Natural Inclinations

I'm cycling through a few thoughts.

Gary and I have had more than a few conversations over the past two weeks.  He's been a source of encouragement when it came to my decision to try an anti-depressant.  And he did remind me that I should be willing to take my own advice.  We joked about how bad my side-effects could actually be in light of his reactions to several medications he has ingested over the past year.  Including, but not limited to, falling asleep due to extreme mood-stabilizer-induced-drowsiness which landed him face-first in his breakfast cereal at the table he shares with the other clients on his ward at Napa State Hospital.  He was practically a narcoleptic there for awhile before the doctors finally wised-up and switched his meds.

One of the guys he befriended on the first ward he entered upon admission was a pyromaniac who went by the nickname 'Raven.'  They were pretty tight there for awhile until Raven's paranoia and jealousy kicked in.  He's the one who threw the hot tea in Gary's face in an effort to burn him.  A most unfortunate cellmate who situated himself on Raven's bad side in prison woke up one morning to find himself wrapped up and set alight.  That landed Raven in the hospital.  Raven has also attempted to turn himself into a human torch more than once.  I can't begin to comprehend the history, brain wiring, and internal pain which shove a man onto such tortuous paths as those.  Recently, Raven landed himself into enough trouble to end up in the local jail, awaiting court and a possible trial for the part he played in injuring a fellow patient.  Gary knew this and felt a bit bummed though he wasn't surprised; he didn't hate the guy . . . just knew he was bad news and incredibly unstable.

So, Gary is in the day room one day.  The local news pops up on the television.  Somewhere between weather and sports is a story about a man housed at the jail after being transferred from the state hospital.  This man had wrapped himself in toilet paper and set himself on fire.  That was all they had.  No more.  No less.  Gary immediately knew it was Raven.  He had employed that identical M.O. on himself before.  It was an unpleasant moment.  These are the types of people in his world.  These intense broken men are his friends, his enemies, his acquaintances, his roommates.  His compassion for them is palpable.  It creates confusion within him as to where to draw clear lines in order to maintain his sanity and safety.

I wonder if it will prove too much for Gary.

In a separate conversation -- or maybe an extension of the same one, how can I ever be sure with the multiplicity of calls between us? -- we hashed over his Tuesday counseling sessions with the 78 year-old psychologist/college professor who so generously agreed to become Gary's one-on-one.  In her role as facilitator and helper, she shares thoughtful stories about herself and folks she has known.  They get Gary's wheels to turning.  Give a little.  Get a little.

She told him of a woman who once worked at the hospital as a psychologist.  Many years ago.  Her mother had been a patient of the hospital; her mother went through pregnancy and delivery at the hospital.  Thus, this psychologist was born to a ward of the State of California.  This was the reason she pursued psychology.  She chose to work there when the opportunity arose in order to give back.  To honor her mother.  To make a difference.  All the many idealized and romantic reasons any zealous greenhorn harbors at the onset of his or her pilgrimage into adult life.

But she found herself in a personal quandary.  The more she delved into her job, the more challenging it became to clearly decipher her place in the pecking order.  Who did she side with?  Where did her loyalties lie?  (Or is that 'lay?'  Michael, are you reading?)  After all, these concrete walls and sterile halls were her first home, her place of origin.  Her knowledge of her own mother created an empathy for all institutionalized patients which blurred the lines when it came to clearcut therapy.  She was a professional who was there to work and assist.  She was also the child of a woman who fell into the ranks of men and women who were trudging through her office on any given day.  Eventually, she felt too compromised to be effective and vacated her position there.

When I heard this woman's story, it stayed with me.  Almost like a haunting, though without the accompanying fear.  Her dilemma fascinated me.  The trajectory of her journey, from birth there to working there, with childhood and schooling sandwiched in between, reflects a purposeful patience I understand.  And she had no guarantee it would all coalesce as she wished in the end.  This, too, I get.  Every other day I remind myself that loving my brother, continuing to be his friend, encouraging him to believe in a future -- none of it ensures a happy ending.  So, I don't approach it with that expectation.  At least not anymore.

