A Back-Breaking Attitude Adjustment

Sometimes, you have to damage your back to realize how lucky you are.

Mood music for this post: “Hell Hole” from Spinal Tap:

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No, I didn’t break my back. But I did jolt my spine somewhere to the left of where it’s supposed to be. It hurts like hell. And yet I’m in a much better mood than I’ve been in recently. This injury may be the thing I needed to get over myself.

It’s hard to get too uptight about the back. I don’t know how I managed to injure it, but I have an excellent chiropractor who will probably manage to fix it after a couple days’ work.

And it’s forced me to do something I typically suck at — lying still and thinking things over.

I’ve been brushing up against depression for the last couple weeks. Much of it was brought on by damaged pride — specifically the need to seek out help for a financial tight spot we found ourselves in. That hurt a lot.

As a result, I’ve been carrying on like the same drama-seeking people that annoy me on a daily basis. I’ve been whining, which makes me even more pissed at myself.

So somewhere along the way, I hurt my back. My first thought was that I wasn’t going to complain about it on Facebook the way other people complain about things. Arrogant, you say? Absolutely. People with a history of OCD and addiction tend to be self-absored and hypocritical. I’m guilty as charged.

But being forced to lie down may have been good for me on this score.

I hate having to be out of commission, especially when I’m not able to help Erin with the housework. I feel like I’m pissing my life away as the world continues to speed by. I am, however, proud of the fact that I’ve managed to have a prolific work week despite all this. I can type away on the laptop while lying flat on my back, and I’ve gotten a fair amount of writing done.

The pain I’m feeling is actually the medicine I needed. You see, I used to have these back problems all the time. I spent a lot of the time between 2000 and 2006 incapacitated. One time, in 2003, paramedics had to take me to the hospital in an ambulance. I was prescribed every pain-killing (and brain-killing) pill under the sun along the way. And I missed A LOT of life.

I found my chiropractor in 2006 and within a couple weeks he found and fixed the source of my constant spasms. This week’s injury is really the first major incident since I started going to this guy.

He’s already working to fix this latest problem. A couple more days and I’ll be back to normal.

And, unlike the past problems, I don’t have pills eating away at my brain as I lie there. I’ve been clear-headed and able to put life in perspective.

Despite the occasional setback, I’m not suffering like I used to. The OCD still runs hot from time to time, and the demon that fuels my addictive behavior tries to talk me into a relapse often.

But so far, I haven’t given in.

That’s probably why I’m in a good mood now. Back when the back pain was constant, I ALWAYS caved to my addictions.

Not this time, and that makes me grateful.

I’m still doing all the service that’s part of 12-Step recovery, and it feels good.

Life is so much better than it used to be. My head is clear. My career is humming along, the sun is shining and I have family and friends that keep me whole.

It just took a back injury to remind me of all that.

Shamed to Death

Why do people with mental and physical illness choose a slow, painful death over recovery?

Mood music for this post: “Estranged” by Guns N Roses:

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Last week I went on a tirade against firms putting limits on coverage for mental health care. It’s the same sorry song that ratchets up the fear level for those suffering from depression, OCD, bipolar disorder and the like, and The Boston Globe’s Kay Lazar shed light on a a particularly galling case.

It’s true that the healthcare industry and many employers make it hard for sufferers to come out into the light. There’s the fear of getting fired or blocked from career advancement. There’s the fear of people defining you by your illness.

But even when there’s a workplace full of loving, supportive people and friends willing to accept a person no matter their issues, it can still be hell for a sufferer to break free, because no matter how accepting their environment, embarrassment is a powerful wall.

It’s like people who are too embarrassed to get a colonoscopy because of how the procedure is done. No one has to know about it except their doctor and maybe a couple family members. But they avoid the test anyway because they still find it embarrassing. Then they end up dying of colon cancer a few years later.

Embarrassment is a powerful thing. It keeps a person from seeing things as they really are and keeps them from facing their demons.

It’s not always bad to be embarrassed. God put the emotion in us for a reason. If we’re a jerk to someone or we get caught doing something unethical, we should feel shame.

