete the work I anticipated doing for my client and now have to carry over about 3-4 hours for next week. This was perhaps the most disappointing aspect of the day. I was unable to assist my wife on her return home from work by having done some of the chores and I was unable to cook the dinner. Insomnia returned and I didn't get to sleep until about 4pm.

I bounced back on Friday after sleeping in late (~11.30am). My sister dropped by with her two daughters and we had coffee. I went out for lunch and met my pastoral counsellor. This was a great time and very encouraging. It was also my wife's day off from work so I spent some of the afternoon with her working in the garden. I was also well enough to cook dinner for the family that night.

Saturday was a challenge. I had to help my brother in law shift house. I arrived a little late after sleeping in but was still able to do quite a bit to get the shifting done (including organising an impromptu cricket match when things got a little slow). But when I arrived home early in the afternoon I was starting to feel a little burnt out from the last day and a half's activity. I slowly drifted downhill to a mini crash and was unable to accompany the family when they went out to church at 6pm. I lay in bed for about four hours half snoozing, half reading, and recovered my enrgy enough to make a late dinner after 9pm. Sleep was getting back to near normal.

And so it goes with my life today. I am reluctantly taking a semi-enforced rest. I actually feel well enough to do things but I don't think I would cope with doing them. What I mean is that I am caught in a vicious circle because of my health. As soon as I feel well I want to be active. As soon as I get active (which is hardly very active at all) I crash. I do virtually nothing and begin to feel ok again. So I get active again and crash, and so on, hoping always to be spiralling upwards and out of this vicious depressive circle.

This is the pattern of my life at the moment. The medication I am on underpins me to a certain extent but I still have to carefully manage my level of activity. Some days my health is a little more amenable to activity than others and I need to adjust accordingly. But this is not always possible given certain commitments to my family and to my work. So I plan for both activity and recovery - its a science and burden in itself. Ultimately depression is a cruel taskmaster as much as it is a cruel affliction.


Wednesday, November 10, 2004

Out on the town

Typically I am not the sort of person to spend much time in bars and clubs but there was a period in the middle of my five years of depression where if you wanted to find me of an evening, or early morning, the best chance of doing so was at the local bar or club. Traditionally, I did socialise a little at uni, after work, or with friends occasionally but I had a strong family life and was involved in local community and church groups (note: I had ceased to participate in these on becoming depressed). For a few years I did not even drink alcohol as I took a leadership position in my local church and they preffered their leaders not to drink. So I was busy with uni, and some community group involvement as well as my local church, and was very satisfied with my life and I didn't miss the odd wine or beer or nip of scotch as much as I expected.

I am not really sure how my involvement in bar hopping and bionge drinking all started but the following were the prevailing circumstances at that time of my transformation. It was about two years into my first major depressive episode and I had recently come off medication. To counteract any possible negative impacts from going off my medication, and to reverse the impact of gaining about 20kg's (44lbs) while depressed, I decided to supplement my health regime with team sport and joined the local football club. Also by this timeI had changed roles from my job in customer service to a planning and reporting role in the department I was soon to manage. I was well on the way back - or so I thought.

In many ways it was such a relief just to begin living a normal life again. I had always held a part time job and been involved in sport or local clubs as a youth so it was my way of life to be active and involved so closely with people in this way. However, with the resumption of normal life and new social networks, I was primed to spend a lot more time than usual with work colleagues and sporting buddies. Before I knew it I was involved in nearly all the social gatherings at the pubs and clubs that I heard about. I had been so starved of companionship during my first bout of illness that when the opportunities to socialise came along I was always there. At first I was there till 8pm, then 9pm then midnight and eventually it was my regular habit to get home in the early hours of the morning. In many ways I was like a social ship that had gethered up its steam and was not able to stop. I was propelled along as much by my interest to socialise with others as the momentum of being active again. It was partly an addiction to people and activity, partly a reckless streak no longer encumbered with inhibitions I held prior to my illnes, partly a longing to maximise the social aspect of life I had missed while ill, partly a compulsion just to do stuff, and partly a rebound in my brains activity that I was unable to properly manage. It all added up to a new personality of partying hard and long.

