The Wasteland ~ footsteps into the unknown

This is essentially an e-book about managing acute crisis.  Although articles are designed so that they can be read individually, they are set out to be read as a cohesive whole from the top down.  Given the constraints of the Blogger format, this means that articles appear to have been written in reverse chronological sequence!  Most articles contain multiple hyperlinks which provide access to further information and the writing of others.

My crisis was a complex mix of physical illness combined with emotional and spiritual trauma.  Those interested in my reassessment of New Age thinking and practices will find a whole section on that topic.  Those not interested in it can skip this entirely and still find  useful pointers and resources in the other sections.  

I wish all readers good health in every respect.
Leigh Christina Russell, 2010.

 
To go to the first article click this link:
About me and this chronicle ~ an introduction

About me and this chronicle ~ an introduction

When we are in the throes of crisis our lives can seem utterly desolate and ruined, yet in the long run much good may come of it.  I feel that this is true for me.  Prior to the onset of the difficulties I describe here I had got way off track, and although I didn't see it that way at the time, the hammer blows of fate that shattered that old way were necessary.  I now feel more true to myself than I was before.  New well-springs do rise up - if we let them.  Life does eventually fill the empty spaces.

I'm a thoughtful, sensitive person and always have been.  I've always been interested in how things work, both physically and spiritually.  I have a similar level of interest in how people function and relate to each other.  These have combined to provide a great deal of interest in my life in many directions, but they have also got me into a lot of strife.  I like to find things out from direct experience, which has led me to explore some dubious territory without realising it.

In my thirties I was working very hard full time and also busy exploring New Age ideas and therapies.  Looking back it is no surprise that this led to a grand crisis by the time I was reaching forty.  I've spent the last ten or so years attempting to recover and make sense of it.

It has been an exceedingly difficult time made more so by the paucity of useful information and the gross unhelpfulness of people in positions whose work it is to help.  The creation of this set of writings has been fuelled not only by my wish that others have better resources than I did but also by my anger at the negligence and mediocrity of all those 'helpers' who appeared as if they couldn't care less.  In other cases good people who did care were constrained by senseless regulations, mindless check lists and far too much to do.  Although I have been difficult to help much of what I needed, and didn't get, was at a very basic level.

Having said that, there has been a small number of professionals from whom I have had  valuable attention.  These and the generous friendship of close family and friends have got me through.  My heartfelt thanks to all of you.  

Isolation is a big issue for each of us at a time of crisis as well as in living with enduring illness and disability.  Researching this set of writings has brought me a much expanded awareness not only of factual information but also the stories of others who are or have been through similar experiences.  Reading about their emotional upheavals as well as the conclusions they've arrived at has opened my eyes - I'm not as alone as I had thought.  Many of these people are authors, doctors and highly trained individuals whose opinions and advice are based on direct personal or professional experience.  I've included lots of links to articles and book information so that you too can find them.

I will probably add to and amend the content of this chronicle from time to time.  Although some changes may take the form of new articles most will probably be made to the existing ones.  I've added an 'updates' page to the top right hand corner of the screen so  that readers can see where new material has been added in.
I wish you all a safe passage.

To go to the next article click this link:

About the T S Eliot quote in the subtitle ~

"I said to my soul, be still, and let the dark come upon you
Which shall be the darkness of God..."
This quote is from T.S.Eliot's poem "East Coker".  In that poem Eliot describes the devastation as well as the paradoxes that confront us in times of acute crisis.  Those two lines in particular summed up a lot of what was going on for me during my time in the Wasteland.

In common with many others in times of difficulty I searched for meaning in the collapse of my world.  Did my suffering have some purpose or was it simply the continued grinding of impersonal fate on a soul in torment?  

I had always taken the existence of God for granted but now forced myself to consider that this might not be so.  The emphasis of contemporary Christian teachings seems to be on God's unconditional love.  Given the quantity and variety of suffering forced on our attention at every turn this view of the Almighty seems to be incomplete to say the least.  Spiritual dilemmas were at the very core of my crisis so the question of whether or not God exists and how the greater scheme of things works came close to overwhelming me.  

I had to conclude that my questions were irrelevant.  Whatever exists or does not exist is what it is, God included.  Things are true, or not, regardless of our thoughts and beliefs.  In a similar way the Earth is round regardless of our localised perceptions of its flatness.  I pushed the weighty questions aside, which in any case I had to - all my energy was focused on surviving as best I could; what I made of my situation was up to me.  But the further unanswered question of how to go on while disintegration continued and all my best efforts were fruitless was a constant source of pain and bewilderment. 

Trying to make things better and work things out when nothing worked only served to make my sense of devastation more complete.  I had to focus on the small everyday things, of managing one small practical thing at a time.  That was the best I could achieve.  But small achievements such as these are what life is made up of and make it possible to continue on.  That is what this chronicle, and indeed each of the Rushleigh Chronicles, is all about - small steps and slow, careful, sensible thinking.

In all other respects I had to let the Darkness of God or of Fate, or whatever else might be at work, ride over my world extracting its unfathomable forfeit and weather the storm as best I could.  I surrendered - not to death but to life, which at that time was chaos. This is the nature of life in the Wasteland.  The paradoxes are part of it.

I drew comfort from T.S.Eliot's poem which describes so clearly what I was going through.  I've quoted a larger part of the poem in my article "I said to my soul be still..."  This last part of Part Three is especially relevant here:
                    You say I am repeating
Something I have said before.  I shall say it again.
Shall I say it again?  In order to arrive there,
To arrive where you are, to get from where you are not,
     You must go by a way wherein there is no ecstasy.
In order to arrive at what you do not know
      You must go by a way which is the way of ignorance.
In order to possess what you do not possess
     You must go by the way of dispossession.
In order to arrive at what you are not
     You must go through the way in which you are not.
And what you do not know is the only thing you know
And what you own is what you do not own
And where you are is where you are not.
That is certainly how it was for me.  It wasn't the end of the world, or even the end of my world.  Rather, it was the end of my world as I knew it then.  And it turned out to be a change for the better.  Not entirely, but in terms of what I want to achieve with my life and maybe even be remembered for, definitely hugely for the better.

While I don't want to be unrealistic or to offer false encouragement about the circumstance of readers which I can't possibly know, I do want to say firmly, that good may come of adversity, not all at once, but perhaps little by little, and in the long term possibly even a fruitfulness that may not previously have been sought or imagined.  Meanwhile, hold on to life, and take care of yourself as best you can.

To go to Part 1 click this link:

"I said to my soul be still..."

I've chosen to begin with a sombre poem.  The Wasteland is a sombre place.  Recognising the reflection of my own state in someone else's words was a comfort: I was not alone after all, and there were words for it.  Here they are:
I said to my soul, be still, and wait without hope
For hope would be for the wrong thing; wait without love
For love would be love of the wrong thing; there is yet faith
But the faith and the love and the hope are all in the waiting.
Wait without thought, for you are not ready for thought:
For the darkness shall be the light, and the stillness the dancing.
Whisper of running streams, and winter lightning.
The wild thyme unseen and the wild strawberry,
The laughter in the garden, echoed ecstasy
Not lost, but requiring, pointing to the agony
Of death and birth.

