Monday, May 25, 2009

Sketches of Clinical Depression © Megan Snider

But thy strong
Hours indignant work'd their wills,
And beat me down and marr'd and wasted me,
And tho' they could not end me,
left me maim'd
And all I was in ashes.
Upon thy glimmering thresholds,
when the steam
Floats up from those dim fields about the homes
Of happy men that have the power to die,
And grassy barrows of the happier dead.
Release me, and restore me to the ground;
Thou seest all things, thou wilt see my grave:
Thou wilt renew thy beauty morn by morn;
I earth in earth forget these empty courts,
And thee returning on thy silver wheels.
--Tennyson, "Tithonus"

This poem, about an immortal, is immortal. One of Tennyson's absolute masterpieces. It also happens to be a glance behind the black curtain of Depression. It is not intended this way, I am sure. It is an epic recounting of an older tale.

For the sake of documentation, I will release yet another one of my man-created labels for mental illness. I have recurrent Major (Clinical) Depression with Psychotic features. Now, remember what Psychosis is-- it's not a psychopath-- it's a break from reality. This break is caused by panic attacks. But that will be a later entry.

Depression is hard to describe without being too cliche. On the surface it looks like a numbness, a loss of ability and function. This is partly true. Depression seeps so easily into the cracks in your psyche. Depression does have a voice, but it is flat and listless, tired of the eternal life that is too long just as Tithonus decrees.

I recently changed the personal message on my cell phone. It used to be in German because I love the German language. I switched it back to English. When I replayed it, I was shocked by my own voice-- no affect, no rising tone. It was beyond tired; it didn't even sound defeated; it didn't really sound like anything. It sounded like nothing. People with Depression are surrounded by nothing. In one of my poems I wrote the line, "Forever never finding(...)" I think that might be an apt comparison to Depression.

I wanted to put off the Depression blog because I knew it would be difficult to write.

Scientifically speaking, researches have discovered that during depressive episodes, the hippocampus actually shrinks in size from neuron damage. The claim is that with treatment, the normal size will return and everyone will live in a fairytale forever after and so on. Amen. Unfortunately, my Depression is drug-resistant. My brain has been fried by almost every anti-depressant made in the U.S.A.

So, where do you go from there? There exists these thoughts, these issues of wanting to be pulled to the grave or to be put down like a sick animal or to go to sleep and never wake up.

I actually hate the sound of birds chirping in the morning.

Depression is not a facade; it is not put on. If Depression were a mask I had been putting on for all these years, then I would have pulled it off decades ago.

Melancholy is appropriate for a writer, I suppose, to some degree.

Once you scrape past that surface of numbness, you expose the twisted nerves pulsating and on fire with memory, regret, guilt, and even anger.

Perhaps numbness is not quite potent enough of a word-- hopelessness would be much better.
The mentally ill believe the depressed thoughts they have-- all the black scenarios, the threats of harm, and the prospect of a future that stretches out before you as a vast, vast...wasteland.

You learn little tricks to shove your desires away, little techniques to suppress wishes and hopes that you believe can never come to fruition.

On of the most interesting line of a song lyric I heard was in the Goo Goo Doll's song "Name" where he sings, "Don't (sic) it make you sad to know that life is more than who you are?"

If good intentions and will were enough to tame the world wild world in my brain and fulfill my dreams, then I would certainly meet those obligations. Unfortunately, life is made up of strife, struggle, pettiness and put downs. After a while, you no longer want to participate in this stage of actors playing out their roles in life. So you hide in you bed, you stay at home, you neglect your personal appearance, and you basically rot.

Depression is not a matter of "having a stiff upper lip" or "marching on" or "pulling up the bootstraps" or (as the Germans would say), "Kopf Hoch".

There's no way you can fool yourself into being happy when your brain is turned inside out by chemical imbalances. Would you tell a man on his deathbed that hope would restore him to life again? Would you tell him that if he only tried harder, he would be able to survive for many more years? These kind of comments and thoughts trivialize Depression and mental illness. Tithonus, in the poem, begs that the gods take back their gift. Is life a gift? Can you wish it back? Depression certainly makes you want to do so.

Rumination is also a part of depression-- never letting go of those old scars, those old souveniers you always carry with you. Yet again, I must quote a Goo Goo Dolls song that says, "And even though the moment's passed me by, I still can't look away."

I think that is how a lot of depressed people feel. The constant things that hurt us keep on being regurgitated but never truly purged. In this respect, maybe the gift that Tithonus wanted to rid himself of was not immortality, but the memory of mortality.

© Megan Snider

Read Tennyson's epic Tithonus here:

General Discussion and the Haldol Dilemma © Megan Snider

Between the desire
And the spasm
Between the potency
and the existence
Between the essence
And the descent
Falls the Shadow
--Eliot, "The Hollow Men"

I Tiresias, though blind, throbbing between two lives
-- Eliot, "The Wasteland"

I feel like I should issue some sort of retraction for my blog the other day. It is not uncharacteristic of me to share my feelings, it is just uncharacteristic of me to put them on display. Certainly having muscle spasms and tremors wasn't my proudest moment. I still remember lying on the E.R. with my back arched and my hands fixed into little claws, my neck bent back, and my eyes glued in an upward direction; I would not claim that as my most wonderful moment. Then the doctor walks in-- a male-- and says, "Well, Megan?"

