(This post is being done in connection with the #DayOfLight initiative on Twitter and Facebook, dedicated to "bringing depression out of the dark". You can learn more about it here. I've only known about this for a few hours, but wanted to make my contribution.)
Although the primary focus of this blog has been diabetes, I've also often written about my struggles with depression and other aspects of mental health. (You can, if you choose, view those posts here.) Most recently, I wrote a post in which I compared my depression to a dragon and about fighting not to lose grip on some healthy changes I'd been making.
That last post turned out to be early on in what has proved to be a lengthy episode of depression. Though this is hardly measurable, it has felt both longer and deeper than I've experienced in several years. Over the last several weeks, I have watched as pieces of my ability to function have fallen away. My never-very-robust attention span is gone with no forwarding address. Making plans seems futile, because I don't know if I'm going to be able to meet my commitment to myself. Though I haven't gone too far in the wrong direction, there has been significant decay in my baby healthy habits. Being sociable (also not ever my strong point) has become difficult as well.
Perhaps telling the dragon about his bad breath was not so smart, huh?
Beyond the persistent sense of disappointment in myself, perhaps the worst aspect of an episode like this is a weird, unfocused sense of dread, that disaster is about to occur and that it will probably be about my fault. This morning, after a fairly successful exercise session, I was continuing to listen to my exercise playlist. As the Led Zeppelin song "When the Levee Breaks" came on, I could not get it turned off fast enough - the song's foreboding meshed so completely with my own, it was almost like a physical wound.
But, I have not lost perspective. I know it will get better. My internal life is pretty unpleasant right now, but I'm hanging in and will continue to do so. There were a couple of hopeful signs today, so maybe the mood is easing a bit. I also know that there have been times in the past that were much, much worse. And, even those episodes eventually eased.
It will get better.
The picture below, which is entitled "But I Repeat Myself", was my contribution to this past Monday's Diabetes Art Day.
For my mouth, some flavors are solitary and some are more social.
Take sour/savory, such as a pickled vegetable that's not too sweet. I can spear a piece of pickled red pepper from a jar, and it's delicious, and it's enough: that flavor is content to be alone. Salty (not salty-fat) is the same way for me: just a few nice olives can be a nice little snack, and my mouth feels that it has been treated well and is content. (Pretzels are an exception for me.)
Fatty flavors are more social: they want more of their own kind around. I've barely got a bite of a good hamburger swallowed before my tongue wants the next bite. The call for "more!" doesn't go away until I feel full or the food is gone .. whichever is later. Fatty/salty is even more so for many people - think potato chips or french fries. There are probably people who can eat one potato chip and fully enjoy it without reaching for the next one
Sweet is more social yet. A modestly-sized cookie wants to be joined by another, and another, and another. I have, on occasion, used mouthwash to try to stop the invitations from going out.
And fatty/sweet, like ice cream or milk chocolate? That's a flavor combo that wants to PAR-TAY, and how can it par-tay without mouthful after mouthful of the same flavor. (Chocolate does not really trigger me like that, but it seems to for many people. Ice cream very much triggers me like that.)
This is just an observation. I don't know if it works like this for others.
(In which I don't discuss health at all.)
The other night I remembered a scrap from a piece by an author pretty widely regarded as one of the greatest writers of English. You know, "great" as in leather-bound editions, academic conferences, the whole bit. I was inspired to look up the larger passage the scrap was from (thank you, Internet!), and I noticed something that struck me pretty forcibly:
The passage I was reading is good. Really, really good.
I then thought about other examples of stuff widely seen as "great" that I really enjoy. The things I thought about included a rock song and a couple of painting.
Of course, nothing works for everybody. I'm not mentioning the works I thought about to take specific examples out of the discussion.
I guess my point is this: sometimes something's reputation as "great" can oddly interfere with our own enjoyment of us. Somehow the acclaim gets in the way of how we might react to it if we came across it unawares.
So, as you may know, I've been able to make some healthy changes in the last few months. There's quite a bit of exercise, both walking and things I do in my *ahem* home gym. (The "home gym" is a living room cluttered with dumbbells and exercise bands.) I'm eating right, and recording what I eat. Emotional eating hasn't been a problem. The home gym exercises can be a challenge some evenings, and some days bring other kinds of challenges Still, I've had a lot of initiative, and it hasn't been killer-hard to keep going.
And then, over the last week or so, ever so slowly, I've been slipping. The home gym sessions got skipped or foreshortened. I had a couple of days when I ate over my calorie goals … then a couple of days when I'm pretty darned sure I did, but I can't be absolutely sure because I didn't bother to record it. The eating was starting to feel out-of-control and intended to feed my heart rather than my body.