This transformation in my character shocked my wife as much as the initial depression. The hope she had on my journey to recovery was soon lost and she was anxious about my recklessness instead of my health. As many as four nights a week I was arriving home in the early hours of the morning without so much as a phonecall. This could not be sustained in a successful marraige and I was eventually brought to my senses about the destructiveness of my behaviour to the marraige after talking to my wife about its impacts (this was quite a dramatic process despite not being conveyed in those terms). I began to seek for and recognise the signs of my recklessness. I placed boundaries on my behaviour and the circumstances I would put myself in. And I eventually scaled down this recklessness in my life and became a worthy man and husband again.

In many ways I want to blame my illness for this episode of my recovery too. If I had never had depression it is highly doubtfuly that my life would have taken this turn. Furthermore I think I legitmately could blame my illness for this turn of events by invoking concepts such as Hypomanic Episodes and using excuses such as alcohol. Whilst I did lack experience in handling my recovery in a completely productive way, and some of these excuses are feasible, the recklessness of my behaviour was not out of my control in the same way as my depression was. To this day, even in my current recovery, I have urges and drives to get carried away recklessly with life just like after my first major depressive episode. But now I am able to monitor my emotions and respond in a positive way.

It is a relief now to be able to resume socialising with friends and former colleagues with my wife's confidence - when my health allows of course. Much has changed in me since that time and I now have the experience to manage the urges and inclinations that would again have me spin recklessly out of control.

And I went to a local bar tonight. It was a trivia night and dinner with former work colleagues. In some ways it was still all about the beer as we went to a bar renound for its own freshly brewed house beer. But I could go there with confidence, at my wife's urging too, and enjoy the time with mates knowing that I was no longer playing with fire but enjoying a normal aspect of life that was once such a danger to me and my family.

Tuesday, November 09, 2004

Work amidst depression

One of the normal aspects of life that has been most impacted by depression is my career. The career I had in an international firm as a manager of a reporting and workforce planning department could not be sustained - not even part time. My workplace attempted to accommodate me with reduced hours until I recovered but I was just too unfit even for that. They also offered to give me extended leave and a comparable job on return to health but to accept that offer would not, I believe, be in mine or my family's best interests (or even the company's). I would still be unable to hold a job with my former employer, even part time, and it has been 12 months since I left them and nearly two years since I came down with my life's second major depressive episode. So after a promising start to my career it soon ended with a bit of a whimper then a thud.

It's interesting, not to mention extremely painful, to learn how far one's identity is caught up in their work. I had been out of work before for short periods of time between jobs but I had never been in the position where it was impossible for me to hold down a job - ie. to acknowledge that I was unemployable! In many ways I was self made and therefore proud of my achievements. I returned to study mature age and fulfilled my dream of holding a job that I didn't dread going to each morning. Humble ambitions I know, but ultimately I wanted to have a challenging job and an enjoyable and well balanced life, and this I had achieved. Anyway, on finally recognising that I was unfit for work, and then resigning from my job, I went through an intense period of anger, resentment, pain, and grief over my own identity and worth in and to the world (ie. within my family and community). Those days were perhaps the darkest of my life. For several months, whilst experiencing a major depressive episode, I was constantly questioning everything that I once took for granted about myself and my life and was facing up to the possibility that my lot in life was being foreshadowed by this immediate experience (the second of its kind). It was a dreadful time. I was extremely miserable, severely agitated, and when I had capacity to feel emotional variety, I was angrier with myself, and the weakness of my body, than I had ever been angry toward anyone or anything in my entire life. It was scary, and I was just as frustrated as I was angry. A couple of times I actually sat in my room and began punching myself in the face stopping only when I reflected that to do that or nothing was equally useless and given I was predisposed to inaction through my depression and that I didn't naturally have any masochistic tendencies the way of inaction prevailed (I have since come to terms with this ordeal and will relate this at another time).