You say I am repeating
Something I have said before. I shall say it again.
Shall I say it again?  In order to arrive there,
To arrive where you are, to get from where you are not,
You must go by a way wherein there is no ecstasy.
In order to arrive at what you do not know
You must go by a way which is the way of ignorance.
In order to possess what you do not possess
You must go by the way of dispossession.
In order to arrive at what you are not
You must go through the way in which you are not.
And what you do not know is the only thing you know
And what you own is what you do not own
And where you are is where you are not.
This extract is from Part Three of T.S. Eliot's poem, "East Coker". 

To go to the next article click this link:
The Wasteland ~ a geography

The wasteland ~ a geography

T.S. Eliot's poem, East Coker, as quoted in the previous entry, describes perfectly the geography of what I call the wasteland.  I came across it when I was in the depths of my own wasteland, a deeply troubled inner world.  When I read it I wept.  These were tears of recognition, of relief at reading words that someone else had found for a state that is largely indescribable.  When I read it now, some ten years later, the tears still well up.  East Coker is one of a set of poems referred to as "The four quartets".  I wonder what experiences in Eliot's life fuelled their creation.

Many things propel us into the actions we choose in life.  It was a conversation with a friend a week or so ago that decided me on setting up this chronicle.  He and I have been through parallel wastelands; our circumstance and troubles had different roots, but the task of getting through those experiences, of surviving, threw us both back on the last vestiges of our strength and for each it was a very narrow pass.  Few can accompany a person in such extremity, and we were fortunate indeed that our friendship endured, fortunate also that we were not traversing the wasteland at the same time.  We emerged much altered and both agreed it would have been helpful to have known a few of the things then that we know now - about the nature of the wasteland, and a few pointers on how to get through it more or less intact.

For me recovery is ongoing.   There is much I still don't understand.  I have struggled to find words for it, and even now talking about it seems almost impossible.  Hopefully I can articulate some of it here so that it makes sense to others which may also help me make sense of it.  This may sound back-to-front, but it needs to be: just as a mirror shows the reverse image of the viewer.  Without communicating some of what happened that part of me remains isolated and snowbound.

I often recognise the signs of extreme experience in others: I see the tracks which shock, rage, terror and grief have written on their countenance, not in a disfiguring way but in the nuance of expression and in their bearing, a certain remote otherness.  The watcher within is wary.  I can stand alongside them and say "I know."  Yet for the most part these people look so very ordinary.  We would pass them on the street or in the supermarket without any such flicker of recognition.  How many there are...

The wasteland seems trackless and endless and the odds insurmountable, but if we have the right prompts and support we can gradually begin to make sense of things, and as we do so, the intensity of our suffering gradually loosens.

Although I won't go into much detail about what landed me in the wasteland, I will share some small part of it along with insights and suggestions that may be helpful to others.

I've written the articles in five cohesive groups, as shown in the blog archive to the right.  Articles should be able to be read individually or in sequence, depending on your interest.  I've used the labels system like an index so that relevant articles can be easily identified and accessed.

To those of you who are at present in the wasteland I wish you safe journey, and to those who stand friend to you, patience.

To go to the next article click this link:
Descent into the Wasteland ~ the falling tower

Descent into the wasteland ~ the falling tower

The falling tower is used here as a metaphor for everything falling apart.  There are many ways we can experience disaster, trauma and ruinous loss: through illness, accident, political or societal injustice, upheavals of the natural world, economic woes, abuse, crime, warfare, loss of loved ones, or just plain disillusionment.

If this sounds like you, it may seem that you've been reduced to nothing, or as close to it as makes no difference.  Sometimes loss and trauma is visible and public, and sometimes it's private.  Either way it's something that has to be lived through - no one else can do that for us.  Nor should they.

You may feel bad if you've fallen apart in a situation which has not affected others the same way.  If so, it may be helpful to remember that  adversity affects each of us differently: what one person takes in their stride may cripple another; we're all different, have different temperaments and capabilities, and different challenges.  Comparing yourself unfavourably with others will just get in the way of you gradually getting back on your feet.

Battling on unassisted with the intention of toughing things out is also unlikely to be helpful: while it will work some of the time this approach may lead to more damage and more to come to terms with further down the track.

On the other hand, acknowledging the extent of your difficulties and beginning to sort through them - with the right support, is helpful and will enable you to begin finding the road back to something approaching 'normal'.

To go to the next article click this link:
My falling tower ~ what happened to me

My falling tower ~ what happened to me

Several aspects of my life had me heading for a blow-out: I was working far too hard and far too seriously at a job with which I felt increasingly at odds, at the same time as dancing attendance on a New Age 'healer' whose demands became more incessant over time.  I became not just drained but exhausted in more ways than one.  In a weakened state I succumbed to a flu-like illness after which I did not seem to regain my vitality.

As my situation worsened I re-examined not only my beliefs but also my values; I carefully re-considered what had been going on and what was expected of me.  I came to see much I didn't like and even more that seemed faulty.  By then I was not only exhausted but also increasingly troubled and depressed.

I broke off my association with the 'healer' and struggled on at work but finally became unable to continue and resigned, saying I needed a change and some rest.  I had no idea then how unwell I was.  I expected that with a bit of time to myself things would come right, maybe in three to six months after which I'd be able to move on to something new.  If only that had been the case!

My world was disintegrating: no longer able to work I lost my income and with it status; a whole social setting which I had thought entirely dependable, disintegrated piece by painful piece; and away from the structure and normalising effect of everyday work my health and general state deteriorated.  All my adult life I had carefully acquired coping mechanisms, but at that point none of them worked any more - not at all.

I needed to go home, but where was it?  I moved back to my home town which I'd been away from for twenty years, with the result that I knew hardly anyone there, still less the professionals from whom I needed help. 

The accumulated shock was unbelievably severe and as the shock waves within me repeated and deepened I came very close to losing my mind.  I felt dislocated and disoriented and had difficulty in thinking in more than the simplest terms.

I didn't understand what had happened to me or see what I could possibly believe in any more. The future seemed so completely blank I wondered if I might be going to die - perhaps I'd 'done it all'.  I had no idea whatsoever of what life could hold for me or what I could or should do, and so on and so on.  I found myself answering polite, kindly enquiries with same answer: "I don't know", "I don't know", "I don't know".

My brain didn't seem to function as it should and hurt most of the time, my whole nervous system felt tinder dry.  Not surprisingly my digestion became troublesome and could cope only with the blandest of foods.  Often when I went out I felt faint and nauseous; there were times when walking to the letterbox and back required effort and concentration.

Exhausted as I was I became afraid to fall asleep, my dreams were so fraught with terrors and catastrophes.  I'd toss and turn in bed, my skin disturbed by itching and twitching which constantly moved, and often, just as I was falling asleep, I'd find myself jerking awake.

Emotionally I discovered the depths of feelings I hadn't guessed I had: volcanic rage which congealed into a weird sort of semi-numb despair only to re-erupt unpredictably, ice cold hatred, grief which vacillated from lengthy spells in which I simply leaked tears, to stark emptiness, and the endless questions which hung unanswered: what was the matter with me, how had this happened to me, how had I let this happen to me, and perhaps most anxiously of all: was it ever going to end?

