Further elucidation in the case of nanci blu, receptionist extraordinaire (last update Dec 28'11).
Thesis: If depression, and related conditions, i.e. anxiety disorders/manic-depression etc, are caused by emotional repression, then anti-depression medications, especially those that go to affecting mood (i.e.depression), are not only useless, but counter-productive to the release of emotions and such that are at the root of depression. Today's Hoxey Elixirs.
The Dilemma: There is a predicament that faces all of us mental health seekers these days, with regard especially to those who experience depressive illnesses, and manic-depression in my particular. Much like the seemingly endless task of finding the right therapist, we are also faced, in the midst of our respective crises, with the daunting challenge of choosing which therapy will be effective. And given the plethora of choices, from cognitive to gestalt to IPT to analytical psychology to psychotherapy to shhhECThhh to a legion of pharmaceuticals ... well, you get the picture: one is hard pressed to make an informed decision. And in a lot of cases I suspect, one's decision is made by one's doctor, by default, because, well, they are the experts, and we tend to trust our experts, and go along with them. Why should we not?
The Scientific Method and the Common Man: Of course, doctors and the like are just people too, faced with much the same problems as the rest of us. And there is so much information out there, so many avenues to pursue, so little time, so much that seems promising but is not necessarily anything that any one is 100% certain about, that even the experts can fall behind the times. We are, after all, all part of the grand experiment, regardless of which side of the maze we think we're on. And in some cases, some professionals may feel they have to know, even when they don't really know, because they are supposed to know, because they have the degrees and certifications to prove they know, and because they are expected to know. Given this, some may make judgements and recommendations not because they do know, but because they feel they should know, and because, well, that's their job. But how does one know anything when one cannot, does not, or will not look in any other direction than the one one has been trained to look in. A philosophical pickle indeed, and one specifically targeted by differentiation, if one has a mind to. On the other hand, I have a neighbour who told me: "oh no, bipolar can never stop. It may go away, but it'll be back again.' How does one such as I refute such an assertion? Impossible, except perhaps with parallel experiences and intersecting theories, these latter validations of a sort, a la scientific method I guess. And there's the rub. The Scientific Method, entitlement for some, dogmatic hooey for others. And how redily does one give up one's socially and scientifically mandated authority to a mere supplicant asking for and perhaps at the same time challenging that authority? A sign in the whirlpool at my community centre reads "do not... without the consent of your doctor." Not advice. Consent! I have also talked to several people who have been diagnosed bi-polar, telling them of my claim, that I have succeeded in my battle with manic-depression, and to a person have been disregarded. I feel like Copernicus. It seems to be beyond comprehension that this could be so. To my mind, were I confronted with a person who claimed to have beaten what ails me, I would want a detailed account of just how that was. Not to be in these cases. These people have been convinced of their 'disability,' wear it like a badge, and nothing it seems is going to get in the way of that. And where did these people get this fatal certainty? Why, from doctors? Who else. So what is the poor health seeker supposed to do in the face of the ubiquitous "doctor's orders" and the preponderance of scientific' (i.e.'most likely' - "Depression," the National Institute of Mental Health, USA, [NIMH] talking about what causes depression) opinion that prevails today?
I was diagnosed Bipolar 1 and Bipolar 2 at different stages of the game, by different doctors of course. Not to mention several other medical opinions that went by the way on my journey to the Self. Academic bean counters seeking to validate their regurgitated training. So much for scientific consistency, not to mention certainty. And not that I begrudge this necessarily. Doubt, uncertainty, and even scientific method is the very bedrock of discovery. But what does one do when the one's mandated to help can not question their own firmly and prescribed beliefs. In the final analysis, the only real 'authority' of one's self is... one's Self. On a certain level (npi), it's all just opinion, and you know what they say about opinion.*
Self Disclosure - I call what I had manic-depression, because that's what it felt like to me. I've been manic, I've been depressed, but I can't say I've ever felt 'polar,' not to mention bipolar. Sounds like some kind of gay Santa's elve thing. Regardless of the diagnoses or the label, for more than twenty years I endured a pretty much steady annual cycle of two three month periods of full blown depression and mania, interspersed with two three month 'transitional' periods, these transitions comprised of short, 9-14 day cycles of up and down, all of the above feeling like a ride on a particularly intense and screwy emotional roller coaster.
