How I fell onto the wagon.

I’m not sure when I started drinking to make myself feel better. I guess I started doing it without really admitting that’s why I was doing it. A social drink with a meal or a beer with a few friends is great, but tossing back a glass of red to make the churning in my stomach go away was something that grew once I realised it actually worked. My burnout had so frightened me, and the anxiety had been so severe for so long, that even when I was in recovery I had a phobia about anxiety. If I felt those butterflies, and the heightened heart rate I would react to it and eventually my go-to was the bottle. After a drink, I felt so much better. I felt calmer, I worried less – heck I practically floated.

There were a couple of downsides I could see though. One was that it slowed me down and some things became harder to do. For example, getting dinner prepared and on the table was slightly harder after a glass of wine or a beer, so I had to go slower. I must admit it was much more enjoyable though.

The other downside was that I worried I was becoming an alcoholic. If I ran out of beer or wine, I was happily drinking port, and if everything ran out, I’d be grabbing the cooking sherry and neat brandy (yucko!). I was starting to keep an eye on stocks at home to make sure I didn’t run out. I started ordering wine by the case and stocking it in the shed. 16 months ago we went away for Christmas and I took the overnight ferry to the mainland with my two boys while my wife and daughter flew across. I smuggled port in an empty juice bottle in my bag, just in case I needed it.

My wife was really concerned with my drinking and she used to ask how many I had consumed for the day. This made me angry. It was my business, not hers. I felt like she was watching me all the time so I was careful to throw the empty’s in the bin so she couldn’t keep track. I think on a couple of occasions I’d cracked a bottle of wine in the shed out the back and from time to time headed out there to toss some back. She used to complain about the smell on my breath.

I didn’t feel good going to the bottleshop on grocery day with the kids in the back seat and emerging with four dozen cans of beer (because they were on special). The kids didn’t seem to like it much either and would ask why I was drinking so much these days. When I first started my “stay-at-home” dad routine, I had the whole day to myself in peace and quiet but my anxiety would grow the closer it came to 3.45pm. At this point, the kids would burst through the door after school like the hungry Mongolian hordes descending the steppes to invade peaceful China. I took to having a drink before they got home, so I would be blissfully calm and welcoming. It was great how the drink enabled me to not get angry about the uneaten lunches, the torn school pants, the drink spilled in the school bag, the forgotten homework, the chaos, the lost school hat, and the usual bickering. At times though, the pre-school-return-invasion drink happened at 11 am. I’m pretty sure the earliest I had a drink to quell the anxiety was about 9am.

I felt a bit ashamed. It was a dirty secret that I drank that early. The only person I told was my psychiatrist. I confessed to her that I was worried about my drinking. I drank every day. She didn’t seem to be worried however, which seemed odd to me. She said that as long as I was drinking less than three drinks a day, and had two days off each week, I wasn’t an alcoholic. Although I wasn’t drinking more than three a day, I was drinking every day. I justified to myself that I was just averaging it out. Did this make me an alcoholic? I reasoned that I could have a day off any day I chose (I’m pretty sure this is what alcoholics think too). Deep down, I knew I was dependent on the drink, but on a surface level I didn’t want to think about it and found it helpful.

Interestingly, my wonderful psych didn’t make an issue of it. She gave me ideas on how to reduce the drinking but was confident that continuing treatment for depression and anxiety would see my alcohol use decrease, and it did. Kind of all by itself. Don’t get me wrong, I still drink – most days. Maybe one, maybe two beers, rarely three unless it’s a dinner party of barbeque. And yes, I still drink if my wife and I have a fight – I find it dulls the pain (resilience is a bit of an issue for me – I crumble easily). But I can go a week without drinking if I’m away, or on a fishing trip for example. I’m paranoid that I’m going to need a drink and be caught short, and I’m certainly not drinking before the kids get home from school so I can handle it better. I think I have a better relationship with the bottle now, where I can enjoy it, without it being my lifesaver.

I feel lucky.

Do you ever get over depression?

I get asked this a bit. Usually by carers of someone with depression, but sometimes from people who are yet to recover. One went something like this.

One thing I am interested in knowing is you don’t talk about having depression anymore, you speak of it as if it were in the past. Do you ever get over it? Are you on medication? I never really asked you about the medication bit and I am leaning towards it because my girlfriend is on Zoloft and she says that she is a changed person.

It’s a good question – one that I’ve thought about for a while (I think it says a lot that I still think about depression). The answer went like this:

I would say I’ve recovered and no longer have depression but I don’t say I’m cured. Basically what I mean is I am not symptomatic anymore and I’m able to do the things I want in life without being impeded by depression.