That was my falling tower.  I was on my own. 

Well, not quite: I was immensely fortunate that my family, partner and one particular friend stood by me.  I was exceedingly hard to help, but I knew that they were there.  They watched over me, and kept on loving me even when I was at my most miserable and incomprehensible, not intrusively but they were there.  A few times I phoned my friend and asked him to come right away which he did.  He talked to me quietly until I calmed down.

Isolated, ill and flinching from contact I turned to nature for solace: the big trees around the house, the stream at the bottom of the garden, and the birds.  Thus began my very gradual recovery.  At that time I had no concept of how long it would take - which was a another problem altogether.

Looking back I can see the threefold symptoms of burnout, chronic fatigue syndrome and acute stress disorder staring me full in the face.  I now also know that two instances of trauma experienced earlier in my life made me vulnerable to developing post-traumatic stress disorder.  But these insights came only gradually and not from any expected source.  If only I had stopped trying to keep things afloat earlier, as trying to push on regardless just made everything worse.  If only I had had adequate professional help.

I still can't properly understand why I was so devastated, other than in a mildly intellectual way.  In emotional terms I can't explain it - but there it was, and is!  I'm still attempting to find answers.   Sharing what I have learnt about the Wasteland experience is part of that quest - to see things more clearly.

It is also driven by a considerable amount of anger, that it was so difficult and that the people whose job it is to make these things easier, were for the most part conspicuously absent, or if present were seriously deficient in providing the sort of basic information and insight that I am setting out here.

When these sorts of crises and disasters happen in our own lives we feel sure we are alone, the only one, and that no one else could possibly understand, but in fact masses of people go through this sort of thing, and I hope that what I have learnt may be of some help to others.

To go to the next article click this link:
Wasteland companions 

Wasteland companions

Although traversing the wasteland is essentially a solitary experience a small number of people may serve as companions.  These are friends but not in the usual sense, as friendship is more commonly based on mutual sharing and support which is likely to be impossible at such a time.  Part of how they help will be by being 'normal' with you - you can relax with them in a way your can't with others because you don't have to pretend to be okay and because you know you are safe.  They are like the tent pegs which hold up the tent, just by being themselves and continuing to be in touch.  They will try to understand.  They may not do so, but they will try.  Don't be angry when they don't - they are at any rate on your side.   They have a vital role to play so treat them well and recognise that they, like you, have needs.

There may be up to four such people.  More than that is likely to be too many, and fewer may result in too much pressure on too few.

People who go through traumatic experiences often say: "I found out who my real friends were" with the implication that not many continued to be in touch.  When I was most unwell this certainly seemed to be the case; I was upset at what seemed like the indifference and defection of those I thought I had been close to and could count on.  I now see this differently: it's the nature of such situations.  This doesn't mean that others drop our friendship, but rather that they can't be our companions at this time, just as we might not be the right companions for them if they were the ones in crisis.  It's important to recognise this so that we don't break off connections with good people who are simply not accompanying us on this part of our journey.  Time will tell if they are there for you in the long run, and those who stick around may not be the ones you expect.  Others will drift away, which is natural.  In any case you will be a different person when you emerge back into a more normal world, and may be looking for different qualities in those around you.

Ideally there are some professionals who can also provide help:
A doctor: In any extreme situation we need to know we have a doctor who can contribute their expertise and advice.   I left a superb doctor behind when I moved cities, and not knowing or being known by anyone comparable in my home town almost crushed me.

A legal person: lawyer/solicitor: When distressed and unwell it's not a good time to make big decisions yet often we have to.
     At such a time one can so easily be parted from considerable chunks of savings, investments and valuables, if only because in our crisis we are unable to think clearly about these sorts of issues.
     It's often easier to walk away than to stand up for our rights.  I encourage you to at least find out what these are.  For example, if you've had workplace issues you may have the right to legal redress.  In New Zealand, employers now have a level of responsibility for the well-being of staff.  I suggest you hold onto your end of the scales and resist the temptation to enter into these sorts of discussions without proper legal advice and support.  It also makes sense not to talk too much about any other difficulties you may be having elsewhere as this can cloud the issue and put you at a disadvantage; when we are in a state of crisis we easily lose perspective and in hindsight may see things quite differently.
     Decisions made at these times can have a huge impact on our lives for many years to come, so it can be really helpful to have a good legal person on your side.  A knowledgeable lawyer or solicitor should be able to advise you and act for you if you wish.  If you are unable to afford the cost you may be able to apply for free legal aid.
      Again, I didn't have this support, and so created additional handicaps for myself.

A therapist, counsellor, or spiritual adviser: indispensable.  I now have one who is just right for me.  When things were at their worst I did not.  There were good reasons why I didn't seek one out sooner, and now that I have this support it's an immense help.  If you are looking for one and make a choice of helper who turns out not to feel right don't give up - try someone else!  Even the best therapist may not be the right match for you, and finding that right match is the essence of a good working relationship in this exceptionally sensitive area.  I didn't get it right the first time, and it was a great relief to stop what wasn't working and look further.  If you can't afford the expense you may find you can get funding for it from a government agency.

An advocate: someone to go with you to any or all of these people or any others you may have to engage with, such as welfare agencies and the like, to act as a support person, to hear what is said, to take your part, and to see you through the process.  A friend or family member may be able to do this for you, or a local support group or welfare agency may provide one.  Don't be afraid to ask.
     The Health and Disability Advocacy service has recently been brought to my attention.  I wish I had known of it sooner.  This document about your rights as a consumer of health and or disability services is useful information.  If you are looking for the original link or want to read it in a different language this document is posted here.

Getting help through agencies when we are in crisis can be a seriously upsetting and humiliating business.  Don't do it alone if you can help it. And do persevere in getting what you need.  It won't come to you on a platter but it is important to get every scrap of support you can.  I can't emphasise this enough! It may not seem like it at the time, but every little bit helps and in the long run it may make a much greater difference than you expect, especially if your recovery turns out to take a lot of time, as mine has.  Good luck.

To go to the next article click this link:
Staying safe and setting boundaries

Staying safe and setting boundaries

I see loss of control over personal boundaries as a central factor in trauma which makes the sufferer much more vulnerable than usual.  These boundaries may take some time to become re-established and while recovery is under way we need to be much more careful than usual about our safety.

It's sensible to use our sense of safety as a guide when considering what to do and with whom. If you're not sure what to do, I suggest you opt to stay safe.  Do what is necessary but don't expose yourself to anything that makes you more vulnerable than you already are or puts you in a situation where you might be - you already have more than enough to deal with.  If such a situation is unavoidable try to have a support person with you.  Here is where you can begin to be back in charge - by looking after yourself!

At the time that I was most unwell some dangers were real in a practical sense and other lesser disturbances perceived as such.

I did put myself in danger of worsening my own extremely vulnerable situation by attempting to battle on unassisted when I lacked the judgement to do so.  At the same time I was aware of teetering on the brink of losing control of my mind which I knew could happen if I surrendered to the anguish and rage within, or allowed myself to dwell too much on what had gone wrong.  Also, I knew I was in danger of alienating those few who provided me with a semblance of support by behaviour which was too anti-social or demanding.  These dangers were very real.