But we shouldn’t feel shame over an illness and shouldn’t be embarrassed about getting help.

Morris L. Roth, president and CEO of Pikes Peak Behavioral Health Group, made the point in a recent column he wrote on how mental health is essential but often misunderstood:

One in 17 suffers from a serious mental illness. And only 40 percent of those will seek treatment.

You are likely to encounter someone in your family, workplace, school, church or community who is experiencing mental health challenges. If you don’t, you’re still impacted by the cost to our society in unemployment, disability, incarceration and homelessness associated with untreated or misdiagnosed mental illnesses.

Many cases of mental illness, even mild depression, go untreated because of the shame and discrimination connected to a long-ago era when mental health patients were locked away in insane asylums, sometimes for their entire lives. Patients were considered “defective” and “incurable” due to a lack of effective treatments. At times, treatments were barbaric.

We’ve come a long way in treating clinical symptoms of mental illness. For most, symptoms can be easily managed. But we’ve made far less headway with societal discrimination. Consider the 2001 Canadian study of people with schizophrenia that found that social withdrawal had a “great impact” on their lives, while the hallucinatory and delusional symptoms of the illness had the “least impact.”

Today, our clients are living proof that persons with even the most severe of mental illnesses can function normally and contribute to society.

Our experience as the community mental health provider in the Pikes Peak region is that a person with a mental health disorder, whether lifelong or temporary, is capable of many remarkable things, if given an opportunity.

Amen to that.

As someone who has been through years of mental therapy and as a lifelong Crohn’s Disease sufferer who has had to have the unpleasant test mentioned above too many times to count (my colon is basically a tube of scar tissue, so they have to keep an eye on it), I’m going to share a couple secrets with you:

1. Most of the people around you have medical procedures all the time that would seem embarrassing on the surface. It’s a necessary part of life. The body is a machine that needs frequent maintenance. It’s as simple as that. There is absolutely no reason you should feel ashamed about taking care of yourself. OB-GYN appointments are never fun for women, but most of those I know have the scruples to keep their appointments. Cervical cancer is not a good alternative. Suicide isn’t a very good alternative to therapy, either.

2. There is no need to feel embarrassed in the presence of a doctor. If you think this stuff is fun for them, you’re out of your mind. Therapists have heard things from their patients that are probably a lot more off the wall than anything you will tell them. They’ve heard it all. Doctors in general have seen it all.

3. If you never seek help, you’ll never know how good your life could be.

Just some thoughts from someone who has faced embarrassing situations more than once.

I got over the shame, and I’m better for it.

The Migraine

Every time the author gets a migraine, he’s reminded of how every day used to be.

Mood music:

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Yesterday I came home from work with a slight headache. It was a hectic day, so I chalked it up to coming down from the whirlwind.

As I made the kids’ lunches for the next school day and cooked supper, it got worse. By the time I settled in to play a game of Battleship with Sean, it was a migraine.

I spent the next nine hours in bed. The ice pack was useless. I felt like throwing up. Finally, I drifted off to sleep and that ended it. I woke up at 4:30 a.m., a half hour later than usual, and the head still hurt, though not at migraine levels.

As I write this, my ears feel clogged but I’m otherwise fine.

Funny thing about migraines. They create black holes in your life and you lose out on precious moments, like playing a game of Battleship with the kids. Sean was winning big-time at the point I had to break away. He had sunk three of my ships and I sunk only one of his. Duncan took over for me when I went to bed, and I’m not sure who prevailed in the end. I am sure Sean wouldn’t have done as well if his Dad wasn’t distracted by pain.

I also missed my Wednesday-night Arise group, which really pissed me off. I get so much from that group, and to miss out is to miss out big-time.

I used to get migraines all the time as a child. The Prednisone I took for Crohn’s Disease would give me the kind of brain pain that sent me to the bathroom throwing up. Entire evenings were shot to hell, often multiple times a week. School work suffered. It was almost as bad as the Chrohn’s Disease itself. Well, not quite as bad, but pretty bad.


