I am a person who experiences chronic depression. I have been active in an online community for people affected by diabetes, and I have known people who deal with other conditions. I am having some thoughts tonight on things that depression has with many other chronic conditions.
1. Because depression is invisible, like many other chronic conditions, some people choose either to not believe that it exists or that depressives are exaggerating.
2. A good attitude can be a powerful assistance, but is not a magic bullet. I believe this to be the truth but recognize that it doesn't made for good motivational talks.
3. Although (as is true with many conditions) depression can be worsened or triggered by other challenges in our lives, these things to not CAUSE depression. Depression is not "about" anything, it just is. No one would ask a person with asthma what they're asthmatic about.
4. Good days happen, bad days happen. So do good months and bad months. These are largely inexplicable.
5. There are medications that may help in the treatment of depression, but these do not in any way cure it. Unlike with some other conditions, however, the use of these medications is a deeply personal choice.
6. Different medication regimens work for different people and even for the same person at different times.
7. Depression is responsible for many deaths.
8. There are lifestyle choices known to help many people deal with depression, but these are not cures and may or may not help a particular patient much.
9. Appropriate medical care is important, but providers are not created equal. The right doctor makes all the difference in the world: alas, so can the wrong one.
10. When I was learning about diabetes from my friends in the community, I came to the conclusion that diabetes makes everything else more complicated, and everything else makes diabetes more complicated. The same is true of depression.
It's been over a year since I posted on this blog about how I'm doing. But I want to support #dblogcheck, and my friend Mary mentioned the other day that she likes to know how I'm really doing.
So here's the straight skinny. Or, more accurately, the straight not-so-skinny.
Two summers ago, I got things relatively in order in terms of eating, and I picked things up in terms of exercise, and I lost a chunk of weight, and I had a lot of hope.
That winter, I let it all go, except for the weight, which (mostly) came back. Or, if you prefer, it all (excepting, again, the weight) escaped. I feel a lot of shame, though I probably shouldn't. (You catching that? That I feel guilty about feeling guilty? I feel a bit guilty about that.)
Unsurprisingly, I don't feel as good as I did for a while. I've felt worse, but I've felt better. There are no signs of diabetes complications, but I get breathy too easily. (I did see my doctor recently, so there's nothing big I'm ignoring.) Though I am feeling my way back forward, my progress in that is slower than I'd like.
The same applies to the state of things between my head. I've been worse (much worse), but I've been better. The return of the longer days and warmer temperatures is a good thing for me.
I feel like this post is disproportionately negative, and that's not a full picture. There is a lot that's good in my life. I have a good job, and I find interesting things to spend my time on. I spent a number of months reading history in most of my spare time, and recently I've been scratching my creativity itch with a lot of sewing and crafting. (Oh, boy, am I starting from the ground level on that stuff!) It's ALWAYS better for me to have an enthusiasm going.
So there's that.
I couldn't figure out how best to introduce this post. Take your pick.
Introduction #1: A number of years ago, I went to the first appointment I'd ever made with a psychiatrist, an appointment at which I would (as it turned out) be diagnosed with clinical depression. I felt hopeful, but I also felt vulnerability and even shame. The receptionist's desk had a page-per-day calendar provided by a pharmaceutical company, and that day's page had a saying along the lines of "Stride confidently into your future!" The contrast between the saying and my situation struck me as both painful and hilarious. I showed it to the receptionist, saying "If I could do that, I wouldn't be here." She didn't see the joke.
Introduction #2: When I was teaching myself to cook, I was very conscious of one advantage I had over many kitchen novices: I had no one else I needed to please. I had no parents or siblings pretending to enjoy a mistake, no partner wishing we'd just ordered pizza, no children convinced that only a microwave could make food edible. I could carve my own way. As I did so, I also learned more about what I like to eat, and I learned how to cater to my own taste.
"Whatever gets you through the night 'salright, 'salright." – John Lennon
People respond in different ways to diabetes or other difficult situations in their lives. I've read posts on diabetes blogs that were optimistic, despairing, angry, loving, sad, and humorous, as well as many that were complex stews of emotion. One participant in an online chat claimed to have no trouble with diabetes whatsoever.
We're all different from each from each other, and each of us is different from moment to moment. We have different needs, and they change. I'm a big fan of each person finding what they need to get through the night (though I suspect that the protagonist of John Lennon's song was thinking of something other than emotional support). We all have to figure out what we need for dinner.
