I'm grateful to have my daughter staying with me. I'm grateful for a chance to make breakfast. I'm grateful for a rainy day for someone else with a new swanky umbrella. I'm grateful for calm and ease and peace and grateful it's contagious. I'm grateful to be sober today.
I’ve dealt with depression for most of my life. It runs on my Mom’s side of the family and she and my grandmother both walked around with pretty significant, untreated cases of depression and anxiety for most of their lives. There was a fair amount of chaos and trauma in my Mom’s early life, and thanks to the wonders of epigenetics and the brain-mapping that occurs between mother and infant, I inherited that struggle.
For me, depression and its symptoms come and go. The loss of appetite, sleep difficulties, obsessive thinking patterns, intrusive thinking patterns, lack of interest in most activities, the sense of impending doom, the feeling of crippling, but terrifyingly non-specific anxiety, wax and wane—often without much warning or any discernible trigger. There is a strong season component as well—and for me, mid-February to mid-March is always pretty rough sledding.
It’s funny, because earlier in February, I woke up one day absurdly happy and at peace and it occurred to me that maybe I had dodged the seasonal bullet, maybe there wouldn’t be another dark, dark February. I chalked that up to the wonders of AA and studying the Big Book and then it came. It’s not a sudden thing, it’s more of a dark fog, a fog that actually has weight to it. I can feel it coming on, like a blanket being slowly pulled over me. Soon, I don’t have an appetite, my sleep becomes even more erratic, I’m irritable, brittle, angry and sad. Thoughts that I thought were carefully filed away, come swirling around again. Ghosts I thought I had made peace with are back like blackmailers looking for more. There’s an inexorability and inevitability to all of it. It’s scary.
The worst part is when it starts to warp my thoughts. Optimism and simple faith are shards on the floor, shattered against the dark weight. There is no point to much of anything—when it used to get really bad and I was trying to treat it with the Kim Crawford miracle cure, well, things like self-care started to seem pointless, too, and the road from there takes you to some pretty ominous destinations.1 For me, the terrible, pernicious thought that creeps in and infects me is that this is somehow my fault. And that spawns more thoughts faster than hamsters in the dark:
I’m not normal. Normal people don’t think like this. Why can’t I stop thinking like this? What’s wrong with me? I’m just really defective and broken. This is never going to get better. Why is my life so terrible? I give up.
Drinking into this is disastrous. The problem is that for us alcoholics and addicts we have a pretty firmly-held conviction that alcohol is the answer for this. And we all know the big problem is that alcohol works really well for us for a long time—but there comes a point when the magic runs out and then you find yourself at what Bill W. described as the “Jumping Off Place.”
I’ve been “treated” for depression a number of times—but it turns out that a lot of the medications that are prescribed to treat depression, the Selective Serotonin Re-uptake Inhibitors (think Lexapro, Paxil, Prozac, Zoloft), might be as effective against depression as eating Peanut M&Ms. Those drugs were developed and are prescribed on the theory that Serotonin levels in the brain were connected to depression. Well, it turns out that there is not much actual scientific evidence that suggests that Serotonin is implicated in depression.2
What does this mean for those SSRI’s that are prescribed to better regulate Serotonin levels and provide relief from the terrible symptoms of Depression? Well, like I said, if you like Peanut M&Ms…
I get concerned, because in this field, when the treatments don’t work, it’s the alcoholics and addicts that get blamed for it. When we relapse after rehab, after all that money spent and the weeks away and the lessons learned and the insights conveyed, in spite of the tools we assiduously developed, all that self-knowledge we gained, the conclusion that gets drawn is not, maybe our treatment isn’t so effective. It’s like no one has gotten the implications of this passage from the Big Book:
Trembling, I stepped from the hospital [rehab] a broken man. Fear sobered me for a bit. Then came the insidious insanity of that first drink and on Armistice Day 1934, I was off again.
Big Book, p. 8
The central teaching of the Big Book, the biggest take-away from Bill W’s story is that self-knowledge is not enough to get sober. Hardcore, lost cause alcoholics like me required a spiritual awakening to be freed from the obsession that drinking was the magic elixir that made everything possible, that made everything better.