I don’t get them anywhere near as much today, but I probably get a good one every other month. Every time I do, it takes me back to what life was like before I found Faith and Recovery.

All the nights I spent alone in my basement, and then on the couch because I was too mentally spent to do anything else — I find myself back there.

Those too were black hole moments. Life was put on hold and I missed out on many, many things.

I’ll tell you one good thing about the migraines I get today: They remind me that there’s no turning back on the life I’ve since built. When I wake up and the pain is gone, it’s one of the best feelings on Earth.

Today I’ll take Erin’s advice and call the doctor for a medicine I can take when a Migraine is coming on.

Erin has had more than her fair share of migraines over the years, but she found a medication that helps. I should listen to her more often.

 

An OCD Diaries Primer

A collection of posts that form the back story of this blog.

Mood music:

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The Long History of OCD

An OCD Christmas. The first entry, where I give an overview of how I got to crazy and found my way to sane.

The Bad Pill Kept Me from the Good Pill. How the drug Prednisone brought me to the brink, and how Prozac was part of my salvation.

The Crazy-Ass Guy in the Newsroom. Think you have troubles at work? You should see what people who worked with me went through.

The Freak and the Redhead: A Love Story. About the wife who saved my life in many ways.

Snowpocalypse and the Fear of Loss. The author remembers a time when fear of loss would cripple his mental capacities, and explains how he got over it — mostly.

The Ego OCD Built. The author admits to having an ego that sometimes swells beyond acceptable levels and that OCD is fuel for the fire. Go ahead. Laugh at him.

Fear Factor. The author describes years of living in a cell built by fear, how he broke free and why there’s no turning back.

Prozac Winter. The author discovers that winter makes his depression worse and that there’s a purely scientific explanation — and solution.

Have Fun with Your Therapist. Mental-illness sufferers often avoid therapists because the stigma around these “shrinks” is as thick as that of the disease. The author is here to explain why you shouldn’t fear them.

The Engine. To really understand how mental illness happens, let’s compare the brain to a machine.

 

Rest Redefined. The author finds that he gets the most relaxation from the things he once feared the most.

Outing Myself. The author on why he chose to “out” himself despite what other people might think.

Why Being a People Pleaser is Dumb. The author used to try very hard to please everybody and was hurt badly in the process. Here’s how he broke free and kept his soul intact.

The Addiction and the Damage Done

The Most Uncool Addiction. In this installment, the author opens up about the binge-eating disorder he tried to hide for years — and how he managed to bring it under control.

Edge of a Relapse. The author comes dangerously close to a relapse, but lives to fight another day.

The 12 Steps of Christmas. The author reviews the 12 Steps of Recovery and takes a personal inventory.

How to Play Your Addictions Like a Piano. The author admits that when an obsessive-compulsive person puts down the addiction that’s most self-destructive, a few smaller addictions rise up to fill the void. But what happens when the money runs out?

Regulating Addictive Food: A Lesson in Futility. As an obsessive-compulsive binge eater, the author feels it’s only proper that he weigh in on the notion that regulating junk food might help. Here’s why the answer is probably not.

The Liar’s Disease. The author reveals an uncomfortable truth about addicts like himself: We tend to have trouble telling the truth.

Portable Recovery. Though addiction will follow the junkie anywhere in the world, the author has discovered that recovery is just as portable.

Revere (Experiences with Addiction, Depression and Loss During The Younger Years)

Bridge Rats and Schoolyard Bullies. The author reviews the imperfections of childhood relationships in search of all his OCD triggers. Along the way, old bullies become friends and he realizes he was pretty damn stupid back then.

Lost Brothers. How the death of an older brother shaped the Hell that arrived later.

Marley and Me. The author describes the second older brother whose death hit harder than that of the first.

The Third Brother. Remembering Peter Sugarman, another adopted brother who died too early — but not before teaching the author some important lessons about life.

Revere Revisited.

Lessons from Dad. The author has learned some surprising lessons from Dad on how to control one’s mental demons.

The Basement. A photo from the old days in Revere spark some vivid flashbacks.