Regardless of what lies ahead, I will simply love him because from the moment I knew he was a growing seed in my mother's belly, I was excited for his arrival and I wanted to know everything about him before he came.  I loved him before he ever was a solid thing that I could discern with my five senses.  I loved him without being privy to his future.  Without any expectation that he should please me or fill any need within me.  Because he was a human being, my natural inclination was to love him.

My natural inclination continues to prevail.

Reluctant Victories

Today history is in the making.  I'm mesmerized.  I have a front row seat to monumental government change in Egypt courtesy of our 42-inch Samsung flatscreen and the worn brown leather couch cushioning my fanny.  Without going into great detail and thus exposing the gaping holes in my knowledge of foreign policy in the Middle East, suffice it to say that after weeks of demonstrations by the varied peoples of Egypt at large, President Hosni Mubarek has finally LEFT THE BUILDING!  Left the country!  My curiosity is greatly piqued concerning the repercussions which will be felt around the world.  Especially how the United States will handle the transition of power with an allied country now on the cusp of developing their own democracy.  The role of the Internet, especially Facebook, in this real-life drama cannot be underplayed.  Times . . . they keep a-changin.

And in that vein, this overwhelmed suburbanite is experiencing her own sizable shifts in personal history.  All morning, a blue plastic package, roughly 3x8 inches and a 1/2-inch wide, has held my inner and outer attention.  I pick it up.  Turn it around and around.  Read the label.  Set it back down on the coffee table.  Move on to a chore.  Return to the coffee table.  Repeat . . . without a lather and rinse.  It's been there since yesterday afternoon when I brought it home from the pharmacy.  Where it had been called in as a prescription by my primary care doctor after a follow-up visit for fatigue and related symptoms.  A visit where I ended up connecting dots I've long found creative ways to keep separate.

To be honest, I think I have known for a year that the emotional quicksand bogs of my periods had begun popping up with increasing frequency and their pull on me went from requiring a mountaineering rope to a construction crane!  And the line between PMS and everyday began to blur.  I was -- I am -- investing far too much daily effort to wrest myself free of the sucking pit at my feet.  Well, over my feet, over my knees,  and sometimes higher.  

Factor in the uncommon:  my ongoing struggles with an eating/body image disorder which has dogged me since the impressionable age of 10; the burden I willingly shoulder for my brother as he battles his childhood, drug use, mental illness, and institutionalized thinking;  standing tall in the wake of two major life crises within our nuclear family over the past two years; supporting my youngest sister as she wends her way through psychiatric treatment/recovery and the Colorado court system after the post-partum psychotically enacted deaths of her two children.  

Include the more common life occurrences: your child graduating and moving on to college, responsibilities to volunteer and do your part with church and school and sports, being there for friends and extended family, keeping a household and its finances out of the RED ink.  Shake it all up and pour it into one person's brain.  Somewhere in that challenging and volatile mix, even the most motivated of thinkers, the most principled of prayer-seeking, the most befriended of gals, the most driven of individuals, the most balanced of 'emoters,' (I think you see where I'm going with this) may discover the quicksand is entirely too wide to avoid, too deep to rely upon the regular rescue.  And folks, I'm not the MOST of anything on that list, save for possibly the 'befriended' category.  1 outta 5 ain't bad!

All of that to say this: I'm depressed.  Out of the seven options in 'dictionary.com' for the word DEPRESSED, there are two I would choose to fit my situation.  I'm combining them here.

adj.  sad; dejected; being below the norm

(I also like a segment of the botanical/zoological definition: flattened down)

Though I don't fit the stereotypical profile of clinical depression which most people carry around in their heads -- I don't sleep all day, neglect personal upkeep, shun social interaction -- I do check off on every single symptom, save for suicidal thoughts, on the depression checklist.  The fact that I can write a positive blog or laugh or find beauty in small things or force myself to exercise, get dressed, and generally push through my days, doesn't exclude depression.  Quite the opposite, as I am consciously making myself do each of these things to fight the descent I feel within me.  People rely on me.  God has a plan for me.  I don't want it there.  I reject its presence.  I've tried a host of non-medication assists to root it out.  But what I'm feeling is beyond a "read your Bible more and pray often" approach.  It has surpassed what the benefits of exercise-induced adrenaline offers.  Organic foods and herbal remedies won't touch it.  The power of positive thinking gains only a foothold.  I'm flattened down.