I do still have a low level of anxiety quite a bit and have a low resistance to sadness so when I’m too busy or haven’t had much self time I tend to get sad. But other than that I’m happy most of the time.

I have changed though, so things aren’t back to the old “normal”. I do things slower. I do less and pace myself more. I am more intentional about self care. My brain doesn’t work as well. But on the upside I’m more patient, understanding, compassionate than before and value simpler things in life because I’m less ambitious. I’m more satisfied and I know myself and accept myself more.

I’m not on antidepressants anymore but they worked really well in controlling my anxiety. They really calmed me down and gave me the space to face my issues. They were important in my recovery. They have their downside (no sex drive and no feeling of happiness either) but on balance I found them useful. They work best for severe depression and anxiety and are line ball for moderate depression and anxiety. My long suffering wife says within 36 hours of me taking it she could talk to me again. Gold!

Recovery is a journey and depression is episodic so I’m not sure I’ll ever be free of it but can still lead a happy,  satisfying and rich life. I don’t regret having it. I only regret coming so close to dying before diagnosis which is why I do the work I’m doing today.

Mindfulness – writing before exams

I’ve mentioned mindfulness a bit in this blog. I don’t practice mindfulness every day in terms of meditation, breathing, body scans etc. But I do try and practice it as a lifestyle. I try and be aware of what I’m experiencing moment to moment, not be too futuristic nor live in the past and to be aware of what’s happening inside me – my thoughts and feelings.

I try and allow my feelings to be and my thoughts to come and go without fusing with them. I try and allow my thoughts and feelings to be the actors on stage while staying in the audience. I experience the drama, but try and refrain from jumping up on stage and being part of the drama. I suppose of verge more toward the ACT (acceptance and commitment therapy) strain of mindfulness than the Buddhist/yoga strain which emphasizes practice (thirty to sixty minutes a day of breathing, sitting etc.) I guess I would really like to do yoga and meditation, but I’m not disciplined enough (I wish I was because there’s no denying the evidence around the changes to the brain that takes place).

Some really interesting research recently came out of Chicago University around the affect of anxiety on performance. Researchers found that students who were prone to test anxiety improved their high–stakes test scores by nearly one grade point after they were given 10 minutes to write about what was causing them fear. Interestingly, researchers showed that it wasn’t just the act of writing that inoculated students against choking; rather, specifically writing about test–related thoughts and feelings had helped.

What they found was that anxiety and stress took up “working memory” – something like RAM in a computer or CPU firepower and decreased performance. Basically this was an exercise in mindfulness. It turns an experience of stress and anxiety, into one of observing the stress and anxiety. Of noticing it, and acknowledging it (by writing it down). How does this work? It re-engages the cognitive left cerebral hemisphere which has been deactivated as brain function has descended into the more primal limbic system where flight, freeze, fight mechanisms have taken over due to the fear, anxiety and stress.

Actions of mindfulness (such as writing) are powerful and practiced consistently can produce a more peaceful, lower stress, richer life experience and the body of evidence continues to grow.

The Return of Anxiety

I’m home alone this morning. I love being alone. No one talks to me. Being a Myers Briggs iNtuitive, my inner world is really important to me. My wife has taken the kids to church. She’s started going again and the kids love it. I think one of the reasons she’s going is because she’s back on antidepressants so she can manage ok. This time she says she’s going to take them daily until she’s better (my fingers are crossed).

I have struggled for a few months with anxiety. I recently did my 09-10 tax and had a blowout. I was threatening to whack the kids and yelling at them. I was in such a state I was reaching for the beer to try and calm down. I’m not sure how long the anxiety has been simmering, but I didn’t become aware of it until June when I organised a mindfulness seminar. After the two day training I felt really anxious. At times I was sucking deep breaths and the knot was back in the stomach. I wondered how a mindfulness seminar could make me anxious, but I realised after a bit that it had just increased my awareness of what was happening inside me.

There was a little bit of denial that was going on too. I wanted to believe that I was better and was fooling myself into ignoring what was happening in my body.

The”why” took me a lot longer to figure out. Work was fine. My home duties were going smoothly. Parenting was all good. I’m still not going to church so there’s some cognitive dissonance still rattling around down there but I don’t think that’s causing any anxiety. Then I realized what it was.

I was getting to a point of hyper-vigilance with my wife. She was erupting on a regular basis and becoming really tense. Seemingly out of the blue she would crack the shits and start riding the kids. While this would make me tense and increase the heartbeat I wouldn’t get involved lest the wrath be turned on me. I figured the kids could absorb it. There were times that I’d chipped in a thought and received a full dose. I even recorded one of them on my iPhone and it’s frightening. So her anxiety, was causing my anxiety. I was walking on egg-shells afraid of her anger and what she could say. It’s not very tough, but if I’m honest, this is what was happening on an emotional level (the brains more primal limbic system) – not a cognitive one.

