The storm passed. The huge trees fell beside our house. My angry, blaming depression spent itself in a fury of hard work cutting up the fallen timber, hauling branches into heaps, lifting and shoving back in place every wind-strewn planter and potted tree that had rolled away under the force of a 60 mph north wind. And then for a couple of weeks, the other side of depression emerged, imposing its quieter and more destructive character. I was full of bleak thoughts, hurting inside, carrying around a weight in my chest that was trying to pull me down into some dark lost place in a hidden underworld. My mind stopped working, settled into a fog of slow motion thought where every intention to do anything emerged only dimly in the mist. Life comes close to a standstill.
What can you do in the midst of that fog?
It’s hard to get to step one in thinking about how to fight against it, how to start pulling myself back to the light of day and its energy, focus, action. I can see two different things going on when my mind gets this bad. One is the endlessly repeated insults my mind is pouring out about how wretched and inadequate I am – and there I have the ability to talk back, tell that grim voice to shut up, contradict all the negativity with the awareness that I’m in a phase of illness that will pass. And these CBT-related tools really work. But the mental fog is different. I have found nothing to dispel that. It comes, it goes on its own. A few days ago, I woke up in the morning and realized my mind was alert and alive again, and I was full of energy to do the twenty things I had let slip while down with this illness. So I made the most of it. The next day, I was back in a dense of cloud. I feel completely helpless about maintaining the basic vitality of mental life and energy.
While I haven’t yet found the answer, here are the things I’ve tried:
- Lists I rely on to-do lists and calendars I’ve put in place beforehand to get the minimal things done at work or at home.
- Writing I write down exactly what I’m going through and thinking. At times, this has actually helped me get through the day, as I described in an earlier post.
- Meds-1 At times, the slow-down of mind turns up as a part of the cycle of going through the day. It occurs to me that this problem has gotten worse over time, but when it was confined to just part of the day I used medication. A doctor had me take different stimulants, ranging from generic ritalin to adderall. These are short acting drugs, exactly the kind used for people with Attention Deficit/ Hyperactivity Disorder (ADD and ADHD). That helped for a while.
- Meds – 2 A longer lasting medication-based treatment came later. A different doctor substituted Strattera, a newer drug that addresses dopamine, to be taken with a serotonin/norepinephrine reuptake inhibitor to act on multiple neurotransmitters. Lately, and most effectively, I’ve switched to Emsam, that uses an older class of drug, a monoamine oxidase inhibitor. This acts also on the three key neurotransmitters, but its particular action and delivery system make it much more effective in helping me maintain mental energy and focus.
- Exercise The drugs, though, do not prevent the deepest plunges into the mind-numbing version of depression that is most destructive of my work life. I try vigorous walking and exercise when I can push myself into it. That provides a short-term brightening that I then try to build on.
- Start Simple Tasks This is where my to-do lists and project schedules play a key role. If I can’t think well, I can at least remind myself of exactly what I’m supposed to be doing. I start by tackling the more mechanical tasks first and then force myself to the phone to call someone I need to talk to, make an appointment, schedule a meeting for another day when i just hope I’ll really be able to focus, react to the flow of email, make sure the most urgent things have been done. Then I try to start on the more substantive issues requiring original thinking and strategizing.
- Habits of Mind If I’m lucky, by this time I’m starting to be in the mental groove for working, and the old habits come back. Thank God that key work skills do become habitual – there is always a core of directed action I know has to be set in motion, and it is second nature to follow certain tried and true thought patterns.
So far, that’s the best I can do with this most insidious side of depression.
What have you found effective against this mental shutdown?
Some Right Reserved by Dimitry Kichenco
Re depression: your website is gloriously interesting and fruitful and helpful, in my opinion. [Here follows lateral leap.] If speed [i.e.,going very fast physically] is one of the defining experiences of our age and if haste is its shadow — an analogy is about to arrive — perhaps the capacity of the minds of many men [people] to see reality substantially more comprehensively than ever before is also a unique and defining experiences of our time, with depression its shadow. In any event, I am very interested in depression, for its savage, life-choking presence in my life has been a rotten experience over many years.