Addicted to Feeling Good. To kick off Lent, the author reflects on some of his dumber quests to feel good.

The lasting Impact of Crohn’s Disease. The author has lived most of his life with Crohn’s Disease and has developed a few quirks as a result.

The Tire and the Footlocker. The author opens up an old footlocker under the stairs and finds himself back in that old Revere basement.

Child of  Metal

How Metal Saved Me. Why Heavy Metal music became a critical OCD coping tool.

Insanity to Recovery in 8 Songs or Less. The author shares some videos that together make a bitchin’ soundtrack for those who wrestle with mental illness and addiction. The first four cover the darkness. The next four cover the light.

Rockit Records Revisited. The author has mentioned Metal music as one of his most important coping tools for OCD and related disorders. Here’s a look at the year he got one of the best therapy sessions ever, simply by working in a cramped little record store.

Metal to Stick in Your Mental Microwave.

Man of God

The Better Angels of My Nature. Why I let Christ in my life.

The Rat in the Church Pew. The author has written much about his Faith as a key to overcoming mental illness. But as this post illustrates, he still has a long way to go in his spiritual development.

Absolute Power Corrupts Absolutely. The author goes to Church and comes away with a strange feeling.

Running from Sin, Running With Scissors. The author writes an open letter to the RCIA Class of 2010 about Faith as a journey, not a destination. He warns that addiction, rage and other bad behavior won’t disappear the second water is dropped over their heads.

Forgiveness is a Bitch. Seeking and giving forgiveness is essential for someone in recovery. But it’s often seen as a green light for more abuse.

Pain in the Lent. The author gives a progress report on the Lenten sacrifices. It aint pretty.


When Pain Drips from the Mind to the Body

The author on why it’s true that mental illness leads to physical sickness.

Mood music:

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I’ve heard a lot of people argue over whether this person’s or that person’s aches and pains were “all in their head.” You know the types: Never any real underlying disease, but they’re always calling out of work with a headache or some intestinal discomfort.

It’s all in their head, you say?

Well, yeah.

It’s called psychosomatic illness, when mental anguish leads to physical sickness.

http://www.rodale.com/files/images/458870.jpgI’ve been there. Migraines. Brutal back pain. A stomach turned inside-out.

But it wasn’t always clear that what ailed me was in my head. Childhood illness confused matters. A huge chunk of my digestive track was in flames and spewing blood because of  Chron’s Disease. I’m told by my parents that the doctors came close to removing the colon more than once, though I don’t remember that myself; probably because the doctors had that conversation with the parents instead of the patient.

To throw it into remission, they used the maximum dose of a drug called Prednisone, which caused another kind of body blow in the form of migraines. You can read more about that in “The Bad Pill Kept me from the Good Pill,” but the bottom line is that these headaches came daily; always making me sick to my stomach.

Later in life, I developed severe back pain, the kind that would knock me onto the couch and keep me there for weeks.

All legitimate physical problems. But at some point my brain lost the ability to differentiate a real Chron’s flare-up or back spasm to an imagined one.

In the end, though, it doesn’t matter. It may as well have been one of those things. Because when the mind thinks it is, it has a habit of BECOMING real.

I found an article in About.com that describes the problem better than I ever could on my own:

Any illness that has physical symptoms, but has the mind and emotions as its origin is called a psychosomatic illness. Although you may be told that it’s “all in your head”, these illnesses are not imaginary. The aches and pains are very real, but because your doctor is looking for an actual physical cause, they are very tricky to diagnose and treat. The key is to look for a source of stress in the person’s life that the person is not coping with. By treating the underlying stress and depression, it may be possible to heal the physical problems as well.

For me, it was easy to separate the Chron’s episodes from the tricky stuff described above, since the disease was sitting there for the doctors to see. I was always told mental stress could trigger flare-ups and I guess they did, especially when my parents divorced 30 years ago and a lot of stress over custody ensued. I’m fairly sure the after-effects of my brother’s death set off the last real flare-up in 1986.

But the migraines and back problems seeped seamlessly into the things that were going wrong with me mentally.