So it was a bold step that I took at the end of June this year to decide that I would start my own business as a personal manager for other small businesses/sole proprietors (I do have an industry of focus where this role makes a lot of sense and is well utilised but I am not confident to reveal that yet). My team of supporters had a mixed reaction, medically it was indavisable, but I figured I had recovered sufficiently to set up the business structure and plan for a beginning of oprations next year. I was still going through constant relapses in my health, which could take me out for a few weeks at a time, but I felt that I was able to concentrate enough to make use of my health downtime by working productively on my PC and online. And so I did.

When I was reasonably well I was able to structure my weeks so that I had a day and a half dedicated to work. My daughter was cared for by family through that time and I was free to spend what usally amounted to between six and eight hours on work each week. On the occasions I was too sick to work, which was about once in every two to three weeks, the rest I obtained from having family members looking after my daughter was keeping me bouyant in my Mr. Mum role for the rest of my week. When able, my work consisted of researching my new industry, networking, business planning, and educating myself through books on relevant topics. It was very low key but I was making strong progress despite some health setbacks.

Soon came some fun. A mutual contact introduced me to a prospective client. My work was now potentially no longer as flexible with my health as I needed it to be but I was determined to see if I could structure any potential work in such a way that it could be flexible. I started fostering my relationship with this potential client and about one month ago we signed a short term contract that will take us through to Christmas. Those of you who have been following this blog will know that this timeframe overlaps with my most recent, and quite serious, health relapse. However, having built a solid relationship with my client before hand, and by providing them with expectations commensurate with my health limitations, I was able to negotiate my health (and my contract responsibilities) in such a way as to be able to perform the necessasry business functions at the necessary times to meet my client's needs. As it turns out I have worked nine hours for my client in the last three to four weeks. And I anticipate another five to six hours will be completed in the next two days now my health is somewhat restored. My client is very happy with my approach to him so far and I was able to ride out a particualrly rough patch in my health through some forethought and planning. My client does not know that I have depression yet. However, before any more permanent or committed relationship has developed I intend to divulge this.

It may not sound like much of an achievement to have worked for nine hours in the last three to four weeks but for me it is a form of bliss, a great satisfaction, and an unlikely goal I have achieved in the midst of my depression. Since mid year I have set up my own business. I have formulated a business plan and model (to accomodate my health) and I have made a successful attempt to execute it so far notwithstanding the setbacks along the way. I have set a modest financial target for my business this year which the completion of my current contract will meet. To me I am totally amazed that a person in my health can manage a form of gainful employment - no matter how modest. I am beginning to think that the opportunities, although unconventional, are there for me to work even if I remain ill with depression for some time yet. One thing for sure is that if I don't have a go I will never know and I refuse to die wondering.

Monday, November 08, 2004

Dickens understood the personal impact of serious illness

I am currently reading Bleak House by Charles Dickens. Mid way through the book I came across the following passage about a serious illness that overcame the main character and I immediately related to it.
  • "I lay ill through several weeks, and the usual tenor of my life became like an old remembrance. But, this was not the effect of time, so much as of the change in all my habits, made by the helplessness and inaction of a sick room. Before I had been confined to it many days, everything else seemed to have retired into a remote distance, where there was little or no separation between the various stages of my life which had been really divided by years. In falling ill, I seemed to have crossed a dark lake, and to have left all my experiences, mingled together by the great distance, on the healthy shore."
I have personally experienced this Dickensian observation of illness on numerous occasions in my serially repetitive major depressive episodes. At times these experiences had lasted months on end but thankfully it is now usually contained to a few weeks and sometimes, mercifully, only a few days.

Dickens also understood the return from illness to strength. I immediately related to a passage on recovery which, unfortunately, I have only partially experienced to date. I hope for the day ahead when the recovery is complete.

  • "By and by, my strength began to be restored. Instead of lying, with so strange a calmness, watching what was done for me, as if it were done for some one else whom I was quietly sorry for, I helped it a little, and so on to a little more and much more, until I became useful to myself, and interested, and attached to life again."
To become useful to myself (and family) again is my hearts desire. And to be fully attached to life again is a yearning I harbour beyond comprehension. What I cannot do in full I now do in part and in part to its utmost. My life is yet a poor shadow of where I long for it to be but it is where all my strength can muster and where all my strength can maintain it.