My experience of depression includes: decades-long therapy, reading and introspection on the possible causes of this ersistent negative experience of life; sincere and ultimately unsuccessful attempts to ameliorate depression based on insight into its causes; attempts simply to accept it as the challenge that reality [or God] has presented to me; much talk with other depressed people to what I can learn from common denominators and the experience of others. Nothing has worked. Therapy has been very helpful in making me better able to identify my feelings so that I may make better & less impulsive decisions; this has improved my relationships, which is a great gift. However, the search for causes and conditions re depression has seemed to my after much, much experience to be
endless and unproductive because it engages my mind and reactivity in what has been an inherently misguided enterprise, that of creating and recreating “narratives” to explain events of Mind. With enough creativity and without any yardstick to apply to the explanatory narratives, I believe that I can spin yarns and unspin them and spin them again with the same or new threads
to weave fascinating tapestries in the Penelope process that is a glorious but not practically helpful tribute to the imagination.
In the past few years, my attempts to deal with depression have changed based on a reformulation of the problem. For decades I have been telling myself that this is a problem of mind, whereas I now believe, based on experience, that depression is more significantly a physical problem. In other words, my experience forces me to see this as a brain problem, not a mind problem. The reason for this belief: my gradual recognition that certain physical experiences have consistently led to an increase in the subjective experience of optimism and hopefulness. These experiences include [1] strenuous aerobic exercise [pulse at 70% to 80% of theoretical maximum] with sprints to push pulse higher at intervals, and [2] intense zazen or Zen meditation. Exercise is primarily in spinning classes and also the use of the Schwinn Airdyne ergometer. Classes help me to achieve consistency of compliance, which is the principal problem of exercise-based treatment of depression. Zazen is also difficult to do consistently & I find it much more likely that I will find reasons to avoid it. However, I have found that retreats at Zen Mountain Monastery in NY state are spectacularly helpful. Results from the combination of the two treatments have been persistently better than the results of insight via therapy or of
medications.
This physical approach might sound Philistine or superficial to some, but it does at least recognize that depression is by definition a distortion of cognition, making my analyses of the experience, even those aided by third-parties, inherently untrustworthy. Moreover, this approach explicitly rejects the notion that the suffering involved in depression is somehow
noble or that it provides special insight; this notion I now reject as erroneous thinking caused by the inborn human need to find teleological processes that lead to good or desirable outcomes. So be it.
The most interesting [to me] dimension of your experience as captured in your website is the connection between depression and imagination. My experience has been that I become what I consistently think about, helps me to understanding the cascading of depression and negative thoughts. This is, for me and sadly, not a skillful use of creative imagination; better is the creation of imagined & practicable states of being toward which I can move. These imaginings arise for me from nowhere, in the sense that they come not from abstract theories of what should be but from physical experiences of not consciously constructing interpretative frames of reference.
Which I forgot to add [getting into public interaction]is crucial to prevent complete shut down for myself. It is an enormous effort to do.Sometimes, it takes me all day to get out to a store, once I’m out with people around me, I tend to feel better [normal for lack of a better word].
I imagine taking the helmet off of my head. When I do, I am also leaving the house, going to places where “it feels normal”. Often feeling misplaced or strange, and realizing we probably all do. It’s a forced effort, and all I can say, is if we surface out into public and appear to others as normal, somehow we believe it ourselves.
It might sound cliche but for me I’ve always relied on music to try and drown out the negative thoughts. At my worst I couldn’t work, my creativity was shot into a million pieces, and seeing as that had been my saving grace I had to find something else. Reading was never any good for me as my mind would wander away from the page or story, but music seemed to be able to tap into my psyche and bring relief, if only for a short while.
I’m sorry to hear you’re still feeling the black depression – but you’re putting positive steps into action and refusing to let it override you. I hope it passes for you soon.
Best Wishes,
Zathyn