Depression

Disclaimer
I am not a healthcare professional.
I have no training in psychiatry.
This essay is only a personal experience.

For most of my life I have been considered an optimist. 'It will always get better.' 'There is always a solution.' I was secure with myself and what I believed. Most of that came from my P's plus some from a small town environment and some from having polio.

Then the world turned upside down. MS continued to take an increasing toll and family issues seemed to multiply. Finally I had to medically retire losing what I had expected was 30 more years of productivity. For a Type A personality it was a hard blow. The result was depression which is a condition I continue to battle and probably always will.

I know of two type of depression . The first results from events that when combined are more than your defense mechanisms can handle. The second type is chemical depression. I had bouts with both at the same time and sought professional help.

The chemical depression was a surprise. It was a symptom listed when I began BetaSeron but I did not pay much attention. The chemical effects became very clear when smart-butt-me decided to reduce then stop taking my anti-depressant. On the second day that I did not take any, I became Mr. Hyde, completely out of character.

Over something as stupid as the color of bed sheets I came unglued. Screaming, throwing objects, turning over furniture, and finally storming out the door afraid I might harm someone. Within one day of starting the anti-depressant again, I was back to reasonable state of mind.

It was a lesson not to be forgotten. I now take Avenex but not long enough to test the effects of reducing the anti-depressant dosage.

The other type of depression has also taken its toll, especially since I have retired. In this case the feelings are the 'don't give a shit' type or the feeling that nothing you can do will make any difference. This is probably more common in MSer's. In fact, I believe MSer's who do not think they will experience depression at some time, need to consider taking 'Reality Pills'. I believe it is as much of a normal response by an MSer to the disease as breathing is to a runner.

If you are one of those Type A+ people, like me, who thinks they can handle any problem alone, then you are a fool. Depression is a 'real' condition and it will prevent any quality of life. There are factors causing it that you will not see and may never be able to understand. However, it is critical to watch for symptoms then take action, because depression can cause as much damage to your life as MS the disease.


An insider never really knows what causes a problem so I can not list all the factors that lead to my depression. The following are obvious ones found early which probably affect most MSer's. One or two of them can normally be handled but put together (plus additional, deeper ones), they add up to trouble that overloads the neurons in the brain.


What caused my problem? (or what I was thinking)

Guilt
It was my fault that my wife had to do more work. I was the reason that the house did not always look OK. My children couldn't go to private school because I wasn't bring in my normal income. My wife was depressed because I could not give her what she needed. We were not a family unit because I could not participate.

Fear
If I do something I want to do then I will not have the energy to do what is necessary. If I try to be intimate then I will fail and be a disappointment. I will not be able to do a chore and get back home.

Jobless
The measure of a man is his job. I had to leave my job and thus I am less of a man. Since I am not working I have nothing to talk about when I am with others.

Role Reversal
My wife became the primary bread winner. I do not feel that I can ask her to do any more. I can not spend any money because I do not make it. I am not very good at keeping house and she is disappointed in me.


(Note: I am not saying that what I was thinking made any sense.)


Other Medical
I had polio in 1954. Sure it adds to the physical MS problems but it also throws in a mental wrinkle. The normal MS patient, if there is such a thing as normal, must learn how to cope with decreasing abilities, from able to less able. Polio does damage first and the patient learns to cope with finding ways to increase abilities. Polio plus MS moves a person from not able to able back to less able.

Think about it. Since the age of three my mind set has been 'I can do it.' Through young adulthood I had been successfully increasing abilities. Then MS dropped in and now I am going the other way. I am not implying that the struggle by other MSer's is not devastating but it is very hard to mentally accept first reaching a goal (not able to able) then lose all that gain ( back to less able ).



So, with all of this happening you ask, When did you know you were getting depressed? Answer: I didn't know.

I knew that things were not right and that my wife and I were having communication problems. After a seminar for MS couples I realized all the problems were not hers. I had a lot of bottled anger and was showing it in unhealthy ways. I decided to get some answers. The following are some of the symptoms of depression that I was expressing.