So my recovery is the walking of a fine line, like walking on the absolute edge of precipice, where a marginally over exuberant effort to be myself and be attached to life again can see me go over the edge and sink back into the depths of the depressive mire of my illness at a moments notice. I hate this disease and what it does to me and my family. But I am fighting and, I believe, slowly winning.

Friday, November 05, 2004

The first time - a story

The haze has gradually lifted over the last couple of days to where my mind is almost as clear as usual again. I spent most of Wednesday in a miserable daze and on Thursday I was back into the swing of looking after my daughter and pushing the limits of activity so as to maintain, but not exacerbate, the remaining haze on my mind. This morning it has been good.

Perhaps a story. It was back in the mid months of 1999 and I was continuing my undergraduate degree in Arts/Science. I had just come off two years of admission to the Dean's Honours list for outstanding academic achievement and was again achieveing well in my academic pursuits ( I don't think I was quite going to have a third successive year on the Dean's Honours list as I picked up a couple of new subjects at second year,but I might have scraped across the line). By this time I had completed my majors in psychology and politics and was picking up the last few subjects I needed to graduate. I did have an offer to complete an Honours year which may have pushed this out by 12 more months but I was not sure that I was going to accept the offer.

I came through my midyear exams quite well and enjoyed the break between semesters. I was at the time the president of a university club as well so the break for me was doubly appreciated. As second semester resumed I noticed that my attendance to lectures and campus was not as often as previous and eventually my attendance stopped alltogether. All I felt was that I couldn't be bothered going to uni and consequently I didn't. During the same time I slowly but surely dropped out of my normal social world and began spending more and more time alone in the house and in front of the computer (playing games, surfing the net, emailing, chat, reading e-books - totally useless stuff). I was also alienating myself more and more from my wife by not paying any attention to her and was essentially a foreigner in our own home.

While my social behaviours were changing dramatically so were my personal habits and state of mind. I ceased being motivated to do anything at all, my mind was always agitated so I was unable to concentrate, emotionally I felt nothing at all - I was neither happy, nor sad, nor angry, just nothing - and I soon ceased the little communication I had maintined. I was in a constant state of agitation, my mind was unable to cope with normal stimuli - someone talking to me became unbearable, I was unable to read, all I could do was lay down and be blank, play basic games on a computer, or watch TV without being able to follow the story. Any interuption to this blankness caused me to react angrily but the worst part of it was I just didn't even feel the anger.

This went on for some weeks and as you can imagine the state of my marraige relationship was at a low. My wife was as isolated as I was and she just saw her life crumbling before her. This was not the man she had married or got to know over the last 6 years and it was unbearable for her. It was also embarassing - who could be told about what was happening and what could be said? Consequently my wife began avoiding her social networks to avoid answering questions about the whereabouts of her husband and the polite 'how's the husband' chit chat.

At the time of my first episode of major depression I had already majored in psychology (and had a minor in beahvioural neuroscience) and was therefore well acquainted with the processes and symptoms of abnormal psychology. Yet I was completely unprepared for, and unaware of, what I was falling into. It was not until 3-4 months after the first significant symptoms began to appear that in a moment of mental respite I considered the possibility that I had depression. I remember speaking to my wife and suggesting the possibility and it resonated with her too (my wife was already working in the health industry and had been exposed to depressed patients). So we went to see my doctor and I was diagnosed with major depression that week.

I remember the peace that occured between my wife and I after we realised what was really happening with me. The marraige was still tough and I still had most of the depressive symptoms, including severe agitation, but we were both able to process what was happening in a completely new way.

Once I had been diagnosed there was a day we decided to spend together as a couple - it was essentially my wife hanging out with a sick guy. It was the weirdest 'date' I had ever been on. We went for a picnic in the hills. To this day I have never felt so week or frail as a man. The torturuous understanding of my crumbling life remained painful but I was able to relax to the extent we finally knew what was going on. My body and brain was absolutley exhausted and I just shuffled around like an octogenerian with a blank but agitated mind that no longer perplexed us with what was occuring. When walking through the park I actually felt like I was walking on the moon and I was so very worn out. My mind too was in as complete a daze as it has ever been and there was my wife with me, the torture of not knowing what was happening gone, walking slowly at the side of a healthy looking invalid.