For myself, I'm not big on inspirational quotations or unmixed optimism. Many people love them, deriving motivation to do and be their best. Perhaps it's due to a loose screw, but I tend to see (and feel bad about) the gap between the sentiment expressed and what I do or feel. I to be more into humor (the feebler the better, as far as I'm concerned). When I come across what's intended as hopeful, I may respond by feeling resentful or even angry. But you know what's great about social media? I don't have to like everything I read. Some days, I conclude
Social media is to me first about expressing the self. I don't want anyone to change how they deal with their situations to suit me if they've said what they want to say, that's the important thing. And if, secondarily, what they've said is part of what someone else needs, that's fabulous. The next person up to the reception counter I mentioned at the beginning may have found that the quote planted a seed of desperately-needed hope.
I don't feel like the Diabetes Online Community is responsible for making sure that everybody finds what they need, although we can certainly hope that they do. More than that, we can't hope that a person WON'T find what they DON'T need. Our best shot at meeting the needs of others is to be ourselves, and hope that people find the voices they need to hear.
I've always been a person whose interests were subject to change. However, I've also tended to return to interests of the past.
It's been four months since I last posted here. In that time, though I've had an idea here and there, there's been nothing (whether solemn or silly) that has really wanted to be written. Writing is too much work to force it, and I can't offhand remember any posts written just to post that have been worth the trouble.
My interests and passions are just elsewhere recently. Yeah, I could post about those things, but I'm not really qualified to, and I can't delude myself that many would be interested.
I'm certainly not closing this down - I just renewed with my hosting company a few weeks ago. My passion for this may well return, and I like having an outlet that I can use if I want it.And, I like to think that past posts may yet suit their original purpose for a few folks. I'm proud of much of what I've done here. I just don't know when I'll do more.
Thanks for stopping by.
This post is my response for today's prompt for Diabetes Blog Week (#dblogweek). I am responding to the wildcard topics "Tell Me A Story: " Write a short story personifying a diabetes tool you use on a daily basis. A meter, syringe, pump, pill, etc. Give it a personality and a name and let it speak through you. What would it be happy about, upset about, mad about? " The post below, originally published 2/11/10, seems to fill the bill.
March 14: Suddenly, I burst into consciousness. It seems that I am a test strip for a glucose meter, a small miracle of technology precisely engineered for an important task. Within minutes of my awakening, I find myself in a small plastic container with 24 of my compatriots. I am puzzled, however, because I am the only strip in my container that appears to be sentient. This is especially unfortunate in the case of the rather attractive strip right next to me - I could share some thoughts with her, if you catch my meaning!
April 7th: After weeks of sitting in warehouses and being bounced around in trucks, I have arrived in a pharmacy. I wonder how long the wait here will be?
May 2nd: I have been purchased. I confess to feeling a little swell of pride at the amount of money paid for me: I am easy, but not cheap.
May 14th: I chafe at the length of my wait. My compatriots have been disappearing one at a time, naturally, that cute strip next to me was the first to go. I must say, the rate at which we're being used is somewhat slower than what I understood to be optimal. Nonetheless, I feel a strong affection for the man who bought me, and look forward to playing my part in supporting his health care goals.
May 18th: The day for which I was created has at last arrived! The container is opened, and I am removed. I am placed into the meter: the fit is perfect. I am touched to a drop of blood, and I process it according to my engineering and deliver the good word to the meter, which promptly displays the result. (163? As a fasting reading for a meds-only T2? What did he EAT last night????)
My joy is complete, my destiny is fulfilled. The man whose very life I have helped preserve has left me in the meter, presumably to contemplate the excellence with which I have perfomed.
May 19th: I begin to wonder, now that my purpose is complete, what my future holds. This morning I was removed from the meter and replaced with another strip. Rather than being placed with dignity in the luxurious final resting place I expected and deserved, I was casually tossed into a pile of other strips that have given their all. It's dusty, too.
May 23rd: My existence gets worse and worse. This morning, the pile I was in was swept into a wastebasket. I, however, fell outside the basket onto the floor. A few minutes later I found myself adhering to the bottom of the man's foot and thus carried into his shower, where the water washed me off his foot and into the tub's drain strainer. The conditions here are unspeakable. How I wish I had entered the waste stream with my fellows, bound for the serenity of the landfill or perhaps even the blessed oblivion the incinerator offers.
May 25th: How long will it take this man to notice me here in the drain? I have come to hate him.
May 26th: At last, the tyrant notices me here in the drain. He plucks me off, and tosses me toward another wastebasket - and again he misses. (I hope his pancreas explodes.) So I lie here, right next to the toilet. I will say no more of my situation here. Oh, that this consciousness with which I was cursed might have an end.
June 3rd: Finally, finally, my blessed end is nigh. Again, I was thrown away, but this time actually made it into the basket. The last few days in the waste stream have been disgusting, but here I am on a moving belt, and I see the incinerator ahead. Oh lovely nothingness, I come!