I came into the weekend feeling the hot breath of failure on the back of my neck, and I had no idea what to do about it. Then, as I was desperately trying to think of how to turn it around, I remembered the dragon.
See, as far back as the eighth grade, I've struggled with episodes of depression. These episodes can come at any time, but the midwinter months are usually hard, and those episodes have sometimes been deep.
You'd think that, since I know all this, I'd start watching for the signs. But, at least for me, depression tends to arrive pretty quietly. This morning, I realized that my healthy changes were being drug down by the challenges of emotional health. As I thought about it, I came to think of the depression as like a dragon. (You can blame a movie ad for the image.)
My initial thoughts for how to make accommodation for the dragon's presence were along the lines of partial surrender. Perhaps I shouldn't even try to do the gym exercises. Maybe I should raise my calorie limits. Maybe I should….
And then I got mad.
"Why," I asked myself, "should I give in to this? Why should I let it make me a failure?" I then talked aloud, perhaps just to myself, perhaps to make dragon, feeling all smaug over there on his gold. (See what I did there?) I would not, I said, give in. I would maintain my standards. I am not (I continued) the same person I used to be, and I will choose what I eat and how I exercise. There were other things I said as well.
Of course, telling a dragon off is not the same thing as defeating him. The dragon is still here, and he will remain here until he decides to go sit on his treasure someplace else for a while. I'm going to have to be careful, for example, to know exactly what my exercise plan is for the day. And, though I will be tempted, this will not be the time to make ambitious additions to my goals. And, I do think it's appropriate to restart the gym work a little slowly. But I will do these things because I CHOOSE to – not because I feel that choice has been taken from me.
And I must never forget that the dragon is there: he is most dangerous when I'm unaware of him.
Take that, you nasty overgrown lizard. And do something about that breath.
This post was edited on 11/25/13 to rearrange a tiny bit and to improve the post's resemblance to English.
This has become my annual World Diabetes Day post. It was first published two years ago.
Today would have been the 120th birthday of Frederick Banting, the man who (along with Dr. Charles Best) discovered insulin.
Perhaps you are an insulin-dependent diabetic, or love such a diabetic, and understand full well what you owe to Sir Frederick and why this day is celebrated as World Diabetes Day. Wish Sir Frederick a happy birthday.
Perhaps you are like me, a diabetic who is at this point still able to produce your own insulin, but realize that a time may come when insulin will be as important to you as oxygen. Wish Sir Frederick a happy birthday.
Perhaps you are not aware of knowing any insulin-dependent diabetics. But you almost certainly have. Spare a thought, today, for the acquaintance, whoever it might be, that you never would have known had it not not been for the work of these men. Wish Sir Frederick a happy birthday.
Please, take just a moment. Even though insulin is in no way a cure for diabetes, it has saved the lives of millions.
Please wish Sir Frederick a happy birthday.
For many years, I have visualized the contents of our hearts and minds as an enormous, intricate and ever-changing network of nodes and rods. Each node represents a belief, a memory, an idea, a feeling, anything like that. The rods make up the billions of the connections between them. Do you ever travel around an area you've lived for a long time and noted all the building for which you have some kind of association? That house is where your friend's boss lived, so you've got nodes related to that house and your friend's boss, and those two nodes each have rods connecting to each other and the node for that friend, as well as to your memory of how badly that boss treated your friend and the sadness you feel about that.
(I often think of this structure, actually, as being made of the Tinkertoys I spent hours with as a child. Kiddies, come listen to Grandpa talk about how they were made of wood in those days.)
Everything that changes for us in however tiny a way requires at least a tweak to some part of that structure. Suppose you read an article about a musician you like. You learn that a forthcoming album is being done with a known producer. So, you add nodes for the new information and add rods of connection to the node for that producer. The article leads you to reevaluate your opinion of a particular album that you'd not liked, so you have to tear out the little bit of structure related to that musician and that album in order build in the new information AND the new opinions AND any new feelings.
(You –do- understand that I’m neither a neurologist nor a psychologist, right?)
When something big happens, in this metaphor, big chunks of the structure may require rebuilding, and I see that kind of work as requiring mental and emotional resources. In recent weeks, I have had trouble sleeping. No, that’s incorrect: I've had trouble choosing to sleep. Into the night, I play silly computer games and do the other things I do in period of stress. It’s my suspicion that my particular makeup uses the quiet of the late evening to do maintenance on my structure.