Throughout the entire experience of falling into depression I had insight into what was occuring. But I just felt guilty about being a lazy and about being a no good husband. I just couldn't understand why I was like that - it was so out of character - but it was how I was and it was awful to live with myself through that time. However, after being diagnosed, I looked at the official dignostic measures for major depression (DSM IV) and it became clear what was happening. The key thing for me was to be reassured that I just wasn't turning into a lazy jack-ass. The truth couldn't have been any more different and the diagnosis helped me see that.

It is interesting to note that the only symptom I did not have throughout this time was "Abnormal morbid thoughts of death (not just fear of dying) or suicide." I will get around to blogging why i think that was the case one day but for now I will leave you with copy of the diagnostic criteria for major depression from the DSM IV manual.

Diagnostic Criteria
A) At least one of the following three abnormal moods which significantly interfered with the person's life:

  1. Abnormal depressed mood most of the day, nearly every day, for at least 2 weeks.
  2. Abnormal loss of all interest and pleasure most of the day, nearly every day, for at least 2 weeks.
  3. If 18 or younger, abnormal irritable mood most of the day, nearly every day, for at least 2 weeks.


B) At least five of the following symptoms have been present during the same 2 week depressed period.

  1. Abnormal depressed mood (or irritable mood if a child or adolescent) [as defined in criterion A].
  2. Abnormal loss of all interest and pleasure [as defined in criterion A2].
  3. Appetite or weight disturbance, either:
    -Abnormal weight loss (when not dieting) or decrease in appetite.
    -Abnormal weight gain or increase in appetite.
  4. Sleep disturbance, either abnormal insomnia or abnormal hypersomnia.
  5. Activity disturbance, either abnormal agitation or abnormal slowing (observable by others).
  6. Abnormal fatigue or loss of energy.
  7. Abnormal self-reproach or inappropriate guilt.
  8. Abnormal poor concentration or indecisiveness.
  9. Abnormal morbid thoughts of death (not just fear of dying) or suicide.

C) The symptoms are not due to a mood-incongruent psychosis.
D) There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode.
E) The symptoms are not due to physical illness, alcohol, medication, or street drugs.
F) The symptoms are not due to normal bereavement.

Tuesday, November 02, 2004

Normalish

The long weekend away was great. It was filled with the normal experiences of a previously normal life. I drove the entire trip, made BBQ's each night (ie. used the grill), went walking, did 'stuff', read books, and was as close to normal as I have been for some time. I was even able to correct the insomnia that has plagued me for the last few months. The relaxed holiday pace sure helped normality endure for five days. On arrival back home the normality lingered for a few hours before being whittled away quite rapidly.

I had agreed to meet a mate shortly after arriving back and review some assignment work of his. At the same time my wife had arranged to head out for the evening and I had to supervise and feed our two year old. No big deal for the newly refreshed right? Well the brain started to freeze over with the tell tale depressive haze about half an hour into the dual tasks of essay and childcare. About an hour in and the brain was cooked (trust me - it does go from freezing to cooked like that).

Shortly after my mate left for home, the toddler was put to bed, and a few deep breaths were had, the mind recovered pretty quickly - but only back to that depressive haze. A few hours on and that's where I remain, in a bit of a haze. I am optimistic that when I wake in the morning I will be ok as long as I don't over do it.

The biggest let down in this cruel reality check was that I couldn't endure being normal in my normal environment. I just hate that my tolerance for normal activity is low if I am to remain feeling normal. Thankfully I am not feeling as frustrated with myself and my weaknesses as I normally would at this point which is a pleasant change. I suppose this has been warded off by the enduring afterglow of five days of near normality, where the only reminders I had of my illness before this evening's disappointments was the need to take my medication regularly and the secret knowledge (or self deception) that I had structured the break with my family to be normal in such a way as to be unobtrusively normalish.