This post (not a repost!) is my response for today's prompt for Diabetes Blog Week: "Diabetes Life Hacks -- Share the (non-medical) tips and tricks that help you in the day-to-day management of diabetes ... Please remember to give non-medical advice only!"
I have griped a time or two (okay, maybe closer to 300 times) about how much I hate sitting down to count out my medications each week, because doing so seems to be a real symbol of my diseases.
But, I really don't mind -taking- the medications. However, it took me several years to figure out how to take them as consistently as I need to. For way too long, I relied on trying to remember the three times a day I have pills to swallow. That just didn't work. Eventually, I had the insight that I needed to keep my meds in sight. (See what I did there?)
The morning meds live on the desk where I used to sit at my computer every morning. (The computer now lives elsewhere, but seeing the desk is reminder enough.) I have a phone-and-computer calendar reminder for the mid-afternoon, when I'm usually at work. And there's a little stand in my bathroom - which I'm sure to visit before I go to bed - that holds the sorter with the things I take at night.
I still manage to forget once in a while, but I'm pretty consistent.
It's simple, but it works for me.
This post, originally published on February, 2013, is my response for today's prompt for Diabetes Blog Week: "Yesterday we opened up about how diabetes can bring us down. Today let’s share what gets us through a hard day. Or more specifically, a hard diabetes day. Is there something positive you tell yourself? Are there mantras that you fall back on to get you through? Is there something specific you do when your mood needs a boost? Maybe we've done that and we can help others do it too?"
Before lunch today I found myself in an extremely grumpy mood, even for me. I felt very put upon and angry, even though nothing in particular had happened to leave me more than a little annoyed. i knew that I was not likely to get much done or have any enjoyment out of the day if I stayed in that mental state.
So, while at lunch, I decided to make a list of everything i could think of in my life that made me angry or annoyed. A few of my items would frustrate most people, and several more dealt with disappointment with myself. Most of the items, I think, were either inconsequential or really had nothing to do with me at all.
Having made my list, I decided to experiment with a little visualization. I've never had much luck doing visualizations, but I thought the situation merited making the attempt. What follows is not a daydream or a delusion, but a recreation of what I told myself to imagine, as if I was listening to a relaxation tape, except that I was making it up as I went.
I am alone in a room, one wall of which is covered with an enormous piece of newsprint paper covered with the list that I had made. I am tearing the paper off the wall and gathering this whole huge piece of paper into a big wad in my arms.
I can smell the newsprint and the felt tip Ink on the paper. I can feel the ball of paper pressing a little bit against my chest as I work with my hands and arms to compact the ball. i can feel the paper with my hands, and that I can hear the rustling of paper as i work to compress the ball of paper.
As i work, I feel my ball grow smaller and the paper itself grow thinner, so what I had at the end of my gathering is grapefruit sized ball of blue tissue paper. With my ball in my hands, I gently breathe a puff of positive energy into it, and I see it burst into a cool blue flame. Though i can feel the warmth of the fire it does not burn me, and I soon hold only.ashes. I blow again, harder this time, and i see the ashes fly into the air and turn into a cloud of silver glitter, which shimmers for a moment before disappearing.
When I reopened my eyes, I felt unburdened and nearly at peace. I won't say that I skipped joyfully back to my desk, but I did succeed it turning around a mood that had become toxic, and I had a productive afternoon. My exercise strike you as weird and New Age-y, and it feels like that to me, but it worked.
This post, originally published on September 10, 2010, is my response for today's prompt for Diabetes Blog Week: "May is Mental Health Month so now seems like a great time to explore the emotional side of living with, or caring for someone with, diabetes. What things can make dealing with diabetes an emotional issue for you and / or your loved one, and how do you cope? (Thanks go out to Scott of Strangely Diabetic for coordinating this topic.)"
Unfortunately, having diabetes is no protection against other conditions, and diabetes has no hesitation about coming to those already having other conditions.
I was recently having an exchange with Rachel Baumgartel on Twitter, and we were talking about depression. She made a comment to the effect that folks often don't consider the impact when diabetes comes to a person who has depression as a "pre-existing condition". I loved that phrase, because it enabled me to start crystallizing thoughts I've been having for a year or more.
Many, many people with diabetes also deal with depression or anxiety. This seems easy to understand: diabetes is a daily challenge that never, ever goes away. It affects our bodies, minds, and relationships. Many diabetics have a strong sense of guilt, whether it relates to stigmas falsely associated with the disease, perceived failures in managing it, or the effect of the disease on the people we love. The literal highs and lows bring fears about serious illness, even death.
And, of course, there may be something physiological about diabetes that creates fertile ground for depression or anxiety.
