Chronic Pain

In June of 2002, I left work in order to have wrist surgery. The doctor, who was highly recommended, indicated that the recovery would only be about two weeks and I would be able to return to work without further complications. Unfortunately, it didn't work out that way. It was actually the beginning of a long and difficult journey through chronic pain.

The human hand is composed of 27 bones. One of the three primary wrist bones, the lunate, in my hand disintegrated due to lack of oxygen. The condition, known as Kienbock's Disease, is rare and is not clearly understood.

The things I learned from this experience are:

1. Importance of relationship with doctor. Bedside manners make a huge difference. This was true when dealing with my issues with my hand. It is even more critical when dealing with the ups and downs of bipolar disorder.
2. Importance of others who have gone through the same experience. One of the most memorable experiences I had while recovering from the pain and lack of mobility in my hand was talking to someone else who had gone through a similar experience. Doctors and therapists could share all kinds of knowledge and played a vital role in the healing/coping process but they could not fully empathize as they had never been there themselves. Talking to someone who had validated the experience for me and helped me cope a little better.
3. Time has a way of making things better. It has been over seven years since I had the operation that fused my wrist. Over the course of that time, the pain in my hand has subsided. It's not totally gone but I'm no longer writhing in pain at the slightest bump. I don't expect it to ever go entirely away, and at some point it may even get worse but for now I'm able to deal with it.
4. My time schedule is not the same as God's. Corollary to number 3 is the fact that I had no idea what the time schedule was for going through the ordeal of having my wrist fused. In fact, I had no idea that it was going to be an ordeal.
5. I had to learn to be flexible. Part of the process for me was not having use at all of my right, dominant hand for a period of six months or so. As a result, I had to learn how to do much with my left hand that I was used to doing with my right hand. Today, I am still much more ambidextrous than I would have been otherwise, i.e. I learned skills that I wouldn't otherwise have.

Although I realize that the similarities between the chronic pain in my hand/wrist and the chronic illness of bipolar disorder only go so far, I am expecting that there will be similar lessons learned from dealing with this challenging disorder.

Reasons to Live

When we are depressed, it can be difficult to remember the reasons we have to live. The following are some of the reasons that I keep in mind when I have those uncomfortable thoughts creeping into my head. It's a bit of a taboo subject but with some 30,000 cases of suicides annually in the United States, we cannot afford to keep this hidden. (That doesn't take into account the fact that there are 30 to 50 times as many attempted suicides as there are actual suicides.)

1. I have a responsibility and commitment to my family.
2. I believe I can learn to adjust to, or cope with, my problems.
3. I want to watch my children as they grow.
4. No matter how bad I feel, I know that it will not last.
5. I am afraid of death.
6. I love and enjoy my family and could not leave them.
7. It would not be fair to leave the children for others to take care of.
8. The effect on my children could be harmful.
9. It would hurt my family too much and I would not want them to suffer.
10. I am afraid that the method of killing myself would fail.
11. I consider it morally wrong.
12. I would not want my family to feel guilty afterward.

Source: Linehan, et al(PDF)

Clinical Depression Myths

In a recent post Therese Borchard outlined "10 Common Myths About Clinical Depression". As I read the post, I found myself nodding in agreement that the myths are prevalent in society. It wasn't until later in the evening as I was struggling to come to grips with my own depression—yep, it's back :(— that I began to realize that a lot of those myths are things I believe myself. I found that I was trying to control my depression as if it were just something I could shake off. I was getting frustrated with myself that I was unable to do so.

I've always considered myself a person of strong character. Besides the mental health issues I've encountered there have always been other significant challenges. (Isn't that true for us all?) But I've always been able to push my way through.

I'm finding that I'm not so easily able to push through this challenge. And I'm going back to meet with my psychiatrist tomorrow to discuss the possibility of my going back to work at least on a part-time basis as early as next week. I've got to say, I don't feel ready for that. Especially in light of the fear and struggles with depression and suicidal tendencies I've encountered in the last few days.

I find the image of an adult male cowering in a corner in fetal position disconcerting but I feel that way myself too often. It is not where I want to be!

Perhaps, it's good to be able to write this out and get this on the screen. On the surface I think I find myself putting on a good show. Something about the writing process allows me the freedom to get my feelings out.

Mood and Diet Connection

With the holiday season upon us, many of us are enjoying the feasts without putting on too much weight. For those of us with depression issues, we can experience the double whammy of not only adding pounds but also dipping into a blue funk.

There are many sources for depression at this time of year--from painful reminders of who's no longer around to seeing all the festivities are involved in but somehow we're left out. Those can be difficult to bear.

Another reason we may be experiencing the doldrums though may be all the extra food that is available at this time of year. From the extra helpings of turkey, stuffing and mashed potatoes at Thanksgiving to the extra cookies and candies that are shared at Christmas parties. It's a festive time of year and all the great food adds to the experience.

Dr. Barry Sears in an article on the Christian Broadcasting Network site provides some great neurology background into how the brain works and how it is affected by diet. He suggests that we reduce the amount of sugar we intake and supplement with a high-quality fish oil.

I don't know if it is from following this type of advice the last couple weeks but since watching more closely what I eat and supplementing with fish oil my mood has definitely lifted--thankfully!

Therese Borchard, in her Beyond the Blues blog posts, also gives some great tips to eating healthily during the holidays:

• 5 Tips for Eating Healthy Through the Holidays
• 7 Ways to Manage Your Diabetic (or Sugar Sensitive) Waistline During the Holidays

Bipolar, ADHD and Depression

Both people with bipolar disorder and those with ADHD often experience depression. This depression may be primary–i.e. due to biochemical reasons the individual becomes depressed without apparent reason–or secondary–i.e. due to external forces such as relationship or work issues. Both primary and secondary forces can work together to exacerbate the depression as has been my case with my latest major depressive episode.

Lately, there has been a lot of advertising on electronic and print media touting anti-depressants. I, personally, don't have experience with taking anti-depressants, but when I'm battling deep depression I sometimes wish I could take something more that would help me out of it. Unfortunately for those with bipolar disorder, anti-depressants can have serious negative side effects: They can bring on hypomanic, manic, and mixed affective states and can cause rapid cycling. (The Bipolar Disorder Survivor Guide, David J. Miklowitz Ph.D., 2002)

To make matters worse, even after negating the side-affects of anti-depressants, there are some clinical studies that show that they are not the panacea the ads purport. (I'd love to hear from those who have taken anti-depressants with good affect.)

For more information on antidepressants, see this informative article on depression medication.

As always, consult your medical professional before making any change to your medication regimen.