A different sort of danger arose from my own extreme state which made me hyper-sensitive to absolutely everything.  This made the sense of being invaded and overwhelmed by various incidents and influences much greater than was realistic; I started at shadows which were to some degree the spooks of my own distorting fear and the effect of sensory overload on already overwrought nervous system.

Those we come across in the course of our everyday lives often lack perception and are much less helpful than we would wish.  Mostly this doesn't greatly matter since we can correct the balance through applying our native survival instincts.

When I most needed help any instincts of this variety had become either too visceral to be allowed expression or so watered down and lacking in focus as to make useful communication impossible, thus in the presence of doctors, bureaucrats and other official helpers I tended to be speechless, tearful, or to prattle on about irrelevancies.  That these professionals were for the most part unable to bridge the gap increased my distress, that and my own manifest inadequacies.  I often wished I hadn't tried. 

My personal boundaries had been shattered and with them my ability to look after my own best interests: I needed help, but had great difficulty locating it, asking for it if it could be found, and receiving it if it was offered and available.

So if you find yourself in similar strife it may be useful to focus on staying safe and to remind yourself how proper boundaries usually work - with all the usual imperfections.  Hang in there!

To go to the next article click this link:
Staying safe with personal disclosure 

Staying safe with personal disclosure

In the midst of a crisis, be it long or short, personal disclosure can be a confusing and troublesome area, so I urge you to think carefully about what you disclose and to whom. 

When our lives are in acute disarray there may be a tendency to 'spill' very personal information at length to all manner of contacts; at such a time our boundaries are likely to be in tatters and the internal pressure to talk about our troubles intense.  Yes, it's a good idea to talk, but it is in your best interests to exercise care and restraint as to who you choose to do that with for two reasons: firstly, too much information about our troubles swamps people who may not have earned that place in our lives, or want it, and who may then begin to distance us; secondly, in some instances it gives those in authority levers of influence they wouldn't otherwise have.  Further down the track when you've cooled off a bit you'll be glad you did, or possibly regret that you didn't!  I've made this mistake repeatedly and seen others do the same.  If you're upset and indisposed, there are very few people to whom you actually owe an explanation.

If you have good reason to disclose more than superficial detail it may be useful to start by describing facts rather than feelings, for example not getting enough sleep, or having a lot of headaches, or noticing that you've been 'a bit irritable lately', and so on.  These are ordinary things that most people can relate to and aren't all that personal.  In my search for the right doctor I repeatedly found myself tied up in anxious inarticulate knots and gabbing on about personal issues which often reduced me to tears, when I could have made myself very much clearer - and got better help, by describing physical symptoms instead.  Regardless of who you're talking to, if you take this approach it will give you time to see what sort of response you're getting and also time to decide whether you then feel safe saying more - if you want to, or if it seems likely to be useful. 

A word about answering 'official' questions, particularly on forms and in interviews: be aware that it may be simpler to decline to answer some questions than to sort out later whether or not certain personal information is kept on file.  A decline may not be challenged whereas getting information removed when you later decide you don't want it kept on record may be impossible.  Having said that, some agencies may find that they are 'unable to provide the usual services' unless 'mandatory information' is provided.  Well, so be it, but you may wish to find out exactly what is mandatory, how your information is to be stored and for how long, and so on.  Most people don't ask these questions but it is reasonable to do so - it's about you.

At the more mundane end of the scale are the small, usually inconsequential exchanges we have when we greet each other.  Being asked how we are is part of this and in New Zealand it's usually a greeting and a conversational gambit only, not a real question at all.   The accepted response is "Fine, thank you" and if you're really polite this is followed by "And you?" Everyone is usually "Fine", a polite fiction which we exchange along with polite smiles.  

While I must say I find this sort of exchange somewhat bizarre it works well enough most of the time with the exception of when we are quite otherwise.  At such a time saying we are fine is likely to make us feel positively surreal, so what can we say that isn't going to make us feel a whole lot worse?  The odds are that we won't feel inclined to talk about how we really are.  Think about what works for you and have it ready so that rather than feeling cornered, you can pick how much you want to disclose and to whom.  Bear firmly in mind that most people really aren't interested - and may even become alarmed if you tell them more than they are expecting! 

People who are nosy and not concerned about our well-being at all can be difficult to deal with.  If you're off work and don't want to disclose that you're unwell you could say that you have leave of absence from work; are taking time out; have retired; are on sabbatical, or writing a book...  This last one can be particularly handy as writers don't usually talk about what it is they're writing!

If conversing with someone who makes you uncomfortable by trying to look you in the eye, you may wish to focus your gaze on the end of their nose; this gives the appearance of meeting a persons gaze while giving you a little more personal space. 

I find it hardest to know what to disclose to long-term acquaintances such as my landlord and neighbours, people I like well enough and chat to fairly often but would not describe as friends.  Do they need to know about my personal life?  The answer has to be 'No', but it can be helpful to acknowledge in part why certain things are the way they are, and in my case this has resulted in offers of help - which I usually don't accept, but it's nice to know who I could call on if I chose to. 

Sharing a modicum of information eases things for everyone and reduces our isolation.  The better acquainted we are with those around us, the more worthwhile it will be to put some effort into getting this level of communication to where it's comfortable - for you.  You're in charge.  Go gently, stay safe.

 
This is the end of Part 1.  To go to Part 2 click this link:
Part 2 ~ Medical and health considerations

Diagnosis ~ what seems to be the matter?

Naming health problems is important for lots of reasons: in identifying treatments, establishing eligibility for welfare support and funding through government health schemes, providing an overview of likely recovery phases and times, and in giving us a point of reference when it's necessary to explain long term disability or indisposition.  We can then undertake our own research and become more fully informed.  

But getting a diagnosis isn't always straightforward and indeed may prove immensely frustrating.

Problems can arise when a range of symptoms is common to a group of health disorders.  Symptoms associated with trauma such as sleep and memory problems, difficulty concentrating, irritability and outbursts, depression, susceptibility to over-stimulation, fatigue (which may worsen with exercise) and headaches are also indicators for depression, burnout (which isn't recognised as a medical condition by authorities here in New Zealand) chronic fatigue syndrome/M.E., the long term effects of head injuries and post-concussion syndrome, as well as post-traumatic stress disorder. If you are female you may even find menopause suggested.

That cures are elusive and treatments often limited to 'managing' these conditions can compound the situation.

Furthermore, one's state may fluctuate inexplicably but not seem to change much overall.   Some of the time we are likely to be fine, at others not at all.  And since it's natural to make an effort when relating to others they are likely to get the impression that we are absolutely fine - another handicap in terms of being understood. 

I am sure that any chronic health disorder is likely to be caused by a cluster of factors.  This certainly seems to have been true for me. (Refer earlier article.)  Had these health challenges occurred singly they might well have been overcome. Although I am long past the acute stage various symptoms persist often in a seemingly random fashion.

Contributing factors may have accrued from much earlier in our lives: when reading up about post-traumatic stress disorder I was interested to discover that those who have experienced trauma earlier in their lives, particularly in childhood, are much more likely to develop this disorder than those who have not.  Motor vehicle accidents, assaults and the sudden, unexpected death of a loved one are all statistically very high stress factors.

In the area of trauma there are no easy answers, but I do encourage others to persevere in finding a doctor who recognises disability and loss of normal function and puts pen to paper accordingly.  Hopefully robust good health will reassert itself over time.  

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Diagnosis ~ medical terminology  

Diagnosis ~ medical terminology

Medical terminology can be baffling to those seeking help.  Once more I urge those in this position to describe their symptoms, and to keep an open mind about the terms that doctors use in response.  I encourage you to focus on the access your doctors diagnosis gives to help, be it medication, counselling, subsidies, or whatever else is available.  

Here are the medical terms I've come to better understand after extended periods of bafflement:

Depression equals, well, just about anything: 
This diagnosis seems to be used as a general term for emotional and mental dysfunction over a wide range.  It's a diagnosis which is readily accepted by bureaucrats as well as the medical profession.
     For years I resisted this diagnosis of my condition; while I do see this as one element of it I don't see it as the primary one, but regardless of my point of view, accepting this diagnosis has given me access to a lot of help I wouldn't otherwise have had. 

Shock equals trauma: 
The medical term for shock seems to be trauma.  Shock that results from being subjected to physical violence or sudden and unexpected bereavement is widely understood to be deeply distressing.  Shock that results from uncovering deceit and the consequent loss of trust or faith is more complex, and often baffling to bystanders, possibly even to those to whom it happens.  It was for me.
     I knew I was suffering from shock, trauma, or whatever else you choose to call it, but health professionals routinely responded with the familiar hold-all, depression.  So be it. 

Burnout equals Chronic Fatigue Syndrome - or depression!
Burnout is not accepted as a medical condition here in New Zealand, and the legal ramifications are far-reaching: without this recognition sickness benefits cannot be obtained and health insurers won't come to the party at all, never mind the medical profession, which leaves the sufferer high and dry.  Until this is established doctors must call it by another name.  Alternatives I've across are Chronic Fatigue Syndrome/M.E. or yes, here we go again, depression, or both. 
     My doctor cheerfully declares that I have both, which in his view isn't surprising because "fifty percent of those with M.E. also suffer from depression".  M.E. is a baffling illness identifiable only by it's symptoms, and definitions vary.  However, I have read one profile that does fit my condition and its inception very closely indeed, so maybe my doctor is correct. 
     There seems to be no literature at all which identifies the physiological components of burnout, which is immensely frustrating.  This is in contrast to studies done on the brain function of trauma victims.  I'm quite clear that my condition is neurological whereas at present burnout is regarded as psychological.  I defy anyone who has experienced severe burnout to agree with that fully; partially certainly, but fully, no! 

Depression-and-anxiety:
Doctors now consider that depression and anxiety often occur together or are closely related.  Treatments offered may be the same or specific to one or the other.  Chronic anxiety may be hard to identify in our own personalities if it is ingrained and habitual. 
     This was certainly the case for me!  I could see it in other members of my family but not in myself, until its sudden absence (temporarily) when trialling a new medication.  While the medication proved unsuitable in other ways it did make me realise how chronic my tensions were, which I could have read in my habitual defensiveness.  I wish doctors had raised this as a possibility when my illness was acute, when it could have been really helpful.
     If you think this may be an issue for you and your doctor hasn't already raised it, you may wish to do so yourself.

Panic attacks:
Believe it or not I experienced these for some time without having the least idea what was going on!  I knew other people had them and that treatment was available but doctors never suggested this to me.  I worried that I might have developed a heart condition, and no wonder.
     A panic attack can seem like a heart attack: the heart may race or thump, and breathing becomes, or seems to become, difficult.  The hyperventilation that can result may cause tingling and faintness.  It's perfectly natural to panic as a result!  Oh dear! 
     I must say I was gratified to see that Jack Nicholson's character in the movie "Something's gotta give", mistakes these symptoms in his convalescence following a genuine heart attack, and the doctor has to explain to him what the difference is.

All this emphasises the importance of describing symptoms adequately to your doctor, and doing what you can to get proper medical advice and information; also the importance of conducting your own study so that you can be your own best expert. 
     If your condition is chronic or long term, you are likely to be seeing a number of specialists.  You are the connecting link and likely to have the best overview.

I'm creating separate entries for some of these conditions so that informational books, articles and links can be usefully placed together.  Refer to the subject index at the right hand side of the page for easy access.

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Treatment ~ it's about looking after you

Treatment ~ it's about looking after you!

Sleep and rest issues:
The combination of deep distress and chronic fatigue can have very serious long-term consequences and I urgently counsel those of you affected in this way to get as much rest and respite from your troubles as early in the piece as possible.  

Proper, restful sleep is so important, as is having a buffer-zone from your own pain.  Talk to your doctor and to trusted advisers and friends about how this could be achieved for you.  

Taking adequate time out early on when a crisis occurs may make a significant difference to your chance of a full recovery.  Allowing yourself to be subjected to more wear and tear when you are already vulnerable until you are unable to continue may cause parts of your system to fail, making this hard or impossible.  I made this mistake with very painful results.

Getting help and treatment in whatever form it takes, isn't giving in to or avoiding the problem, it's looking after yourself, so that you can get through it and have the chance of a normal, healthy life in the future, and hopefully sooner rather than later.

Orthodox medicine offers:
Medication in the form of antidepressants, anti-anxiety pills, pain killers, anti-inflammatory pills and sleeping pills. It may take time to work out what's suitable for you.  If you are fearful of these treatments say so to your doctor and those you're close to.  It may take time and a lot of reassurance to find what's suitable for you - don't give up.
     I've found pharmacists very helpful in discussing medications, and more forthcoming about them than doctors.
     You may like to gather your own information from reputable websites such as the New Zealand Medsafe site.

Medical doctors are also able to facilitate referrals for counselling which may then be able to be subsidized.

Other therapeutic treatments which may be available are:
Acupuncture, nutritional advice, and Ayervedic medicine and practices, and many more.
     I'm cautious about speaking of these forms of treatment as in my opinion they may promise more than they deliver, and there are fewer safety mechanisms with them than with orthodox medicine.  Medical doctors and other personnel can be called to account if need be, whereas alternative health practitioners do not operate within similar structures. I know it can be difficult to find the right doctor, but while that role can be supplemented by alternative health practitioners and treatments, it's important not to substitute alternatives for a regular doctor altogether.  If you've become seriously distressed and/or unwell, you need proper medical supervision.  This is one of the few instances in which I am making a bald statement rather than a suggestion!  I am speaking from considerable experience of success and failure in both quarters.

Adverse reactions:
Hopefully the medicines and treatments you choose are successful or at least satisfactory.  However, even the best of doctors and most routine of treatments won't be suitable for everyone - there are always exceptions and there may be no way of knowing that in advance.  I've had good and bad reactions to the most humdrum of orthodox as well as alternative treatments.
     Quite a lot of people think that if a remedy or therapeutic practice is natural it can't do any harm, or even that more is better.  Both concepts are faulty as I have found to my cost.  
     In my case four out of five serious adverse reactions resulted in  intense depression.  They resulted from transcendental meditation, a homoeopathic remedy I was not told the name of, Ayervedic self-massage, and the mildest possible dose of a widely used antidepressant.  These would seem harmless enough for most people but were clearly unsuitable for me.  (The homeopath was in fact delighted: "A classical response!" was her cheerful pronouncement, which was all very well for her, but  potentially dangerous for me!)  These episodes were widely spaced over three decades and were not preceded by anything that might have suggested this response.  In each instance depression receded after I stopped the practice, remedy or medication.
     I've said it before and I'll say it again, I do caution readers to exercise self-care before any other consideration in pursuing therapeutic options.  If they make you feel worse it may be wise to discontinue them, at least for a time.  An adverse reaction is our body's way of giving us important information.  Everything in the right time and place - don't push yourself.  Go gently.

Those interested in reading more about the possible adverse reactions that can arise from meditation may wish to read:
"Meditation, delusion and deception", by David J. Bardin and is about general problems which can occur.
"Warning: meditating may be hazardous to your health" by Sandy Brundage and is about transcendental meditation in particular.

My rule is this, and yes, it is a rule, which I urge you to follow: if a treatment makes you feel more stable and steady, fine; if it doesn't, stop!  Practitioners who are otherwise intelligent may encourage you to persevere, to push through a difficult patch in order to clear out old blocked energy or resistance.  My advice is the complete opposite!  You have enough difficulty in your life already.  What you need is respite from it. It's vitally important to go slow and allow your system the time it needs to clear itself at its own pace and in its own style.  Struggling may be what landed you in your present predicament and you don't need more of it!  Do you walk on a broken leg?  No!   Do you go out into the cold and snow if you have pneumonia?  No!  Do you recover from violent upheavals by forcing yourself to take on more hardship?  No!  If you think you can sense the steam pouring out of my ears you're right - and it still is!
     I think a lot of health professionals don't comprehend the hyper-sensitivity which can result from distress and an overwrought nervous system.  What is needed are calming influences and quiet, and some serious rest.  The instinct for self-preservation is to block out further disturbance and this should be respected.

The healing power of contact with the natural world and its peace and quiet is considerable: when most unwell, I spent a lot of time in an easy chair at an open door, wrapped in blankets and resting my eyes on the big trees and watching the birds come and go.  Unable to find rest and respite in sleep which was routinely a kaleidoscope of nightmares, and plagued by headaches and other troubles by day, I found that sitting gazing out into the natural world and breathing the fresh air was a life saver - literally.  Gradually things calmed down.  

More about medications I've tried:  (This passage added 29th August 2011)
Please note that what I say here is not medical advice, but the sharing of my own experiences.  I wish someone had talked to me about this sort of thing when I was making these choices myself.  As with so much of what I was coping with when my difficulties were most severe, no one talked to me about it in the way that I could take in or identify with - so here you are: this is the path that I took:
     Lacking knowledge of better choices, there were a number of years when I took Ibuprofen (also known as Nurofen) regularly, which I found helpful for settling what I call 'a bad head', when my head ached or I couldn't think straight or see clearly.  And when my nerves felt completely out on stalks or I simply couldn't sleep I found that Panadeine helped.  Both can be bought over the counter here in New Zealand, but I had mine prescribed by my doctor.  For a long time he was happy for me to take them as long as I stuck to the recommended dose.  (Exceeding that can have dire results so care is important.)
     More recently my doctor expressed concern that my regular usage of painkillers could be contributing to my lowered state. He said that research now shows that use of painkillers on more than ten days a month can actually cause headaches and suggested I try a different strategy.  As a result I drastically reduced the amount I was taking, and did feel considerably clearer as a result, and surprise - experienced fewer headaches.
     Having established what was something approximating normal for me I then started on the mildest possible dose of Citalopram, an SSRI medication used for treating depression and anxiety. This has turned out to be much more effective.  Although there were some side effects initially, they did fade in about a week, and an almost immediate benefit was that I am now able to get to sleep relatively easily most nights.
     I have never accepted that my main problem was depression, but could identify that I suffered from chronic anxiety and nervous tension.  The major benefit from the new medication has been that I now feel more relaxed generally and have a bit more ease in my nervous system.  I wish I'd tried this out years ago.  It hasn't magically set everything to rights or blotted out my 'issues' but it has helped, and I've needed that.
     It's important to be clear that medications work very differently on different people, so what has worked for me may not work for others the same way, and having a bad experience can be very off-putting.  For example, my system can't tolerate Amitriptyline at all, an older style of medication, and the appalling reaction I had to that totally put me off trying anything else, which in hindsight is a pity.
     So one more time, I'll say firmly: Do get adequate medical support when making these choices and do not hesitate to phone up your doctor, and / or consult your pharmacist if you have any concerns at all once you've started trialling any new medicine.  Let them help you.  Keep that support close at hand and improvement will hopefully become evident with time. 

In conclusion:
During that most difficult time I did try to find a suitable doctor, but when it was most crucial I lacked the medical support I needed.  If I had had proper medical attention things could have been so much easier.  For this I was partly responsible as I did largely resist orthodox medication.  This is why I'm putting these points so strenuously - I'd like it to be easier, less harmful, for others.  
All strength to you.

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Chronic Fatigue Syndrome / M.E. ~ comments and links

Chronic Fatigue Syndrome / M.E. ~ comments and links

There is a mass of information and material on the web about this condition.  My purpose here is to present a useful cross-section from what look like reputable sources.

Chronic fatigue can have many causes and long term fatigue is not necessarily the same thing as Chronic Fatigue Syndrome, otherwise known as Myalgic Encephalomyelitis or M.E.

The Whittemore Peterson Institute provides a good crisp definition.
Definitions vary somewhat so I have also included two others:
New York Times health guide - definition

Those suffering from chronic fatigue conditions could expect their doctor to investigate other possible causes before arriving at a diagnosis of CFS.

Difficulties in diagnosing CFS arise from lack of identifiable causes and no conclusive tests.  However, the Pacific Fatigue Lab in California has recently conducted heartening research on post-exertional fatigue.  It shows not only that many CFS sufferers are uncharacteristically exhausted by exercise and take a long time to recover, but also that if exercise is repeated after a reasonably short interval, there is a further, much more severe drop-off of exercise capability.  This unexpected response is distinctive in many CFS sufferers.  The original article published by the lab itself has been removed from their site recently.  Fortunately I found this article which provides a full discussion of it. 

Other research has extended to the study of genes which is referred to in this BBC news item.

CFS sufferers include some very articulate people whose views and experiences can be read on the following sites:
  • The link here is to the review of a book on CFS which includes interesting comments from sufferers.  Please note that this book has proved unpopular with most reviewers.
The book "Surviving M.E." by Joyce Fox (Vermillion, 1996) is highly recommended by a friend.  Here is a brief review.  Note that it's the top review only.  Despite its old publication date it can still be obtained new from both Amazon UK and Amazon.com.


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Burnout ~ comments and links

Burnout ~ comments and links

At a basic level burnout could be described as a combination of severe exhaustion, distress, dis-empowerment and depression.  When we keep going and our inner self has been saying "Stop!" unheeded for too long burnout may result.  In severe cases continuing in the old way is then impossible.  Recovery requires time, lifestyle changes and clarification of personal issues and values.

This article in Wikipedia provides a good overview which is just as well as I found no mention of it on either the BBC or the New York Times health guide sites.  I know that burnout doesn't have medical status in New Zealand or in the U.S. and from its omission from the BBC site I presume it isn't recognised as such in the U.K. either.

The medical profession's refusal to recognise the condition is puzzling as any web search immediately throws up masses of articles about the degree to which those in the medical profession suffer from it.  Here is an example in the New Zealand Medical Journal.
 
Some years ago I read a book which discussed the legalities involved with this in America, but unfortunately have no record of the title.  Those researchers were well aware that this lack of recognition meant that doctors and patients had to find another way of placing it. Chronic Fatigue Syndrome, otherwise referred to as M.E., is one of them, and as this condition is often accompanied by depression it would appear to fit it quite well.  My personal view is that it is a distinct condition and I hope that one day it will be recognised as such.

Burnout certainly does have strong psychological components.  With CFS, on the other hand, depression is considered to be a separate issue.  Those who claim that burnout and CFS are related are unlikely to have formal research or health authorities supporting their views.  Such claims can at the best be considered as conjecture.

So how then do doctors end up making this compromise?  I don't know, but I suppose that if burnout isn't acknowledged as a medical condition it isn't seen as a compromise at all, and if CFS-like symptoms continue for an unexpectedly long time it's not a surprising conclusion.  Alternatively, maybe the physical and emotional trauma of burnout makes one vulnerable to developing the more serious and long term condition of CFS.  Clearly more research is needed.

I do highly recommend Dina Glouberman's book  "The Joy of Burnout" which I found very helpful indeed.  The author describes the condition with the conviction that arises from her own experience.  Dina is a psychotherapist so this is her angle on profiling  it, relating different cases, and offering suggestions about managing recovery.  It's very easy to read and her crisp identification of what's distinctive and important kept me turning the pages.
Here are:
And also:

Dina makes the important point that burnout isn't caused by overwork, but by overwork in situations in which we repeatedly over-ride our own judgement, ethics and natural limitations - often in order to please others.  Those with an over-active sense of duty and obligation please step forward! 

If this is you, I suggest you urgently reassess your situation and scale your efforts back to what fits you better.  It's not worth repeatedly going that extra mile for others, believe me.  You might consider bringing that fine quality of duty to bear on your own well-being. 

It may be helpful to remember the instructions of what to do if you are on an aeroplane and the oxygen masks drop down: you put on your own mask first before attempting to help others.  If you pass out before doing so, you are of no use to anybody - rather the reverse.  Our own well-being really is our first responsibility!  This may seem obvious or selfish depending on your point of view, but it's true nonetheless and very easy to lose track of when we are closely involved with those who are dependent and / or demanding.

My only disappointment with Dina's book is that there is no discussion at all of the physiological effects of burnout.  It certainly is frustrating that so little research seems to have been done, and what I have been able to find focuses on the adrenal function rather than neurological factors.  Severe burnout isn't marked only by what feels like near-death fatigue and emotional malaise, but also by what feels like a neurological disaster: blinding headaches, cognitive incompetence, super-hyper-sensitivity to absolutely everything and chaotic nightmares - all, in my opinion, obvious signs of a brain in melt-down.

While it's important to address the mindset and behaviours that landed us in this degree of physical crisis, recovery isn't going to be achieved purely by changing our priorities and improving our outlook.  Much more is needed, but what?

I have come across one doctor who responded affirmatively when I asked him about burnout.  I needed medical attention for quite a different matter, but asked this question in addition.  Yes, he said quite matter-of-fact, it was a condition in its own right and distinct from Chronic Fatigue Syndrome.  He went on to say that once one loses the degree of function that I had it wasn't possible to fully regain it.  His acknowledgement of burnout as a condition was heartening but his prognosis sobering.  I wanted to talk more, to find out more, but greatly to my disappointment he was 'only a duty doctor' at a twenty four hour health practice so I was unable to consult him again.

I do hope you have better luck.  I'm sure that most people would understand that doctors need properly researched and accepted studies before making their own pronouncements.  We expect that.  If doctors are taking their present stance due to these and legal constraints it would be helpful if they could at least say so.

Footnote, 29th August 2011: 
I've added a passage about medications I've tried in relation to this, to my article Treatment ~ it's about looking after you.

Book shop link for interested NZ readers:

Fishpond.co.nz - sorry, no image of cover available.

Depression ~ my experience

I've found this a difficult subject to write about and decided that the only valid way to do so is to relate my own experience.

But first, for those looking for general points of reference, here are the links to:
And on the other side of the equation, here is the link to:
  • Anne Sheffield's website.  This woman has written a number of books about  surviving the depression of loved ones.  One of her books comes to my attention with a particularly high recommendation: 
  • "How You Can Survive When They're Depressed: Living and Coping with Depression Fallout"
There are no easy answers to the difficulties of managing depression.  It requires patience, staying power and insight.  Medication and understanding all have the potential to help, but still leave us with our own choices to make and lives to live.  What works for some may not work for others.  It's a very individual thing and good solutions are likely to take some time to work out.  All the best with it. 

Regarding my own situation I had always thought that the main symptoms of depression were an absence of feeling, a sort of paralytic numbness and lethargy, and a general loss of interest in life.  Although I've experienced this at times it certainly didn't fit what was going on for me when I was sick: my interests and motivation remained high and my level of feeling was at the other end of the scale - too much and a lot of it destructive, although not towards myself, I must add.  I contained all this only with considerable effort.  I knew I was suffering from shock, grief and anger, but depression, no.  Or so I thought.  No one talked to me properly about this.

One of the difficulties about defining depression is that it is a very general term which is used to cover a wide range of emotional difficulties and states of mind.  A measure I've since found much more useful is loss of pleasure.  Medical people these days have charts and weighted questionnaires from which they are able to deduce this sort of thing by totting up the resulting scores.  That approach has its place: the difficulty with measuring an emotional state is that there is no laboratory test for it - it cannot be seen under a microscope.

As I've said elsewhere I realise now that anxiety has been a really big issue for me, and as with any chronic condition we can become so inured to it that it feels normal.  However, when I was most ill I did know I was anxious and would have been much more responsive to the idea of treatment for that than for depression, even if the treatment for both had been the same.

But to put it most simply, I needed some kind of buffer zone between myself and the pain I was in to save my frayed nervous system and teetering sanity from further wear and tear.  As it was I refused antidepressants.  Looking back I can see it could have helped if a suitable sort could have been found; possibly I would have emerged from that acute phase sooner.  It's very difficult to recover if one is constantly stretched out like a high tension wire.  Relaxing was practically impossible - so I stayed stuck for a very long time.  To some extent I still am, although in a different sort of way.  It's frustrating.

Finally, a year or so ago, I did try a very mild antidepressant on the lowest possible dose.  It was not successful: in the week after I started taking it I found it harder and harder to get out of bed, to climb the stairs, to do anything.  After about a week I really did have raging depression: I was disoriented, had no idea why I had moved house a year previously, or why I had chosen the house where we now live.  I had no idea why I had ever decided to live with my partner and considered separating.  (He wasn't that keen on me just then either, although he was too kind to say so!)  I felt absolutely awful.