But does it go the other way? I've been a diabetic for about two and a half years. I've dealt with depression for nearly forty years. So, in my case, diabetes came to a person already pre-disposed to have problems with the psychological aspects of the disease. I had a pre-existing condition called depression.
(I've written elsewhere in some detail about my experience with depression. I won't do so here, at least not today.)
So, two questions to ponder:
1) What if diabetes comes to a person already suffering from depression or another disorder of the heart or mind?
2) What if diabetes comes to a person who does not yet have depression or another disorder of the heart or mindor another disorder of the heart or mind, but whose body or life already contains the seeds of such a condition?
The answer is going to vary tremendously from person to person. But two things seem pretty certain:
1) The heart/mind disorder is going to make managing the diabetes much more difficult.
2) The diabetes is going to make managing the heart/mind disorder much more difficult.
I'll tell you how it is for me. Depression is a great teller of lies: on not-so-good days, I believe those lies. I don't take as good care of myself because I don't feel worth the trouble. In those moments, healthy changes seem impossible for me, and complications feel inevitable. I don't sleep well, and feel physically weak, so exercise would be more difficult even if I could find the motivation. (There's a key irony here: exercise is fabulous therapy for depression. Do I remember that when I need it? Of course not.) Without really noticing, I feed the fatigue with increased caffeine. And food. And the food isn't free veggies.
On good days, I don't believe the lies, and do take care of myself. But if the not-so-good days have strung together, as sometimes happens, I've lost some previous progress and have some catching up to do.
All of this, good days and not-so-good days, occurs while I'm getting up, going to work, and being good at my job.
Of course, everyone with depression will experience it differently. And depression is only one of the things that can attack a person's mind or spirit, and diabetics with other conditions will have their own challenges.
It would be a wonderful thing if our care providers knew to watch for symptoms of depression and other maladies, and understood that those of us who already have them have extra challenges. But I suspect that most of us don't have such providers, and may need to be assertive in getting the care that we need.
Please, whatever your situation, be gentle with yourself. And, please be gentle with the rest of us.
(Originally posted to diabetesdaily.com)
This post, originally published on September 23, 2010, is my response for today's prompt for Diabetes Blog Week.
I wrote the below as relief from having written several rather earnest posts. I hope none of the below crosses the line from funny to offensive for you, and hope that you'll forgive me if they do.
My doctor had offered me kudos
On maintaining an excellent glucose
But I blew it away
On the way home that day
That sweet shop was entirely too close!
A 'betic in old Narragansett
Who hated to swap out her lancet,
Said, "I know that it's strange,
But it's annoying to change,
So I guess that I'll just have to chance it!"
My pharmacist showed an example
Of a test strip that took a small sample
"You don't need a quart,
I'm pleased to report,
A teensy bit ought to be ample!"
I've known for a long time that one of the most effective ways to deal with depression is to get interested in something. I believe that an important part of the way out of perhaps the worst episode of my life was the reading i did about rock music history.
I have always been a person that suddenly acquires an interest in something, be deeply involved in it for a few days or weeks or months, and then lose interest just as suddenly. While there are some interests I've come back to several times, most just disappear into the void. (This is part of why I'm not a scholar - I don't have the temperament for it. I wouldn't wager my career in something still interesting me in a week, let alone in thirty years.) Unfortunately, I can't choose to have an interest - enthusiasm is something that happens to me rather than something I do. But having a subject I'm excited about is an important part of feeling good for me.
Although I have been slowly climbing out of my winter trough since I last posted about it, it's been a period without an active enthusiasm. For a couple of years now, my interest in cooking has been fairly constant, but there have been gaps and I'm in one now. I can barely summon an interest in making dinner, let alone take on a kitchen project.
But I've now been bitten. For some time now I've been a little dismayed at how uninspiring my food photographs look, especially in contrast with the beautiful pictures taken by my friend Pearlsa. Then, over the weekend, I was admiring some of the fabulous nature shots taken by my friend Mike. As I did so, it occurred to me that maybe photography is one of those things that learning a little more could make an out-sized difference. Maybe I could learn enough not to be great but to be less cruddy. (You can find Pearlsa's Instagram account at http://www.instagram.com/pearlsa and Mike's new photography blog at www.sparrowtreephotography.com.)
I'm having fun with it. I've been reading about taking photographs with my smartphone, and I've been taking lots of pictures. (There are a lot of 19th and early-20th century commercial buildings in my area, and I'm finding that I love taking pictures of funky little architectural details.)
How long is this particular enthusiasm going to last? I have no idea. But, in the meantime, I'm going to ride it like the fellow in this picture (which I took this weekend) is riding his horse. Because I have an interest is feeling good.