Kinder and Gentler

This posting seems inevitable and misguided, but that's just my routine negative thoughts speaking. 

The same negative thoughts that brought me to the desire -- the imperative -- to end what was going on in my head.  Fortunately I asked and received help, which sometimes felt like being in jail.
 My fellow patients, however, did not seem crazy at all. 

Many were just like me. 

I'm writing this as a blog post with the knowledge that next to no one ever reads this. Why? 

Because the stigma and shame depression has to be calmed. I feel better.

 Here's what happened:

Things became stressful in  2008. I had been depressed since  could remember and had concealed it fairly well. Then came the death of my father and a sister, open heart surgery to repair a floppy mitral valve, and throat cancer.

To top this all off I was laid off as science editor of the New Haven Register after 30 years of work.

Unfortunately for me, I loved that job. It was interesting, challenging and satisfying.  Writing about medicine and science did not seem like work -- and thus became an easily worn identity. At the  time I frequently brought a negative attitude to work.

More than a negative attitude.  I was looking at the world through lenses colored by difficult parents, shaky genes, and a problematic environment. Depression started when I was a child.

Depression has remained a vague and under-researched condition. The word has a 19th Century feel. One word that describes a variety of disorders that have similar symptoms, like "the croup."  Depression can make a person eat too much or too little; sleep too much or too little; talk too much or too little; etc.

No one deserves to be laid off after 30 years, not even a sarcastic, ironic know-it-all.  Collected unemployment, taught at Quinnipiac University, paid back unemployment, wrote a bit for the New Haven Independent, and ended up in the straits of volunteers.

I got booted from New Haven Reads.  I am not aware of this happening to anyone else. I wrote the following limerick and another person left it faced up on her desk:

Unemployment's a terrible curse

and it's only going to get worse.

I don't have a future to bandage or suture

so I guess I'll just wait for a hearse.

Maybe it was a "cry for help."  The person then in  charge of New Haven Reads asked I was OK. I said no one was OK. She asked if I was receiving psychiatric help. I said everyone there could use psychiatric help.  I subsequently received an email informing me that I was not a "good fit" with the program.

With nothing to do but ruminate, nothing I wanted to do, depression worsened and I became increasingly irritable. Friends did not see this because I saved it all for my wife, who began to talk about selling the house and moving out.

My whole fetid world was thrown into chaos and my brain began to produce waves of intolerable panic.  Panic that could not be controlled or confined. Panic that made me feel like what I imagine a trapped mouse feels.

Panic became unbearable and I concluded that it must be stopped. Looking out of a window on a sunny fall day I decided that I either had to start consuming heroic amounts of alcohol. Or stop my brain with a shotgun blast.

 Why did I not choose drinking? That has all sorts of societal and medical ramifications. That blowing my brains out seemed like a better solution now seems darkly funny.  Sort of.

I drove to a nearby mall where I recall having gone to a sporting goods store that sold rifles, pistols and shotguns. No panic at all. I had the serenity of someone who has solved a problem. The calmness that comes from knowing a solution, an easy solution, to what seems like the end of the world.  

A still-healthy part of my mind directed me to a store, which had gone out of business. I drove home and called one of my sisters and told her what I was planing.  She suggested  --strongly -- that I go to a hospital.

I reluctantly admitted myself and then spent a month at Yale Psychiatric Hospital on a floor I could not leave surrounded by equally, and sometimes more screwy, patients.  Several were there to detox from alcohol,  synthetic or actual opiates, prescription drugs, and who knows what else.

Others were like I had been. No one on the floor mentioned suicide. Maybe that was beside the point, or perhaps there was no reason, already locked up in a loony bin.

If I could think of anything original to write about life in a mental hospital I would.

During my stay I met with psychiatrists who suggested that electro-convulsive therapy (ECT) might help me.  ECT, which, by the way, does not include electric shocks, had been suggested to me before. Now it seemed like the time.

ECT does not magically transform most patients in a single treatment. But as I was treated, I did feel the undertow of depression begin to fade.

Modern ECT (No grimacing, thrashing, broken bones, shackles, or amnesia) has helped many people, most of whom are not eager to share the experience.
Dick Cavett,  Kitty DuKakis, David Foster Wallace and Dr. Sherwin Nuland, are a few who did not mind sharing.

I'm hoping depression has lost its grip and does not return.

Meanwhile, I'm trying to be gentler and kinder to myself and others, including my wife.

Why am I so sure?

^{Why am I so sure that people who take film flam seriously are mistaken or deluded?}

^{Why can I not sit silently as otherwise intelligent people spout ridiculous nonsense based on fallacious reasoning?}

^{Am I skeptical or merely contemptuous? Aware but disdainful? As if I know everything. People do not like this behavior yet I persist.}

 ^{Yes, I have much work to do on myself.}

^{One pitfall I have avoided is alternative “medicine” that makes no sense.  The treatments are senseless as are the people who spend money on them. It’s one area in which intellectuals indulge in anti-intellectual “medical” treatments based on self-delusion and placebo.} 

^{Let’s start with homeopathy.  Homeopathy was developed by Samuel Hahnemann in 1796. He was not a doctor, but even doctors then were not doctors in the sense that they helped patients.} 

^{As you know, this was centuries before Louis Pasteur, Ignaz Philipp Semmelweis, and later scientists who discovered bacteria, viruses and developed the germ theory of disease. Semmelweis famously reduced infant mortality in a hospital by having nurses wash their hands.} 

^{But back to Hahnemann. His theory was “like cures like,” or in Latin, similia similibus curentur.  In practice this means if you present with stomach pains you get some substance that causes stomach pains.  Have a headache? Take something that gives you a headache.}  

^{Does that make any sense?} 

No.  All it has is an appealing dialectical symmetry. If you’re into that kind of gobbledygook.  

