Wednesday, October 14, 2015

In defense of antidepressants



The other day I was on a preschool class field trip to the pumpkin patch with Jovie, my nieces Pea and Hazel in tow. While learning about corn and apples and pollination and pumpkins, I watched one of Jovie's classmates who came with her grandfather. He was quiet and had the kindest eyes. He hung back when she raced ahead to walk with her friends, but held her hand when she looked tired or unsure of her surroundings. Every once and a while, a small smile played on his face as he observed the all the children or shepherded his granddaughter around the straw maze. 

The joy he soaked in from this shared time with this small person was evident. Though not loud. Not bells ringing or a tree full of songbirds. It was serene and enveloping – a blanket of snow or the sun on your face in a sweet-smelling field. 

As I pulled away from the orchard, the two of them walking hand in hand in the distance (that tender and steady love) my throat tightened. My eyes burned. I missed my grandfather. My dad. Being little and loved in such a simple way. 

This physical reaction to some unreachable emotional ache was unexpected. 

Two months ago, this was every day. Every day something would happen that would flatten me. Sometimes multiple things would happen. A passive-aggressive comment from a neighbor or that song on the radio or another story about the awful nature of humans. Two months ago I was convinced that the world was the sum total of its ugliness. 

But I've been coming away from that perspective. Slow and steady. 

Last week as the bittersweet tears started forming in my eyes, I was frantic. For a minute anyway. Not again, I thought to myself. I can't be feeling this way again. The fraying of nerves. The fragility. 

I found myself careening down the winding path into the dark woods of my psyche. I would never get out of this place. It was foolish to ever believe I could ever outrun that melancholy.

Then I realized I hadn't taken my antidepressant in a couple days.

And that's when I knew they were working. 

I took a deep breath. And another. I was OK. I am OK.

I am so grateful for this moment. 

Months ago, I knew I was depressed. It was obvious – I'd been there often enough to know. But I was in denial of it. For so long. I kept waiting for it to lift, as my low spells had in years past. They'd hang out for a few days, maybe a week. And then I'd feel more like myself.

This was different though. The longer the fog stayed, the thicker it got. I now understand why it is that people "sink into depression." That's what it feels like. The horse dying in the swamp in "The Never-ending Story." The longer you stay, the longer you'll stay.

In July or August, several months after I realized my mental health was shaky, I was on the phone with my sister and I lost it. I don't even remember what was going on that day, it didn't really matter probably. She heard it in my voice though and suggested it might be time to take care of myself. Go on an antidepressant, talk to a therapist. 

I don't want to go to the doctor, I told her. I don't want to have to call to schedule the appointment and tell the receptionist that I'm seeking treatment for depression. I don't want to have to  explain to the nurse who takes my blood pressure and temperature that the reason I'm in is depression. I don't want to have a conversation with the doctor where I tell them I'm sad and that I've been sad and that I really don't know why. I don't want to cry in front of strangers. Because I know I'll cry.

What's more. I didn't want to be on an antidepressant. Years ago, when I'd taken them they left me drowsy and made me feel slightly removed and disaffected. Like I was living above my life somehow. Not really having an authentic experience.

Laura, of course, understood. But gently pointed out that if I was at the point where I was bawling at the doctor's office. Well, it was definitely time to do something.

She was right. 

Because my depression wasn't just affecting me. I wasn't the only one who was sad because of it. I at wasn't my best for my girls or for Brad. I wasn't even at my mediocre. A family flounders or flourishes depending on their weakest link. I couldn't be the weakest link anymore.

So I made the appointment. And I went to it. And I cried in front of the doctor. Some youngish guy I'd never met before (I'd just switched practices last year). He told me he wanted me to stay on the medication for a year. That sounded like an eternity to me. In the past I lasted a month, maybe, Before I took myself off of them. 

Yeah. Yeah. I know. You're not supposed to do that.