I haven’t been able to think away my depression. No doctor has been able to “cure” it. The spiritual awakening and the changes in my life have certainly improved my symptoms, but they won’t cure it either. Like my alcoholism, I view my Depression as a long-term chronic condition that I have to manage. My inability to cure myself of these conditions does not represent a failure or weakness or suggest that I’m somehow to blame. These are diseases, we alcoholics and addicts die like these are diseases, and yet there is still a hint that it’s all our fault when the “treatments” don’t work.
My Depression took pretty solid root this year. It preyed on a lot of pre-existing fear and uncertainty, maybe a fair amount of sadness and it’s taken me on a tour of some pretty bleak places.
You know what? Things are okay.
I know what it feels like now when Depression makes her stifling appearance. I know not to trust the weird thoughts and jarring, intrusive conclusions that race through my brain. I know they aren’t true. I know this will pass and that I just need to let things flow by me. I focus on small things, don’t push myself too hard, don’t make long, unrealistic to-do lists. I do make myself get out for regular walks and trips to the gym—because that is proven to work!! You can look it up.3 I work on maintaining my faith, reminding myself that the end is not actually nigh, that this is just how my fucked-up brain gets some times and I just need to wait it out. That is essentially what I’ve found is the most effective “treatment” for my depression.
I don’t take medications for depression anymore. I’m not one of those who poo-poos drug-based treatment, I am a big believer in the efficacy of Antabuse and I think Naltrexone is helpful, too. I just haven’t found any of the drugs prescribed to “treat” my Depression actually helped. What has helped me the most is finally recognizing that just as my alcoholism was not my fault, neither was the fact that I suffer from Depression. That doesn’t let me off the hook, though—it’s up to me to manage those chronic conditions.
Things got deep and dark pretty quickly this time, and it caught me a little off-guard. I really felt like I was in free-fall for a bit, that I’d finally managed to make the last hash of everything, that it was finally time to pay the piper. But I know those poisonous thoughts aren’t coming from my Higher Power, they’re not coming from the people who love me, they certainly don’t come from the shaggy, inner seventeen year old who’s often at the controls here. They are symptoms of a disease that I inherited. They’re not excuses or requests to be absolved, they are simply evidence that there is some fucked-up shit that takes place in my brain from time to time.
I don’t mean to rail or pound my shoe on the podium, I just think that somewhat inadvertently, a lot of the treatments for addiction, alcoholism, Depression and so many other conditions may actually generate more shame for the patients. Like I said, when the best rehab money can buy can’t keep you sober for more than two hours on the outside, who’s fault is that? “It’s no one’s fault” is the correct answer. I just think we don’t know enough about alcoholism and addiction and I think we have unrealistic expectations about what treatment can accomplish.
Like Bill, going to rehab was invaluable for me, the learning and the self-knowledge, the support and the compassion were really important parts of my sobriety.
Like Bill, none of that was enough to keep me sober.
That took a spiritual awakening which was prompted by one simple kernel of thought: Maybe there is a power out there, a power greater than me, a power that can help me see the life I was meant to lead, a power that can lead me on the path back to the people who loved me, the path back to me. When things got bad this year, I turned to that Higher Power and I asked some pointed questions. I was kind of angry because I feel like I’ve been doing my part, I was lonely and sad and I really wanted to point that out to whomever is in charge. What I got back was orange and yellow light filling my apartment in the morning. What I got were little bits of blue sky. What I got was the sense that this would pass, I just needed to be gentle with myself and keep squeezing that gripper thing that builds the faith muscle. I keep in mind what Dr. Silkworth said to Bill W, that I’d better hang on to this, whatever it is, because it’s way better than what I had before. I’m looking forward to Spring.
This is one of my preferred brands of Sauvignon Blanc. I feel like I should do an encyclopaedic review of Sauvignon Blancs one day—so that all of that tasting may not have been in vain. You could expect entries like, “pairs well with the destruction of trust in relationships.”
I’ve written about this before: Daily Gratitude List 7.24.22
Also, the science shows that AA works!!!
I am just going to say that any creature that sheds its skin properly does not feel good just before doing so. I have learned and grown because you share your experiences. Every climb takes all I have and then the view just gets better until I need to move on.
Thank you for your authentic perspectives and artistry.
Such a great post. The insights of others into their depression are always very instructive - what do they have in common with my own experience? How are they different? How can I learn from them?
Indeed, rather like everything else I get from TFLMS.
Sending strength, TBD. You're an absolute star.