In a nutshell -- I rather like the appearance of the Brazil nut -- I am in turns angry, irritated, upset to the point of crying, sometimes sobbing, more than is healthy for my outlook.  More than is healthy for my kids to witness.  Or for my husband to comfort.  I don't enjoy gardening, cooking, reading or writing with the same passion I once did.  My once sharp edges are dull.  Outside of the iron- and B12-deficient fatigue dragging me down, there is an underlying weariness which constantly tugs at every elemental corner of who I am.  I recognize this dark character as someone I've met in other men and women over my lifetime.  When he gains entry, some folks allow him to unload his furniture and live rent-free while he tears down brightly-painted walls and rips out gorgeous hardwood flooring.  I have no wish to be his landlord.  Instead, I'm hoping to serve final eviction papers.  ASAP! 

SSRI's (selective serotonin reuptake inhibitors) are a specific class of antidepressants which can pick up the slack where personal efforts leave off for people truly seeking a leg UP and OUT of the quicksand.  They work by increasing the brain's level of serotonin -- a hormone which acts as a neurotransmitter and is often considered a 'feed good' chemical.  Think Prozac, Paxil, Luvox, Lexapro, Zoloft, and Celexa.  Prozac was sub-branded several years back as a product called Sarafem and marketed to counter the very real effects of PMDD (pre-menstrual dysphoric disorder).  The actual word, 'seraphim' refers to celestial beings, the highest order of angels, and appears in Isaiah's vision as written in the Old Testament.  I'm not sure what the company was alluding to there though I have actually cried out to the heavens during my more agonizing period episodes and felt the opposite of angelic in the foggy emotion-impaired state preceding these monthly painful interludes!  My little blue plastic box contains the generic version of Celexa.

You know, I tell my brother, "Gary, you have a chemical imbalance in your brain which you can't control.  Take the lithium while you get counseling and gather the tools you need to begin managing your life!" and I believe it.  Beyond all doubt, I know he needs medication.  I've listened to the very real stories of close friends and family members who reached similar points in their own lives, some with obvious triggers and others with no discernible cause, and they were helped by antidepressants.  Combining their use with counseling, exercise, stress reduction, and time, in varying degrees, improved their ability to function outside of the robotic life movements which often accompany moderate depression.  These were not not flawed, weak, or 'crazy' people.  I didn't judge them.  I could appreciate their journey out of a mental and emotional quagmire.

But I am judging myself, as is my habit, afraid I will turn out to be the broken one who can't be repaired. I'm also beating back that lurking fear of medication which kept me from taking something as simple as OTC ibuprofen for labor-like period pains for over a year.  I also realize that by posting this, it leaves me open to criticism and conjecture.  There is yet a mystique associated with an endeavor like this.  My own teenage daughter exclaimed, "Oh my God, what's the matter with you!?" when I told her I was trying an antidepressant.  On the other side of that coin, though, are people who identify with all or part of this cycle.  Maybe this will encourage a fellow sufferer to take the plunge.  Or remind one in the midst of treatment that he or she made the right choice.  Or I'll receive a healthy dose of empathy from one of the many success stories out there who have graduated from 'forcing their way through life' to 'purposefully navigating through life.'  

The reality, however, is painfully clear to me.  Unless I enjoy thick sludgy nastiness flooding my ears, eyes, nose, and throat, I'd better pop the foil on that RDY 343-imprinted Citalopram tablet and chase it back with a full eight ounces of cool filtered water.

Bottoms up.