Symptoms I showed

I have always had a good sense of humor but I stopped laughing. I felt sorry for myself as if I thought the world was doing me harm. I felt guilty for other people's problems even though I could not do anything about them.

Withdrawal was a major problem. I stopped going out unless I had to and I avoided phone calls because I didn't want to talk with anyone. The hobbies I wanted to do, I never started. I stopped writing even about the things that were bothering me the most.

Since my wife is the closest one to me and thus the most secure person for me to direct anger toward, she received a lot of miss-placed blame. I avoided her and avoided conflicts that could have brought to the surface some of my problems. Our intimacy went into the toilet.

I became moody and short tempered. I could not tolerate the children. I did not want to see my extended family. I still get physically ill when I make plans to visit extended family.

I started kicking the cat, fed ExLax to my dog, and made dirty phone calls to Newt Gingrige.
Bottom line, I did not like myself nor few people around me.



What do you do? GET HELP! This is a condition you can not battle alone. Helpers might include:

Your Significant Other
Your Family
Your Peers
Your Physician
Your Pastor
A local MS Support Group
and even an Online MS Forum

However, to spearhead the battle with you, I recommend a good psychiatrist that you trust and who has worked with MS patients before. They will help you stay focused without the fear of hurting your feelings such as with family. In addition, a support group or some emotional outlet is a must for long term health.



Over the past couple of years I have had counseling both individual and group. I talked with my family and peers. I read a lot and made half-hearted attempts to do 'something' positive. Still I slipped deeper into the depths.

As mentioned before my wife and I were attending an MS couples seminar. In the last session the spouse of another MSer said to me in a loving and concerned voice, I hear strong anger in your words. You do not know how to express it and you do not know what to do about it. Yea, it had been said to me before but until that night I had not heard it clearly.

I realized what was happening to me was caused by me. As my grandfather used to say, You are what you eat. (He was kind of a farmer.) After four months of weekly sessions with an ass-kicking, no-shit psycho doc, I finally stopped hurting so bad and started building a new, better and more full life.


What I Done, Done

Saw a shrink, and listened
Grew a beard
Volunteered for MS AQ
Put together a HomePage
Started writing essays again
Bought some jelly beans

This may not seem like much but it is a thousand miles from where I was a year ago. It is a start and now there are a million things I want to do, and believe I CAN do. I do not know if my family would say that I have changed but some things are different.



Where Am I Now?

I am developing a routine that is good for me. Sometimes it matches other's needs and sometimes it does not. It does meet my needs which helps me have more to give others.

I am looking for and seeing more humor. I am laughing more and feel better each day. In simple ways I am having more fun and starting to look for more ways to enjoy living.

I am consciously confronting the fear of failure. It is a fear I have not experience before and I am happy to actively push it away.

I am starting to recognize unwarranted guilt.

..... MS and polio are not my fault.
..... It's OK if I don't feel like participating.
..... It's OK if I use a "good" day just for me.
..... It's OK to take a nap when I am tired.
..... It's OK if the chore list doesn't get completed.
..... It is not my fault if someone else has a bad day.
It is possible for me to meet my expectation level.
..... ..... It is NOT possible for me to reach a level set by someone else.


I am beginning to like myself again and beginning to have faith in my beliefs again.
When I try to be what someone wants me to be, then I do not like myself.

You have to love yourself before you are capable of
allowing someone to love you




I have not said anything about the problems faced by the caregiver. However, the caregiver has a whole set of different but just as difficult problems as those faced by the MSer. Each other's problems fuel the other person's problems. When the cycle downward starts it is very hard to stop. Maybe I will be able to get my wife to write something about the issues she has had to face.



Both the MSer and the caregiver need to watch depression seriously. It is an illness that can destroy a life and a relationship. Unlike MS it is an illness that can be treated and cured, when acknowledged. I believe it is an illness to which MSer's are highly susceptible.
Please watch for the warning signs and do not fall into the hole, the one that I am still trying to get out of.




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