It’s really odd how she couldn’t see it though. Even a few weeks ago she was insisting that I wasn’t well and that I needed to go back on medication and get treatment. She felt that I was the problem. But somewhere along the line she’s been able to get some space and get in touch with what’s happening inside her and realise that she’s not well. She has used antidepressants before but pops them like Panadol. The problem with this is that it calms her down, but it’s only after an episode of lashing out and spinning out of control which isn’t much good for us. She’s never followed the psych’s recommendation of being on them for a solid period of time while engaging in talking therapy to unpack what’s going on.

But this time she says she’ll do it. So far, so good. And my anxiety has almost all but disappeared. I’m not vigilant or wary of her anymore – which is a good thing in a marriage! I feel in the main part happy again and calm. Now I only feel anxiety in “normal” stressful situations (meeting a tax deadline, running late for an appointment – that sort of thing). I’m still hyper sensitive to stress where I react to the stress and stress about stress, but I’m working on that. As I say, the only way to make a marriage work is if each one owns their own shit.

Antidepressants; to pop or not?

Recently I was invited to speak to a few groups who train people in suicide prevention using a one day course. It’s a brilliant course, one that I completed last year and thoroughly recommend. I generally share my story of depression and having strong suicidal tendencies which led me to research deadly methods to end my life. In the course of conversation afterward the topic of anti-depressants arose and the fact that those under treatment are notorious for not taking their medication. For those of you who’ve cared for someone on medication I’m sure you’ve all asked the question “did you take your meds today?”

Asking that question is a bit like my uncle who as a boy climbed up onto the roof and as his father was passing underneath dropped a brick on him and asked “did that hurt?” It’s going to attract the same kind of response my grandfather had. He hauled the mischievous boy down, gave him a hiding and said “did that hurt?” Be prepared to don a flack jacket and helmet prior to asking the question.

So we got onto talking about why people go off them all the time and in the main it’s basically all about the downsides:

Firstly there’s the stigma. One bloke describe them as “old lady pills” – and even old ladies don’t want to take old lady pills, let alone the rest of us. For someone with depression whose self esteem is scraping rock bottom, the blow of having to take meds is yet another bitter pill to swallow (no pun intended). It took me months to fill the script I had while I struggled to accept that I needed them.

Second I had no feelings on antidepressants. I didn’t feel angry, frustrated, and irritable which was great – but nor did I feel any joy, hope, or happiness either. Interestingly I didn’t even feel fear when I should have (riding a mates Yamaha 450 dirt bike through the scrub at full tilt should have triggered some red lights in my head but it didn’t). I just felt totally calm. It was millpond still inside, but in an uncanny way.

Finally my performance in the sack took a big nose dive – one thing I like to think I was pretty good at (what guy doesn’t?). Now I sucked at that as well. My libido went on holidays and didn’t leave a forwarding address. This is the biggie and this is the one that was raised by the suicide prevention group leader. Everyone she knew who was medicated went off them frequently because they didn’t like having a non-existent sex life. I found that by going off them for 48 hours things worked again, but the crankiness returned pretty quickly and I was back on them again. Still, having my libido back even if it was just visiting was a good thing.

So do I recommend taking antidepressants? It depends. For severe depression it’s highly recommended. That in conjunction with therapy is a proven effective treatment. The meds are like floaties. They’re not the solution, but they do support you while you learn to swim. For moderate depression – maybe. But studies show that talking therapies (in particular CBT or Mindfulness Based CBT which I prefer) work at the same rate of effectiveness. For mild depression meds aren’t recommended. There’s a whole host of things that can help there from exercise to eating well, sleep, recreation etc. that will do wonders. For more on what works for depression, check out beyondblue’s comprehensive publication (clicking this link will download the pdf)

For us, medication was critical. Within 48 hours of starting, my wife said I was totally different and that she could talk to me again and have a normal conversation. Profound peace and calm returned to me and all the aggression and irritability totally dissipated. I was much better to be around. It was the pressure relief valve I needed to give me the breathing space to deal with the issues that had caused me to become so ill.

For you? That’s something that only you can and should work out for yourself.

I’m on some kind of weed – St Johns Wort

I’m assuming St Johns wort is a weed. Why would any plant have the ignominy of being called a wort if it was anything other than a weed? In our country we have a noxious weed called Ragwort and a lot of effort goes into its eradication and control.