In more prosaic terms, I know what it is to lay on a couch or in a bed for months at at time, depression the "pit of despond" I spiralled deeper and deeper into day by interminable day, unable to do anything outside of the bare essentials, stuck to my sofa like last week's spaghetti. And I know mania, believe me, mania so high cocaine doesn't touch it, songs, poems and other creative endevours pouring out of my mouth like "endless rain into a paper cup, my musicianship at a peak, I profoundly glib, my mood so jubilant and intense friends avoided me like the plague And I know what it's like to short cycle between both, one day just really great, the next not so thank you very much. And, just like that it seems, it's all gone. Like the calm after a hurricane. Ahhh. And not really just like that either. It took years, and a lot of trial and error, and a little serendipity along the way. But here I am, in uncharted territory, life a vast river and I, smack dab in the middle, moving along now
with the flow, my once cycling and alternating moods morphing into a cohesive, unified whole. Not just feeling better, mind you, or 'coping,' thank you very much, but now, after years of internal division and misapprehended repression, very much my Self, intact, whole, and with some significant data, however anecdotal to some, to back up the promise of my seemingly improbable prognosis. A significant factor: I wrote this article during my 'depression zone.' That is decidedly atypical.The only truly significant factor left, as far as I am concerned,** is time, and I'm experiencing that like I never have before. Ahhh indeed! After 50 years of being an emotional zombie, I am feeling, real time again. And it is "the best of times, [and] it [is] the worst of times."
To Drug or to Drone On: So what is the ‘state of the art’ regarding treatment of depressive 'disorders' these days? It seems that out of all the choices with which one is faced, it kind of all boils down to two main avenues of approach: pharmacology, or psychology, i.e. repress it, or express it. On the repress it side of the coin we have the National Institute of Mental Health, USA, (NIMH) and its "detailed booklet that describes Depression symptoms, - causes, and treatments, with information on getting help and coping." The NIMH more or less champions the pharmacological approach, with scant nod to psychology, this latter discipline relegated in the NIMH's estimation to gathering data regarding "any family history of depression or other
mental disorder, [to] get a complete history of [one's] symptoms," (
NIMH, Depression), I suppose to corroborate genetic hand me down theory, or to deal with the coping thing. No mention of psychology perhaps playing a major role. The heavy lifting according to the NIMH is to be done with drugs, or perhaps some light tinkering a la Cognitive or ITP Therapy for "for mild to moderate depression...," and once again, only for the coping thing. Hold your nose and turn around three times whispering.... Welcome to the lab. "Research [indicates] that depressive illnesses are disorders of the brain," and as such, according to the NIMH, are hard wired and need science, or at least, drugs or some other physical agent to dispel their deleterious effects. The NIMH creates the impression, if not quite out and out stating it, that manic-depression is a physical condition of some sort, somatic, genetic perhaps, or chemically induced, a disorder that once manifest, is a permanent feature of one's singularity: a
disability that "
Most likely, [depression] is caused by a combination of genetic, biological, environmental, and
psychological factors," i.e. just about anything under the sun. Most likely indeed, of course, and if one is looking at treating symptoms with chemicals while having basically no real idea as to what is causing them, then what else can one do really but try to minimize the adverse effects of those symptoms.
Trouble is, the NIMH and it's ilk doesn't just stop there, but at the same time, experiments on whomever with almost whatever comes to 'scientific' hand, because that's what the scientific method is all about. But many 'anti-depressants' are not just high falutin pain killers and relaxants. They are mind altering chemicals aimed at manipulating or otherwise affecting the genetic/chemical/biological structure of the brain and the genetic/chemical/biological chimera that are to be found just around discovery's dark corner. And in the case of manic depression "...[it being] a long-term illness that must be carefully managed throughout a person's life," we have a model that makes the 'mental health consumer' not only a victim of their own biology, but a human lab rat sipping from the pharmaceutical trough, resigned to a lifetime of pharmacological dependency. "Research indicates," a scientific proclamation on the one hand, and "most likely" a self serving disclaimer on the other. More opinion, but opinion etched in the very DNA of scientific supremacy, and dispensed in impressive little booklets with good English. Just, 'open up please, and tell me how does this one make you feel?' And what an impressive cornucopia of pharmacia does the NIMH indeed present in its list of chemical candidates they would like you to try out for them. The question is, how interested are you in joining the rest of the lab rat population?
On the other side of the coin we have the view that depression is a psychological
effect, a signpost really, symptomatic perhaps of cognitive mal adaptations, current adverse circumstances etc, these causal agents resolvable thru various psychological and otherwise 'talk' therapies such as deep psychotherapy, cognitive, gestalt, group therapy and so on, with no end necessarily in sight. Another morass of confusion and indecision indeed. Where does one begin?