I was evaluated by two male doctors, face and body twitching and spasming, with my hair pulled back into a messy ponytail. I'm not sure which hurt worse, imagining what I must have looked like or remembering how those sensations felt.

Muscle pain is quite unique. What I had was muscle rigor, contracting, and stiff muscles. And the pain was quite indescribable. When your muscles clench, it isn't like how they bunch together when your reach for something or move; it was full exertion and rigor of the muscle for countless seconds punctuated by small pauses. My teeth were literally grinding against each other and making noise. I'm still in pain today, but it's alright.

I wanted to share with you that my reaction actually began over the course of hours. When the symptoms became unbearable, I went to my room to hide and wait for it to be over. Things like that don't blow over by themselves, though. I am sure I could have driven myself to the hospital somehow, but I was lucky to have my family take me.

I am writing this as a warning. You see, I had been on Haldol prior to this incident. I was on Haldol previously without Artane for a few days. I always have facial twitches with Haldol, but I couldn't feel them, so I felt it was not too much of a bother. Nothing happened then. But something happened this time. My point is not to write for sympathy. Sympathy is wasteful sometimes and a plea for sympathy is rather pathetic. I am writing because I want someone, maybe just one person, to learn from what's going on in the world of psychiatric "care".

I hesitate to call it "care" because it would be deemed cruelty to administer a drug that causes convulsions and muscle rigidity upon a lab animal, but I suppose it is okay to do this to the mentally ill. We hesitate to carry out cosmetic testing on bunny rabbits, but we'll let kids lick anti-psychotics out of our hands.

Believe me, I'm not anti-drug. I am anti-horrible-side-effect. It's difficult because, as a person with diagnosed illnesses, all I want is to get better. That's all anyone wants. But it seems like no one is sure what to do yet. We know so frighteningly little about the brain. We give things names that we can't even explain.

What I want out of this tiny little room of words is just education and a place where people can communicate without being judged.

My second bout of Haldol was fine. I was actually going to write a blog about how much it seemed to be helping the day I went into convulsions. And, to some degree, Haldol is a good drug. But no one should have to go through that sort of physical pain because some doctors are ill-equipped to treat their patients or too quick to diagnose.

Here's what you should do: the minute you feel ticking to start or little spasms and they have a spark of a tingle to them or hurt a little, start on your way to the hospital. As minutes go by, it gets worse. The doctors will probably shoot you up with Benadryl and then give you a prescription for 25 to 50 milligrams of Benadryl and 5 millagrams of Artane (trihexyphenidyl) to take 3 times a day as needed. I'm asking you that if you take Haldol, keep BOTH Benadryl (regular over-the-counter) AND Artane in your medicine cabinet.

Tardive dyskinesia is defined as repetitive involuntary movement or spasms in response to high dosages of anti-psychotics. Artance states in its drug fact sheet that it only treats tremors and not Tardive dyskinesia. I am unsure where we draw the line between Tardive dyskinesia and muscle rigidity or spasming. I'm not a doctor, but by the time I die I might be.

Does anyone remember the push for Abilify as the new miracle antipsychotic? The new third generation push behind it entailed ad campaigns and colorful Internet banners. You can get Tardive dyskinesia from Abilify. So, I'm wondering where all this "new and safe" hype is coming from.

Oh, I must point out two things before I forget-- the reference from "The Hollow Men" is not about Tardive dyskinesia. (Ha ha.) Also, the quote from "The Wasteland" referring to Tiresias, throbbing between two lives, is an allusion to the fact that he is both male and female. At least, that's how I was taught the poem. The interesting metaphor there is that a lot of people live two lives. If you're mentally ill, you basically have to.

I remember sitting in an office at college with one of the doctors. This doctor had been a good friend of mine and I mentioned that the therapist had mentioned Schizophrenia in my diagnosis and I remember the college professor simply gasping, "Oh, my God!/ Jeez!" or something to that effect. And I remember being disappointed by that reaction. I suppose it was warranted, but the remark burns the existence of stigma in response to mental illness right into the middle of your forehead.

Now, I'm not sure if that is an official diagnosis. No one wants it to be. But, then again, no one wants to have cancer, either. But cancer is treated with kindness. If someone acts silly no one yells, "Hey! What's wrong with you? Do you have cancer?" at him. They yell, "Hey! What's wrong with you? Are you crazy?"

It's unlikely for me to approach writing in a casual way. I think writing is art and should be applied quite carefully. That is why I want to reject my last two blogs. But, on the other hand, they preserve raw emotion and that is just every bit as important as finding the right words.

Modern writing has changed so much with men like Eliot and Cummings that it really is hard to classify anymore. Maybe communication has gone that way, too. Maybe all of our voices are just tiny imitations of what we read and like and think about. And what of Mr. Beckett's contribution to the arts? That's a tough absurdist cookie, right there. A lot of mental illness has to do with trying to communicate what is unspeakable. In a way, the great writers communicated what hurt, sometimes why it hurt, and how to fix it without even making much literal sense at all.

© Megan Snider

Talk about a co-morbidity: That's genius and that's illness.
Read Eliot's "The Hollow Men" here:
(Mr. Kurtz-- he dead...LOLFTWBBQ)
Read Eliot's "The Wasteland" here: