Topic: Depression

This is the day I think of as “So Low That Down Is Up” day…the day where there is more darkness than any other day of the year. I’m a light-lover by nature, and so these long cold winter nights are hard on me.

Not only me. I think the majority of us are affected by the darkness. Hope seems thin. It’s hard to get out of bed in the morning. Life feels heavy and it’s just a tougher slog than in the winter than other times of the year. It’s hard to get moving…and the cold makes it even more difficult to talk oneself out of staying on the couch and doing something productive. And on days like today, it just seems that potato chips, chocolate, or ________ (insert high sugar/high fat carb here) would make it all go away for a while. It doesn’t really, but one could convince oneself easily and regularly to be so.

Natural full spectrum light plays an important role in our biology, our neurochemistry. It regulates melatonin, which interacts and affects other substances in our body, which impacts on quality of sleep and energy level. It has been suggested that sunshine in an important nutrient to us.

To that end, people as far north as we are, and as bundled as we are, and as avoidant of the outdoors as many of us can be when it’s cold, many Winnipeggers are impacted by the winter and experience what some might call “the winter blues”.

The sure cure for this is beach time on some tropical beach (preferably with a good book and some sort of drink with one of those little cute umbrellas in it). Alas, that isn’t a feasible option for many of us, and so we’re challenged with coming up with other, albeit less effective, strategies. Natural antidepressants can be helpful…and need to not be underestimated:

• Exercise. Preferably outdoors. Getting moving does good things for our bodies, changes body chemistry by releasing endorphins and regulating all those hormones that can shape mood. Regular exercise is great for those winter blues.
  
• Good Food Choices. High fat and food with simple sugars create a quick lift…and then a quick crash as our body swings with the quick digestion. Food with more complex carbohydrates with fibre and foods high in protein facilitate a longer “burn” evening out blood sugar levels.
  
• Human Connection. We are created to be social beings, and having meaningful relationships, and getting together with others in positive ways has the same effect on our brains as antidepressant medication. Call a friend. Go for coffee.
  

Heck…go for a brisk walk outside with a friend/cousin/co-worker, with a high fibre bar and get’em all done at once. ;)

Sure…I know I’m preaching to the choir here…the above is no surprise to the vast majority of Joe Q. Public who knows these things. But actually implementing them, when the chocolate chip cookies and couch in front of the TV are both calling your name persistently…not so easy. Just like knowing the four food groups doesn’t automatically mean a person eats well. To know something and do something…2 different things.

So…I found a secret weapon…and it’s working well for me. My own little light box:


As I drink my morning tea and deal with my morning emails, I have my new little friend off to the side shining it’s bright rays from the periphery into my eyes for 20 minutes. Within about 3 days, I was able to hear the cookies call my name and say, “No thanx”…within a week, their voices got quieter…and while they still call, “Carolyn, Carolyn”, I am able to decide…and most of the time I say, “no”…and when I say yes, I have one, and enjoy it thoroughly. I’m more regular with getting out to run. I don’t feel as “draggish” during the day. I wouldn’t say that this winter is “easy” for me, but it is definitely a significant improvement over other years.

Twas funny when, the other day, I was complimenting myself to Melanie, marveling at my recently improved ability to stay on top of my paperwork/administration. I often have this cloud of undone things hanging over my head…and I’d been getting at it much better recently. She reminded me of my little but powerful light…and I realized that it had started getting better shortly after I had started using it regularly…a side benefit that I hadn’t counted on or could have predicted. (But I’ll take it!!)

We need to work at creating hope wherever we can. I have “hope” hanging up on my Christmas tree…we as human beings crave hope. Hope gives us reason to move forward. The darkness of today, of this season can put a damper on hope. Many other reasons this season can make hope hard for blog readers, each with their own story. The above strategies don’t make it all better…but they can give some hope to help cope.

The light box is working well for me…I was a skeptic before I tried it, but I was looking for something that would give hope during a season when hope is bleak.


May you find reason to hope this season…a season of hope in the darkness of the winter, maybe in a dark winter of your life. May you find ways of creating hope in creative ways that work for you.

We are hard wired for connection...we need other people in our lives like we need oxygen.

I was listening to CBC several weeks ago, and heard an interview that grabbed me.  I'm a self-admitted CBC geek...tho I don't listen all the time.  I do have a favorite station that plays music (and a junior tribe member who feels self entitled to change it to change it to his station without discussion or consideration of others...one that plays the same 1/2 dozen songs over and over and over again).  Often, when I get in the car, I check to see what show is on, or who is being interviewed and often decide to stick around and listen further.

One evening, on "Q", the author being interviewed was Mazier Bahari, a journalist who was imprisoned in Iran in 2009.  There was a line in his interview that has stuck in my brain since...I went online to relisten to the part I can't get out of my head:

Gian (host): “Most of the 118 days you spent in Evin [prison] you are in solitary confinement. There was a moment when you thought of suicide. Tell me about that?

Mazier: “Well, you know, I spent 107 days in solitary confinement. And sometimes when I tell people that, they ask me, ‘And were you also tortured?’ and that is like if you ask someone who has cancer, “And do you have any other illnesses?” Solitary confinement is the worst kind of torture. Human beings are social animals. Human beings need to communicate, need to be loved, need to touch other people.”

Mazier goes on to describe the mental anguish that comes with solitary confinement, the physical sensations of isolation which are too intense to tolerate, and the thought distortions that creep up as a result of being completely alone....having him contemplate suicide very seriously. 

He didn't kill himself...why?  Because he had an inner conversation with his father...his father talked him out of it.  His father told him that completing suicide would be allowing his captors the victory, and he dare not allow that to happen.  In solitary confinement, it was the deep connection he had with a loved one that allowed him to stay alive...imagining conversation with his dad.

It feels hopeless to live with depression.

Others may think it's not hopeless, but somewhat by definition, a person in the depths of depression feels hopeless.  It feels awful, and it feels like it can never end.

I'm giving a talk on depression in a couple of weeks, and went over some old notes from a while back.  I asked good friends of mine who had depression to let me know a little about what it was like.  To read their words took the wind outta my sails, and stole my breath away. It left me feeling a little desolate and heartbroken to know that although they somehow go through the motions, carrying on through the day, it's not easy for them.  There's a whole world of inner blackness that others may not know about or only guess at.

In 1835, a man visited a doctor in Florence Italy. He was filled with anxiety and exhausted from lack of sleep. He couldn’t eat and he avoided his friends. In other words, he had symptoms that were consistent with depression. The doctor examined him and found that he was in prime physical condition. Concluding his patient needed to have a good time, the physician told him about a circus in town and its star performer, a clown named Grimaldi. Night after night he had the people rolling in the aisles. “you must go and see him, “ the doctor advised. “Grimaldi is the world’s funniest clown He’ll make you laugh and cure your sadness” “no,” replied the despairing man, “he can’t help me. You see, I am Grimaldi”

These are words that my pals used to describe depression.  I'm gonna let these words speak for themselves. Not going to turn it around at the end saying something trite and cheerful and motivating to encourage to people to go for counselling to make it all better.  It's not that easy for most, and I get that. Some of you who are "there" right now might find it meaningful to know that there are others who feel the same as you. 

“Hell” is what I describe depression. Fatigue, not caring about anything, no interest in anything takes over your life, not to mention the physical symptoms. Between both the mental anguish and the physical symptoms, it is easier to die than to keep living in “hell”. It gets so bad that taking a breath is too much effort and death is the only solution that will take away this painful feeling.

I would go through a period of happiness and hope and then move into a period of sadness. At first it was subtle, but then over the years, the dark periods become darker and longer and the happy periods almost nonexistent. It was then that I began to wonder if I was experiencing depression.

In a fog. Sad. Surviving. Pretending. Alone. Isolated. Wanting escape.

 A canvas of moving clouds colored various shades of grey and black. Sometimes the clouds shift and allow some light through, some sun, a shaft of radiance, perhaps its an evening out without working at being pleasant, perhaps it’s the smile of someone, perhaps it’s the sun outside, or a funny movie that has forced the clouds to break. But the clouds return, they shift, sometimes heavier, sometimes lighter. Sometimes tornadoes, downward spirals (thoughts go from bad to worse, and then yet worse, and the the worst is that you actually BELIEVE them), rip through the canvas and create destruction: not one is being responsible, no one cares. I’m carrying the entire world on my shoulders, it gets hard to breathe, there’s heavy pressure on the chest, even the stomach has a knot in it.