This time I made the commitment to be responsible and give the medication a chance to work like it's supposed to. Not only that, but I was going to go back to yoga and look for off-screen activities that brought me joy – like helping at the farm.

And it's working. I feel more like myself. I laugh more than I cry. My patience has returned. My mood swings are fewer. There's more of an equilibrium between light and dark. The scales more balanced.

I think there is a sense among creative sorts – or anyone who struggles with depression, really – that medication will dampen their creativity or make them less of themselves. Will prevent them from accessing the wells of emotion so critical to art. But the biggest killer to my interest and willingness to engage in right-brained pursuits has been depression. That wall constructed in my psyche. 

Antidepressants have chipped away at that wall. 

I'm not writing fiction again yet. But I'm writing. I'm showing up here, which had been almost painful in previous months. This feels right, so this is where I am. The rest will come in turn.

I'm not immune to feeling as I always worried I would be. I still get goosebumps listening to "Girl in the War" by Josh Ritter. 

In depression all you see is gray and tar black. The colors are returning. 

There was this wonderful post on the On Being blog this week. Sharon Salzberg explores the buddhist concept of dukkha:
"One of the traditional Buddhist illustrations of the term dukkha shows a chariot with an axle that simply doesn’t fit quite right. If the chariot were to move, there would be a rub, a jolt. Maybe nothing dramatic happens as a result; maybe the wheel stays put on the chariot, and all that results from a ride is a bit of discomfort. But the rider’s presumable awareness of the not-quite-rightness shades the experience with a level of discomfort. That is duke...
"...Through my own meditation practice and through teaching, I now know that dukkha, suffering, the sense of dis-ease in our lives — no matter what you want to call it — arrives most achingly not from uncomfortable circumstances but from our reactions to them. Culturally, we are all taught to turn away from pain, to disguise it as if it were disgraceful. Or, if we don’t disguise it, we label it or judge ourselves for feeling it and become the person in the chariot worrying about the effects of the ill-fitting wheel. We feel isolated rather than seeing our pain as part of the human experience." 
Reading this helped me understand that depression begets more depression. I was depressed and so focused on my depression and the pain it was causing that the rest of my life was muted. And I couldn't really define that outlines of the depression and why it was there. What's more, I was ashamed of it. Ashamed that it made me a weaker, indulgent person. But it doesn't really matter about appearances. This is my life. My one life. So I can't spend it like this.

I won't be defined by my ill-fitting wheel. 

A while back I heard this TED Talk by Andrew Solomon on depression – it's a pretty popular one, but worth sharing to understand this ... illness? Disorder? He defends medication (why is it that no matter how many people are on antidepressants right now, it still feels like it needs to be defended? It still feels embarrassing, right? To talk about it? But it shouldn't be.) 

In it, he sums up well this new perspective I'm developing:
"The opposite of depression is not happiness, but vitality, and these days, my life is vital, even on the days when I'm sad. I felt that funeral in my brain, and I sat next to the colossus at the edge of the world, and I have discovered something inside of myself that I would have to call a soul that I had never formulated until that day 20 years ago when hell came to pay me a surprise visit. 
28:37"I think that while I hated being depressed and would hate to be depressed again, I've found a way to love my depression. I love it because it has forced me to find and cling to joy. I love it because each day I decide, sometimes gamely, and sometimes against the moment's reason, to cleave to the reasons for living. And that, I think, is a highly privileged rapture."
In yoga you sink into your poses, allowing your breath and gravity to help you give in and so find more strength. I sunk into depression, and now as I work on standing up up again, I too, feel grateful for the lessons it's taught me as well.