Fortunately, I had enough brain to get to the chemist and have a proper talk about the medication, which helped me decide to stop taking it.  The pharmacist expressed puzzlement as to why I had been prescribed that medication when I already had a serious fatigue problem...  Also fortunately, on the way home I came across a second-hand collection of some of Georgette Heyer's novels.  These two things saved the day: I got myself home, climbed into bed and enveloped myself in those stories, blocking everything else out.  I did not take my pill that evening.

The next morning I woke up feeling fine.  It was as if a switch had been flipped - I felt better than I had for a very long time, cheerful without trying in the least.  It was such an abrupt change that if I hadn't experienced it I wouldn't have believed it possible.  Probably the direct physical effect was accentuated by my relief but I did realise I had relaxed - fantastic!  I also knew that that particular medication was not right for me at all.  I realised more fully that anxiety and tension were areas I needed to become much more vigilant about addressing and / or discarding.  A psychotherapist I was seeing at the time added weight to my decision not to pursue trying other antidepressants saying "they are completely ineffective for those with M.E."  I accepted that pronouncement then because it chimed with my own decision.  Now I wouldn't do that so readily.

It wasn't until I was writing the earlier passage about adverse reactions that I thought more seriously again about depression for this reason: when I counted up the adverse reactions I'd had to therapeutic treatments four out of five resulted in raging depression - which lifted after I stopped the treatments.  I thought to myself that this must be more than a coincidence.

So I think that yes, I probably do suffer from depression, but it must be trapped underneath what I'm usually aware of.  If this is so it would explain why it surfaces when I'm receiving various treatments and I start relaxing.  Oh dear.  But why the depression?  I'm still looking for answers.  At present what I've experienced seems too large and shapeless to even begin.  I have no idea what it's about even, although I can think of reasons.  One can always think of reasons...  Fortunately I am currently seeing a psychotherapist with whom I'm comfortable and we are starting to look into this.  I definitely do need to have someone skilled to walk through this with me.

A few days ago when I sat down to begin work on this article I couldn't get started at all.  Sometimes if I'm stuck I find it helps to write just whatever comes to mind, so I did that and wrote the following passage - and abandoned the project for the day!  I'm pleased to be able to report that the next morning I felt much more normal, cheerful even, but it was a stark reminder of what it can be like.  I was interested to see that it centred around problems with fatigue, noise, tension and lack of sleep.  All of these factors seem to be triggers.  Here it is:
It's an odd coincidence, maybe, that in the few hours leading up to beginning work on this article I find I am feeling quite distinctly depressed.  I'm not often like this.  But now I am.  Feeling heavy and awkward, neglected and listless.  Not about anything in particular although I can always find a reason.
Good things have happened today, I remind myself: we did the shopping, paid a bill, collected this and that.  That's our weekly shop done now and out of the way.  Good.  Tired now.  Tired when we got home.  Bone tired.  Lay down but couldn't sleep.  Lay there, rested anyway for an hour or so, then decided nothing further gained by continuing horizontal and something further to be gained by getting up and doing a bit more to tidy the garage.  Energy will come with action, hopefully.  All the sound, sound louder, clatter ricochets in my head and out through my nerve endings, rattling me, again and again.  I'm shaking inside my feelings too, crashing about.  I just want to be still and sink down, sink down, sink down, silent, silently, silence.  But no, more rattling about.  No use complaining or shushing.  Just go on, first move, second move, third move.  Small gains.  Dishes washed up and put away; one more corner, one more side of the garage clean and tidy.  Colder now.  Lonely though not alone.  Lonely.  Inside television on.  Stupid people making stupid noise.  Stupid.  Tired again, tired.  Feel flat and empty.  Sit starring.  At nothing. 
My attempt to get some kind of line into starting this isn't working tonight.  Bed.
So it's an on-going story...  And a lot more of it still to be worked out.

More about those adverse reactions:
The other treatments that triggered me into serious depression those other times were: transcendental meditation, a homoeopathic remedy I was not told the name of, and Ayervedic self-massage.  These would seem harmless enough for most people but were clearly unsuitable for me.  (The homeopath was in fact delighted: "A classical response!" was her cheerful pronouncement, which was all very well for her, but potentially dangerous for me!)  These episodes were widely spaced over three decades and were not preceded by anything that might have suggested this response.  I've said it before and I'll say it again, I do caution readers to exercise self-care before any other consideration in pursuing therapeutic options.  If they make you feel worse it may be wise to discontinue them, at least for a time.  An adverse reaction is our body's way of giving us important information.  Everything in the right time and place - don't push yourself.  Go gently.

Those interested in reading more about the possible adverse reactions that can arise from meditation may wish to read:
"Meditation, delusion and deception", by David J. Bardin and is about general problems which can occur.
"Warning: meditating may be hazardous to your health" by Sandy Brundage and is about transcendental meditation in particular.

More about medications I've tried:  (This passage added 29th August 2011)
Please note that what I say here is not medical advice, but the sharing of my own experiences.  I wish someone had talked to me about this sort of thing when I was making these choices myself.  As with so much of what I was coping with when my difficulties were most severe, no one talked to me about it in the way that I could take in or identify with - so here you are: this is the path that I took:
     Lacking knowledge of better choices, there were a number of years when I took Ibuprofen (also known as Nurofen) regularly, which I found helpful for settling what I call 'a bad head', when my head ached or I couldn't think straight or see clearly.  And when my nerves felt completely out on stalks or I simply couldn't sleep I found that Panadeine helped.  Both can be bought over the counter here in New Zealand, but I had mine prescribed by my doctor.  For a long time he was happy for me to take them as long as I stuck to the recommended dose.  (Exceeding that can have dire results so care is important.)
     More recently my doctor expressed concern that my regular usage of painkillers could be contributing to my lowered state. He said that research now shows that use of painkillers on more than ten days a month can actually cause headaches and suggested I try a different strategy.  As a result I drastically reduced the amount I was taking, and did feel considerably clearer as a result, and surprise - experienced fewer headaches.
     Having established what was something approximating normal for me I then started on the mildest possible dose of Citalopram, an SSRI medication used for treating depression and anxiety. This has turned out to be much more effective.  Although there were some side effects initially, they did fade in about a week, and an almost immediate benefit was that I am now able to get to sleep relatively easily most nights.
     I have never accepted that my main problem was depression, but could identify that I suffered from chronic anxiety and nervous tension.  The major benefit from the new medication has been that I now feel more relaxed generally and have a bit more ease in my nervous system.  I wish I'd tried this out years ago.  It hasn't magically set everything to rights or blotted out my 'issues' but it has helped, and I've needed that.
     It's important to be clear that medications work very differently on different people, so what has worked for me may not work for others the same way, and having a bad experience can be very off-putting.  For example, my system can't tolerate Amitriptyline at all, an older style of medication, and the appalling reaction I had to that totally put me off trying anything else, which in hindsight is a pity.
     So one more time, I'll say firmly: Do get adequate medical support when making these choices and do not hesitate to phone up your doctor, and / or consult your pharmacist if you have any concerns at all once you've started trialling any new medicine.  Let them help you.  Keep that support close at hand and improvement will hopefully become evident with time. 


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