This is not the “blues” because with the blues you cry, this is not crying, this is destructive, this is hate, this is madness, this is hating what you love and loving what you hate. This could only come from hell itself.

In some ways I feel cut off from God. I would usually wake up early, go downstairs and spend time crying out to God, asking him to help me experience his love and peace. I cam to rely on God in a way I never had before. Sometimes I wondered if this dependence was really faith or just a crutch I needed because I was such a loser.

"There is a deep hole in your being, like an abyss.  You will never succeed in filling that hole, because your needs are inexhaustible.  You have to work around it so that gradually the abyss closes.
Since the hole is so enormous and your anguish so deep, you will always be tempted to flee from it.  There are two extremes to avoid:  being completely absorbed in your pain and being distracted by so many things that you stay far away from the wound you want to heal."

Henri J. M. Nouwen
The Inner Voice of Love

Sometimes, following your gut instinct is NOT the way to go.

Now I realize that might sound heretical for a therapist to say...so much of the work we do is have people work to discover what is going on inside of them, and to trust that and act on it.

Mostly, that is of benefit.

But sometimes, all we can hear is a part of ourselves that is scared or angry and that actually isn’t our deepest “gut” talking, but rather an anxious part that hijacks us and masquerades as a “gut feeling”. We get fooled by that, and if not self-aware can get sucked into doing something that is exactly the opposite of what is good for us.

I was reminded of this the other day as I found myself going through my pictures from summer. And I came across the following photos, taken at the edge of downtown Vancouver:

A friend of mine kayaks…she went to a week of white water kayaking school for vacation…not my idea of fun, but it was hers.

She talked about the various skills she was taught. The skill she had most trouble with was uprighting herself when the kayak turned over. Capsizing a kayak is not a big deal once you know this skill…and white water rafting requires this skills because of how the water currents can toss a person upside down. Time after time, as the instructor tipped her over, she would struggle to flip the kayak upright and fail…she would need to use the prearranged signal that of knocking on the side of the kayak. The instructor would help to release the waterproof skirt, and pull her to the surface so she could breathe again. Then she would get back in the kayak and try again.

She took several days to finally “get it”. The challenge was, she said, to not listen to what her body wanted to do, but to do what her instructor told her to do. Success wasn't achieved until she stopped listening to what her body told her to do, and she did what her body didn't want to do.

See, when you’re underwater upsidedown in a kayak, your brain has one agenda…OXYGEN. Your brain wants your lungs to be able to take a fresh load of air. That’s a really strong drive, that breathing thing, eh? Desperately strong.

So, in one’s priority to get oxygen, the body seeks to have a person’s nose above the water…so as a person is suspended in the kayak under the water, it is a natural drive to twist the body to strain to have your face emerge from the water to breathe.

Only it doesn’t work that way. The more you try to get your face on top of the water, the farther you get from being able to get your face up above the water.

To actually be able to get your face out of the water, to satisfy the insatiable desire to breathe, one must do something completely counterintuitive: you need to temporarily not work towards having your face out of the water.  It will be the last part of the body to emerge out of the water. The trick is to keep your center of gravity low…which means rolling out of the water one vertebrae at a time. Think of it as first bringing out your lower trunk, then middle trunk, then rib cage, then neck, and very lastly, your head. THEN you can breathe.

It took her four days to conquer what her body WANTED to do, to do what her body actually NEEDED to do to survive. When she did what she NEEDED to do, she got to do what her body longed for—breath. It was mind over matter until her body felt the feeling of what it was to do it right and be able to breathe successfully at the end. Once she “got it”, she could do it over and over again.  Her body knew the feeling, and knew how it could get the air it needed.

 I think sometimes our lives are like that:

• A person who finds it excruciatingly hard to get out of bed in the morning, actually does

 And realizes hours later that it would have been worse to stay in bed

• A person who is anxious and concerned and preoccupied knows that exercise is a natural destressor. She fights it—nothing in her wants to bother exercising, but gives in when a friend is at the end of the driveway on the way to the gym and won't drive away without her.