Monday, October 5, 2015

On being small and temporary


I haven't been to church in years. Aside from the occasional wedding or funeral or Christmas mass. 
Growing up I went to mass every Sunday. Early. Seven or 7:30. The parking lot at the later services tended to inspire somewhat less-than-Christian sentiments from Dad. Ditto for the Costco after 10 (you had to get there before the Methodists got out). 
Sunday mornings were about the soapy smell of candles and the acrid scent of Dad's black coffee. The echoing thud of the pew kneelers hitting the floor in a near-empty church. Hymns sung acapella because most of the time the organist didn't get up that early. Cold, hard benches. Squeezing Dad's calloused woodworker's hand during the Lord's Prayer. His kiss on my cheek and a "peace by with you." How I looked forward to those moments with my father. In my mind, he was always so stern and stoic. But on Sunday mornings he was softer. Warmer. He even sang a little. 
I fell away from church in college. Because I was a disenchanted 20-something-year-old Catholic kid. It's kind of what we do. Sometimes I went to a Methodist service with my roommate. It was good to be around regular families. The pastors always spoke to my heart. There was warmth and homeyness there that I rarely observed during Mass and all its ceremony and ritual. Though as time passes I appreciate more ceremony and ritual. It's not terribly original to be an ex-Catholic. But I'm a woman raising two girls who I want to feel empowered and valued and respected and strong. I can't really square being Catholic with all that.
I haven't been to church in years. So I found a new ritual for my Sunday mornings. I wake up and pull on a pair of weathered, holey jeans. Shoes covered in mud and straw. I drive up the interstate, which is deserted, heading north to the farm. To church.
On the way there I listen to NPR. At that hour it's "On Being," perfect for a Sunday mornings designed reflection. Yesterday, the guest was author and anthropologist Mary Catherine Bateson. toward the end of the interview, the host asks Betson to reflect on the question of what it means to be human (you know, a little light conversation for 7:30 ...).
"MS. TIPPETT: Let me ask you this. This large question, what does it mean to be human? Which is a philosophical question, it’s a theological question, and it’s an anthropological question. It’s a question your mother, Margaret Mead, and your father, Gregory Bateson, were asking. I know it’s also a huge question. How would you start to talk about how your sense of that has evolved in the course of this life you’ve lived? Perhaps in ways that have taken you by surprise or not.
DR. BATESON: I was going to give you an excessively intellectual answer about having to do with consciousness. And you made it a much more personal question. Consciousness is important. Reflection is important. Thinking about what you’re doing, and what it means, and the search for meaning. One of the things that I came to believe when I wrote that piece you referred to about my father’s death is that death is a very important part of life that we shouldn’t deny. That in spite of our terrible hubris, and greed, and competitiveness, that we can learn to see ourselves in proportion and realize that we’re small, and temporary. And don’t understand as much as we need to. And we live in a time of real urgency where we have to mine the insights of the past. I guess one way of saying it is we have to learn to use the word “we” to include all of life on earth. We have to learn to experience that as a terrible and tender beauty. And shape everything we do to protect it."
"We have to learn to use the world 'we' to include all the life on earth. We have to learn to experience that as a terrible and tender beauty. And shape everything we do to protect it."

There's no better place to learn to love the creatures great and small than on the farm – a place of endless rituals. Hauling and watering and picking and feeding and coaxing and patting. The feathered congregants are always singing. The pigs often reluctant to emerge from the cozy burrows they've dug under the straw. If they must get up on cool mornings, a back scratch or belly rub is necessary. The hooved devotees are anxious for breakfast. 
I'm empathetic. This is familiar territory.
It's just like when I was a kid. Except I'm left to derive my own homily from the sun rising over the hillside, the way Bear the cow leans into me as I scratch his back, the erratic flock of birds flying and landing and flying away, moved by the invisible rhythms of their clan. 
I am small and temporary. And grateful for the gift of all this life. Grateful to be be conscious of all the wonderful souls surrounding me. Even as the cow tries to steal my feed bucket and the turkeys peck at my ears and dust stings my eyes. 
Life is both terrible and tender. 
That's as it has to be.
My hands are becoming rough like my father's. Like him, I've been baptized in sawdust.
If we go to church to gain a deeper understanding of ourselves and our place in our community – to learn compassion and form connections and find meaning in this whole capricious, predictable endeavor – than this is a cathedral.