Why is so much work required right now? A couple of months ago, I started walking a certain amount every day. About a month ago, I started tracking what I eat and adjusting what I eat to meet the daily targets. Shortly after that, I started adding light calisthenics and dumbbell work. In short, I’m making changes. And, at this point, most of the changes feel sustainable: doing these things don’t require a triumph of will on most days.
(Do not read any of this as even a HINT that you should do ANY of this, too. I am not going to become one of those people who becomes convinced that what worked for them is The Answer. If I DO become that person, please shoot me.)
I have been seriously overweight for about four decades. For three and a half of those decades, I have made sporadic efforts to live in a way that might help with that, and I have ultimately failed in all of those efforts. I have felt bad about being fat, and I have felt bad about being unable to do anything about it. Since my diagnosis, when it became clear that healthy changes would be beneficial whether I lost any weight or not, my inability to make those changes has become deeply frustrating and deeply perplexing. More than anything else, this lack of success in moving forward has been what this blog has been about. All of this, I think, is a fairly big part of my structure of nodes and rods.
So, the change from Bob-as-I've-always-been to Bob-who-mostly-eats-well-and-exercises is a major one. I don’t know if it would be for anyone else, but it is for me. My last post was an attempt to begin to wrap my head around becoming a different-in-a-big-way person.There is, if my metaphor is valid, a great deal of rebuilding going on.
And that, I think, is what I’m doing late into the night when it seems like I’m just playing solitaire.
Shouldn't I see myself?
One of the aims of ethnic and racial diversity efforts is to have advertisements reflect the diversity of our society. Similarly, concern about societal messages about beauty and body image have led to some pressure on companies to feature a variety of body types in advertising.
Those issues are important. They are worthy of both attention and action. My concern tonight is not nearly as important, but it bothers me anyway.
Periodically, I go looking for information about exercise and similar topics. Though I can cite no studies, it seems that the photographs on most relevant websites feature either healthy-looking young women or heavily muscled men. Though there are doubtless many exceptions, I believe that my basic observation is valid. When I look at magazines with a focus on general health topics, the people on the covers fit those categories almost exclusively.
I'm not female. I'm not young. And I have no desire to look like Hercules.
I don't exactly blame the sites and magazines for this. My guess would be that their core audience mostly consists of folks that either fit those categories or WANT to fit those categories. I can't complain about this.
The pictures, and the tenor and content of many accompanying articles, show a split in how the fitness goals of men and women are perceived. Women, it is apparently believed, want to be generally healthy and/or sexy. Men are seen as wanting to look like bodybuilders.
I don't know that this is a problem. What I do know is that on many websites and in many magazines, I don't see me. I don't even see the person I'd like to be.
This post is not a call for action. I don't know that what I'm seeing is a bad thing.
All I know is that it makes me a little sad.
"Your honor, we the jury find the defendant to be not guilty."
On Thursday morning, I had a checkup. Since this was my first time with a new doctor, I had worries about that in addition to the normal medical appointment jitters.
There was some good news. Most importantly, I like the doctor and believe he can help me. It was interesting to get a five minute lecture on patient empowerment, although he did not use that phrase.
Additionally, my cholesterol panel looked really good. The one number that is still out of range continues to improve.
I suppose it's good news of a sort that I was measured as being 5" 5' tall. I suspect there is some kind of error there, because I don't think I've ever been told that I'm that tall. But, maybe I'm having a growth spurt in my early 50s.
The not so good news was that my A1c jumped quite significantly and is now a little bit above the target range.
I've been puzzled about my reaction, or lack of reaction, to that last bit of news. I didn't seem to be feeling the things that I'd expect to feel, or even much of anything at all. Was I shocked into numbness?
But then I figured it out:
I don't feel guilty.
I simply don't find myself awash in the "should haves" and "could haves" I would have expected. I'm seeing my doctor again in a little over a month, and I'm going to be developing an action plan. For the moment, the doctor isn't changing my medication.
I'm sure that my good feelings about my walking program mostly explain the lack of guilt, despite my feeling lately that my eating is somewhat out of control. But, I think my heart is finally beginning to believe what my heart has known for five years: I have a disease, and a progressive disease at that. My choices are part of what determines the rate of progression, but only part. I know I have things I need to do, but I am able to see this clearly instead of through a fog of shame. I can explore options for improving the health of my body without feeling so much like my worth as a person is on the line.
I've been acquitted. Now I just wonder how I'm going to pay off my lawyer.