To my mind, there is but one place to begin, and that is at the beginning. And there is one approach that to me bears special scrutiny above and beyond and decidedly before the rest, and the championing of which in it's absence is remarkable to me. To Alice Miller (1923-2010), psychologist and world renowned author of such books as: Drama of the Gifted Child, Thou Shalt Not Be Aware, For Your Own Good, and many others, and to my mind, a leading if not
the leading resource in these regards, one's childhood memories and emotions, repressed and unresolved, represent a fundamental denial of one's very Self, "the categorical denial of the pain we suffered at the beginning of our lives... harmful in the extreme,"(
Alice Miller Depression: Compulsive Self-Deception), depression the debilitating result of this denial. Once the repressed and unresolved emotions are addressed, depression will dissipate like smog lifting from doused peat moss. Miller's advice: seek out these feelings and express them. (
To someone significant if possible - nb). These feelings are in you, are you, and what it takes to heal oneself is listening to, hearing, recognizing, acknowledging and expressing those feelings.
And, if it is indeed as Alice Miller and her proponents say, that at the bottom of one's depression or other symptoms of repression, i.e. anxiety, mania, etc is a Self denied, histories and attendant feelings half dead carcasses rotting in the caverns of the unconscious as it were, mouldering in ambered childhood as we mosey along our prescribed and prescriptioned adult ways, pursuing all things worldly and in the final analysis, mostly irrelevant, then it would seem to me that not only are anti-depressants and the like not conducive to recovery, but that they are actually counter productive to recovery, as what they do is add yet another layer to the denial of the Self and the feelings and such that are the cause of one's depressive and otherwise symptoms in the first place, these latter not disabilities or disorders, but rather, signposts indicating the nature of the problem, much as a Charlie Horse signals one to the existence of a muscle cramp.
In my case it took years of trying this and that, workshops here, therapists there, encounter and 12 step programs everywhere, trying on remedies and therapies like cheap clothing in a discount store, hoping for that nugget or personal truth that will make one's search worthwhile, and finally arriving where I am today, witness to the results I speak of, not slave to some theory or ideology, my ride on the bipolar express done (at least for now as my sceptics would have it), my emotions now real time, my moods stable and a more tolerable range, my life a whole new ballgame. My path? Re-association, Individuation, Ego Death, Mindfulness, Anger Management, Reconciliation and Actualization, and in that order basically, all steps in a process leading to my very Self. But that's another story, another article, another day.
And, if, as Alice Miller points out, "... we have to avoid mental pain at all costs... [and] there is basically not much left to sustain our vitality..." as a result of avoiding mental pain," then I can attest to that personally also, from a visceral perspective, and am, in fact, the very corroboration of Alice Miller's findings in this regard. Now free from the need to suppress my repressed childhood emotions, these now having been expressed in meaningful and ultimately cathartic ways, there is nothing which I need to keep the lid on, and I do indeed find I have much more... brainpower, ease, libido (a la Jung?) perhaps, that sustains me somehow, and enables me to do things that I never could before, no matter how hard I tried, this new found vitality another unlooked for dividend in my pursuit of self awareness. Truly, I awake refreshed each day to a new and wonderfully stable emotional affect. Life is just getting better and better.
So there you have it, more or less, from a mental health seeker's perspective. The matters at hand:
- Depressive Illnesses, especially manic-depression
- The Treatments: pharmacology or psychology. And let me restate my case in a nutshell. On the one side of the coin we have the notion, or perhaps belief is a better word, ironic that, that emotional childhood development has no significant basis in the outcome of a human adult, and that we are more or less meat machines with defective parts that need correcting, adjusting, replacing, tailoring, tinkering with or masking, whatever, and that a lifetime of coordinated pharmalogica is the required prospectus. On the other side of the coin we have observations and at least one experience that indicates that yes indeed, events and circumstance during one's developmental years have profound effects on who we are as adults, and that we can do something about the less pleasant symptoms of these early, negative circumstances by reaching into ourselves and coming to terms with what we find there.
- The Testimonial. One who has negotiated the trips and turns outlined above and has come to a personal and satisfactory resolution, drug and symptom free.
- The Conclusion. Does one put one's faith in one's self, or in the hands and opinions of others who, while perhaps well meaning and knowledgeable to the nth degree, know nothing more than what they have been taught and have observed thru the lens of that training? I have never felt better in my life, and I now know what works for me.
*Anonymous - Opinions are like assholes. Everyone has one, (and I'm no exception - nb).
** In the interest of full disclosure, I have two more time points to go, one regarding an inverted cycle anomaly, the other the next 'manic zone.' However, having just moved thru the depression period sans event, there being no 'there' there it seems, no deep pit of despond to cycle down to, I am reasonably confident of my positive prognosis. As I say, only time will tell. And in that, the bean counters have their way.
***Gender specific pronouns et: Mz., + He/She/ZE, him/hir/ZIR, his/hers/ZIRZ = 'other' or genflex pronouns.
he, she, ZEE, it;
him, her, ZIR, them
his, hers, ZIRZ, theirs
I, me, we, us, they you