 And she feels great after

• A husband who knows his wife is ticked at him because she thinks he’s not involved enough. He’s so done with disappointing her that he finds excuses to hide out at the computer or the hockey rink (which keeps him from her scowl, but as far as she's concerned further proves her point)…but with the support of his therapist, he turns towards her to hear her pain

And over time they become more connected, and she gets less frustrated.

• A wife who nags her husband to get more involved with the kids, clean up after himself, to remember his mother’s birthday etc. etc. and most of all just really really wants to be noticed by him. The counsellor works with her to understand her pain and, over time, she becomes less demanding as she discovers the underlying source of her pain. She is able to back off

 And he becomes more engaged as he feels less like he has to run away.

Hearing about kayaking was a way for me to learn how clearly that sometimes a person has to not do what feels right but rather, to do what is effective--which may be very different.

Of course, a person needs to use their judgment carefully when doing something other than what their gut says. It takes some thoughtful contemplation to look at what your body is saying to you...making careful choices about if it is coming from a fearful part that is hijacking you, or from the very best core of who you are providing you with some solid truth.  Often the gut can be focused on immediate safety, rather than ultimate effectiveness--check it out

Think about it sometime. Sometime when you're scared and wanting to pull away, pull in, or pull out.

Depression is a condition that many who have "not been there" is difficult to understand.

Henri Nouwen, writes in one of my favorite books, The Inner Voice of Love, a description of his own depression.  It captures feelings and concepts that parallel the descriptions people have described to me.  It hit shortly after he began a time of rest at a L'arche community. Listen in:

Just when all those around me were assuring me they loved, me, cared for me, appreciated me, yes, even admired me, I experienced myself as useless, unloved, and despicable person.  Just when people were putting their arms around me, I saw the endless depth of my human misery and felt that there was nothing worth living for.  Just when I had found a home, I felt absolutely homeless.  Just when I was being praised for my spiritual insights, I felt devoid of faith.  Just when people were thanking me for bringing them closer to God, I felt that God had abandoned me.  It was as if the house I had finally found had no floors.  The anguish completely paralyzed me.  I could no longer sleep. I cried uncontrollably for hours.  I could not be reaching by consoling words or arguments. I no longer had any interest in other people's problems.  I lost all appetite for food and could not appreciate the beauty of music, art, or even nature.  All had become darkness.  Within me there was one long scream coming from a place I didn't know existed...

(page xiv)

The forlorn plaintiveness of the above paragraph strikes me at its very core.  This feeling is something that can't be argued against, rationalized, understood in a logical sense.  It brings an all-consuming-overwhelming-can't-catch-my-breath-I-think-I want-to die kind of pain. 

When one is in the middle of it, it seems almost impossible to believe that it won't always be that way. Nouwen comments that, "the two guides who were given to me did not leave me alone and kept gently moving me from one day to the next, holding on to me as parents hold a wounded child....Thanks to my attentive and caring guides, I was able to take very small steps toward life." (page xvii)

Nouwen's experience resonates with research that states that meaningful relationships are a powerful antidote to recovery from depression.  Powerful connections with others to have conversations to plumb the depths of the pain...to find the place that you didn't know exists (but does) and to know it, has it lose its power.  Over time, colors re-emerge, sounds become brighter, and beauty re-enters.

Depression is painful, incredibly so--too often misunderstood and therefore, minimized by others--which further increases the isolation and alienation of depression. Reaching out to others who are meaningfuly supportive isn't a quick fix, but it is an important first step in the long journey of recover.

Albert Camus, a philosopher, came up with this line. I am quite certain he was never in Winnipeg--and on the surface, the above line is proof of that! ;)

Seriously, I love that line. I came across it as I was going through my file of quotes that I put on the bulletin board in our counselling office. We change the quote every week or so. We don't just put this one up in winter...many of our clients are experiencing a winter of sorts in their lives regardless what time of year they come to see us.

I love the hope in that line...that when things are dark and dreary and cold and stark, it is often possible to see the spark of life inside that even adversity doesn't extinguish. In fact, the tough times help illuminate it--rather like how a candle's light is much more prominent in the darkness.

I love the truth in that line. I have the privilege of walking with clients through the winters of their lives...and the honor of witnessing the discovery of the "invincible summer" deep within. The beauty and warmth that emerges as a person looks beyond the crap and the pain and realizes what they are truly made of, what the core of their being expresses.

It snowed yesterday...may you find summer today.