When the top blows off. Caregiving and depression.
This is an excerpt from my soon-to-be-published book Riding Shotgun. The reason for posting it now was inspired by Paul Walter's recent article https://www.bebee.com/producer/@paul-walters/when-the-black-dog-growls-battling-depressions-terrible-demons. It takes a special kind of courageous vulnerability to open the door to one's mental health. For all the talk of enabling those of us with issues revolving around depression, anxiety and other disorders, the larger community still would prefer that we keep these not-so-invisible illnesses to ourselves. Until each of us decides to speak out little real advancement will occur and that's why I am sharing this piece which speaks to my experience of depression (diagnosed in 1991) and the particulars surrounding how it can impact on one's ability to provide care. My thanks to Paul, Lisa Gallagher, Randy Keho and others who have come forward to share their perspectives and experiences.
What happens when the gloves come off?
Imagine for the moment that you live in the shadow of a volcano. Like Vesuvius, it gets a little cranky from time to time and blows off some poisonous gas. So long as you’re upwind you’ll avoid the worst effects. Such are the occurrences that you can chalk up to normal stress, and even those living cancer-free lives will have the occasional Etna-like day.
But hold on to your britches ‘cause this ride is about to get hot and bumpy.
You can predict with even greater certainty than the world’s most skillful seismologist. Vulcanologists have no more claim to an accurate predictive index than you do and yet, like a dumb-struck mule, you stand locked in place waiting for the moment when the entire top of the mountain comes off.
Here’s a little definition of a volcano from Wikipedia
“A volcano is an opening from the earth’s surface into pools of hot liquid rock (magma) beneath the earth’s crust. The opening allows magma to expand and erupt, where it takes the form of lava, ash, cinders, or gas. Because the magma is under extreme pressure from the overlying crust, ejections of this material can expand explosively, causing an area of destruction several miles wide. Ejected ash, dust, and gas can persist in the atmosphere for weeks or months. Eruptions in or near the ocean can also generate tsunamis.”
You’re now coming to understand a little more about how this fight wears and tears you down. You’re getting a glimpse, with terrifying transparency, of how a disease sets off rumblings within your core. How, even with all of the best support and being forearmed with knowledge, you remain frozen to the spot as the bombs drop on you as they did on Pompeii.
It doesn’t take something cataclysmic to set off the events. More often it will be a culmination of small indignities, cynical commentary, or a simple, if messy, domestic mishap.
It’s at this point that pretty much everyone at the party says something inappropriate and emotions, kept in check for days, just let rip.
It is this aspect of this disease that really tears me up.
I end up behaving “like a baby.”
I launch into diatribes.
I become immune to notions of decency.
My medial prefrontal cortex goes completely offline and my lizard brain takes over.
What to do?
I live with clinical depression. Things get a little more complicated for a caregiver living with clinical depression. Depression is often expressed as hostility, rejection, and irritability.
Despite all of the advances in the recognition of depression as a real illness, there are still people who believe that we should just “snap out of it”, “buck up”, and “be strong”. After all, what we’re afflicted with won’t kill us.
Or will it?
A high percentage of caregivers develop depression? I didn’t. Of course, I already had it. In some respects, I can consider myself fortunate that this wasn’t something new to me.
“Caregiving does not cause depression, nor will everyone who provides care experience the negative feelings that go with depression. But in an effort to provide the best possible care for a family member or friend, caregivers often sacrifice their own physical and emotional needs and the emotional and physical experiences involved with providing care can strain even the most capable person. The resulting feelings of anger, anxiety, sadness, isolation, exhaustion—and then guilt for having these feelings—can exact a heavy toll.
Everyone has negative feelings that come and go over time, but when these feelings become more intense and leave caregivers totally drained of energy, crying frequently or easily angered by their loved one or other people, it may well be a warning sign of depression. Concerns about depression arise when the sadness and crying don’t go away or when those negative feelings are unrelenting.
Early attention to symptoms of depression through exercise, a healthy diet, positive support of family and friends, or consultation with a trained health or mental health professional may help to prevent the development of a more serious depression over time.”
So, is there a point somewhere in all of this?
Acknowledge that the task you’ve chosen is a real bitch. If you’re already someone with a vulnerability - in my case, clinical depression - do what ever you can to gird your loins for rumblings at the earth’s core.
Talk to friends. Don’t try to handle it all by yourself and know that the one whom you love most will not always be the person from whom you can expect compassionate insight. After all, they are the ones whose veins are injected with poison and the last thing we should do is compound the pain.
Remember though, that we have to look after ourselves too. On days when I lose it I am of no use. I am more of a detriment so I must find ways to shake off the black dog or at the very least send him chasing after a stick while leaving me to enjoy the park by myself. Even momentarily.
2016 Don Kerr. All rights reserved.
No part of this book may be reproduced, stored in a retrieval system, or transmitted by any means without the written permission of the author.
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