 ^{Hahnemann, who was treating “miasmas” also believed that diluting the “medicine” made it more powerful, speaking of obviously ineffective methods of treatment. He diluted and diluted and diluted whatever he was preparing to the point that the “medicine” might have one or two molecules of the original herb, or whatever.  Many preparations contain no medicine. So, the person with a stomach ache is not even receiving the ill-conceived stuff that helps by causing stomach pain.} 

^{Perhaps a more interesting pseudoscience is chiropractic. Chiropractic was invented by Daniel David Palmer in 1895.  Palmer’s theory, if you want to call it that, was that diseases are caused by spinal imbalances that can be corrected by manipulating a patient’s back.} 

^{Palmer’s thoughts are more complicated than this, but since it’s all bunkum, no greater explanation is necessary.  Needless to say, Palmer had no medical training, nor was his idea based on any accepted knowledge.} 

^{Despite its sheer ridiculous underpinning chiropractic attracts otherwise intelligent patients. Since 1895, the practice has inched closer to massage, and is less likely to cause injury.}

^{This is a fine place to introduce the idea of the placebo effect. Placebo is from the Latin word  placebo, meaning “I shall please.”  Placebos have no actual medication. They depend on the brain’s expectations of relief.} 

^{Researchers frequently test potential drugs by dividing subjects into two groups. For example, lets say they are testing a compound that relieves the pain and swelling of osteoarthritis. All of the test subjects have arthritis. They are divided into two groups.}

^{One group gets the experimental treatment and other receives a placebo. The researchers frequently do not know which patients are getting the drug, and who is getting the placebo. That is called a double-blind study.}

^{The placebo effect is fascinating as it demonstrates the role that mind and perception play in many illnesses.  Pain, inflammation, concentration, mood, and other subjective ills respond to placebos.}  

^{Consequently, if a person is convinced that homeopathic medicine works, even though it is plain water, the preparation my effectively relieve a headache. In other words, the person with the headache is self-medicating with endogenous peptides or other compounds.}  

^{This is why medication tests frequently compare the efficacy of the drug versus the action of a placebo, because people are convinced that pills work.  Centuries ago when treatment involved blood letting to balance nonexistent humors, some patients may have felt better before they bled to death.} 

^{How’s this for a study:  Subjects with back pain receive either a real chiropractic adjustment, or a non-chiropractic jostling.   See if there’s any difference between the two groups.  The placebo effect seems evident in chiropractic, but is complicated by the role that human touch plays in health.} 

^{For interesting yet mysterious reasons, many Americans place their trust in ancient Chinese medicine — but would never agree to be bled. Some Chinese medicines may contain active compounds. Those that do not have the placebo effect.}

^{Some include heavy metals and other toxic materials. This should not be surprising, as the development of Chinese medicine was not based on empirical research.  Ancient Chinese healers did not understand anatomy, the causes of diseases, and reasons why some plants work and others do not.} 

^{While Europeans had the four humors — phlegm, black bile, yellow bile, and blood — on which to base treatments, Chinese healers developed complex ideas about Chi, the life force, and the paths it travels through the body.}

^{Modern adherents believe that Chi is real. They do not believe in the four humors, but accept an equally arbitrary construct of philosophy and religion. Thus we have reflexology, a pseudoscience that is believed and used by many otherwise “intelligent” people.}

^{They accept chi but sneer at the four humors.} 

^{Biologists know how human metabolism works, how proteins, sugars and fats are broken down and converted in complex processes to energy-rich phosphate bonds. These are ATP and ADP.  Google them. ( Here’s some things to look up to get you started: cytochrome. electron transport. mitochondria. citric acid cycle. catabolism of glucose.)} 

^{That is where human energy originates. More specifically, that is the only way humans, other mammals and vertebrates and invertebrates produce energy.  This energy is used to move muscles, make other proteins, maintain the immune system, fight infections, and keep all of the organs working as they should.} 

^{If I know this, why doesn’t everyone else? Or do they know it and disregard it because Chinese medicines and reflexology and homeopathy seem less profit-driven? More pure?}  

^{Do people not appreciate major advances such as  vaccines, clean water, sewerage systems, sanitation, antibiotics, and a plethora of drugs that have increased the human life span?} 

^{Why would people with access to doctors choose obviously bogus modalities such as homeopathy and chiropractic?} 

^{Do they have untreatable conditions? Have they exhausted all conventional therapies and procedures? Perhaps, but what logic is there in turning from disappointing  reality to outright fakery?}