But I heard good things about St Johns wort and it’s viability as a treatment for depression, so I thought I’d give it a go. I thought that I’d be a bit of a guinea pig for y’all and let you know my thoughts. I don’t have severe depression anymore, but I still have a few of the symptoms. I get anxiety at times, still lack motivation in certain areas and can’t handle the kids in large doses and generally have limited emotional energy so I still budget it closely.

I haven’t been on prescription medication for about 12 months now. Prior to that I was taking Paroxetine which I found extremely effective. It worked fast (not the 2-4 weeks that doctors recommend), but almost overnight. Its big downside for me was the numbness and loss of libido.

In terms of numbness, I remember visiting a client who has bipolar disorder. He had been off medication for seven months and just run out of food in his house as his disorder had taken over. He resumed his medication that day. I asked how long it would take to kick in and he said in 48 hours, everything inside would go quiet. I hadn’t heard it expressed that way, but I knew exactly what he was saying. On antidepressants it’s like everything goes still, calm and quiet on the inside – numb in other words. The downside of this is you don’t experience any good feelings either – happiness, joy, excitement – meh.

As far as libido goes, I experienced a loss of interest in sex and found that even if I notionally thought it would be a good idea, couldn’t climax when I was on the prescribed amount. It was a little embarrassing like “well dear, I’m about puffed now, and I really don’t think anything’s going to happen, so I’ll be climbing off now”. So that was a big downer. I’m fairly red blooded and still relatively young and never had that happen before. I scrounged through the fine print and yep, there it was.

So back to the wort. I’d heard good things, and it was time to have a go. I’ve been taking it for about a month. I miss a day every now and then out of forgetfulness (I think this is common – if medication is effective and we “feel” ok, we’re likely to forget we have an illness!). I think it is more gentle and mild than the prescription SSRI I was taking, but the modus operandi is similar. It does make things a little more “quiet” and “numb” but not to the same extent as the Paroxetine. I think it has a similar effect on libido, but that’s probably not such a bad thing… it stops me bugging my wife so much.

There are conflicting studies, just as there are with prescription drugs. Many studies show placebos just as effective and prescription drugs, but St Johns Wort is showing to be “as effective” as prescription and more effective than placebos at treating mild or moderate depression (not recommended for severe). All the research just brings me back to my basic philosophy that each individual has to find what works for them. Note – you can’t take prescription anti depressants in conjunction with the wort. There’s loads of info out there, but I think this article from the Black Dog Institute is a good start.

I think I’ll keep taking it for a while. I’ve never been on the weed before, but maybe this is one weed that a little experimentation with may be useful.

Yours truly, the Guinea Pig.

My warped thinking and a little ray of lucidity

Here’s an example of how warped depression can make one’s thinking. I mean suicide is the obvious example, and for me, suicidal thoughts was the thing that actually triggered help seeking. At that point, I realized I couldn’t be ok and started to get help. But the example of crazy thinking that I want to relate today, was a little more subtle, but possibly as deadly.

I remember I used to wish I could get cancer.

See I was stuck in this position that was literally killing me. My ability to get the job done was slipping through my fingers in front of my eyes. The less work I got done, the more behind I got and the pressure ratcheted up. I was stuck in the position because my vocation was my calling, which in my mind was my destiny, therefore there was no plan B. This was it! Being in full time ministry, leading a large church that would grow and impact the region was my life goal. I had no thought of resigning and doing anything else.

In my mind, the only way out was to be too sick to do the job. Ironically, I was already too sick to do the job, I just didn’t know it. So I wished I could contract cancer. The way my messed up mind reasoned it, was that if I had cancer, I could bow out, and go to bed. My wife would stop nagging and criticizing me. The church would leave me alone, except for the well-wishers of course. I could get some sympathy. But best of all, I could stay in bed all day and never come out. Then in a few months I’d be dead and everyone could just move on.

You might think that’s a naive thought. No-one who knows anything about cancer, would want to contract it. But I did. During the time I was ill, a close friend of mine in the church suffered the loss of his wife to cancer. I was the first to arrive minutes after she died. She was emaciated beyond recognition. I had watched her die over the months she had fought the melanoma. Yeah I knew what it was like alright, but I still wanted it. That’s how badly I needed to get out of my situation. The mind really does do some crazy things when depression takes hold.

But in a lucid moment, self doubt crept in and I realized this wasn’t normal. I typed into my browser www.beyondblue.org.au and looked at the checklist and mentally ticked off almost all the signs and symptoms of depression. This was the beginning and the end. The beginning of help seeking and the beginning of the end of my career as I knew it.