Anxiety attacks felt essentially the same as a heart attack, complete with the pain shooting from the chest to the neck and down the arms. Migraines followed. Work stress often sparked migraines and back pain.

While it was difficult to separate other legitimate physical problems from those stemming from mental distress, I can tell you that dealing with my underlying OCD, depression and addiction made a lot of ailments go away.

I’m not sure I can credit it with ending the back problems. Though mental illness most likely enhanced the back pain, that problem was eventually diagnosed as three out-of-whack vertebrae the chiropractor knocks back into alignment every other week. No more imprisonment on the couch.

But these things have gone away — and have not returned — since I got a handle on the OCD and related binge-eating disorder:

–Puking up stomach acid in the middle of the night

–Numbing of the feet

–A strange poked-in-the-eye sensation that would hit me early mornings and leave me with blurred vision for a day or more.

–A dull ache in the left hand, which often got worse as my mind spun out of control with thoughts that it MIGHT be a heart-attack.

–Fatigue that would cause all my joints to ache unless I were to lie down and go to sleep.

–Heart palpatations.

All disappeared once I started to attack the core problem.

The ultimate take-away from all this is that something in your head can cause real, physical pain.

And when you deal with what’s in your head, the pain in the rest of your body can be eradicated.

Understanding Mental Disorders: The Brain as an Engine

I’ve written a lot about my use of Prozac as just one of many tools to treat my OCD. [See The Bad Pill Kept Me From The Good Pill]

Mood music:

As a result I’ve gotten a fair amount of questions about the true value of anti-depressants. I’m not a doctor, so don’t take my perspective as Gospel. Also remember there’s no one-size-fits-all solution here. What I write here is based on my own personal experiences. What works for me may not work for the next person.

http://activephilosophy.files.wordpress.com/2009/11/brain-engine.jpg

The more I read up on depression, mental illness and the drugs prescribed for it, the more I see the human brain as an engine. Comparing it to an engine makes this whole think easier to understand.

We know that the engine of a car is made up of many small parts and when one part gets worn out the rest of the engine can fail. We know that a car needs just the right amount of oil, transmission fluid, brake fluid etc. to function properly. If the oil runs out, the engine seizes up. If the brake fluid runs dry, the breaks fail. On the flip side, too much of these fluids can harm the engine.

We also know that the auto mechanic uses many different techniques to keep engines healthy or fix them when they break.

The brain works much the same way.

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Think of the different drugs as different tools to deal with very specific problems in the engine.

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In my case, Prozac addresses the very specific fluid deficiencies that spark OCD behavior. The effect is not as simple as the image below suggests (though I do like the image and need to find the artist so I can properly credit him/her):

https://theocddiaries.com/wp-content/uploads/2012/04/prozac.jpg?w=218

It may also be useful to think of the therapist as the auto mechanic who is well versed in how to regulate the different engine fluids and pinpoint specific fixes for specific problems. It’s also true that there are good mechanics and bad mechanics who sometimes make the problem worse. [More on this in my previous post: Have Fun With Your Therapist (A.K.A.: The Shrink Stigma)]

In the brain, when certain fluids are running low, the engine stops working properly. The result is depression and a host of other mental disorders.

Since OCD is essentially the brain pumping and spinning out of control, I like to think of my specific problem as a lack of brake fluid.

But the good folks at WebMD explain it much better than I ever could. Here’s some WebMD wisdom I included in a previous post, Prozac Winter:

How Antidepressants Work

Most antidepressants work by changing the balance of brain chemicals called neurotransmitters. In people with depression, these chemicals are not used properly by the brain. Antidepressants make the chemicals more available to brain cells like the one shown on the right side of this slide:

Photo Composite of Neurotransmitters at Work

Antidepressants can be prescribed by primary care physicians, but people with severe symptoms are usually referred to a psychiatrist.

 

Realistic Expectations

In general, antidepressants are highly effective, especially when used along with psychotherapy. (The combination has proven to be the most effective treatment for depression.) Most people on antidepressants report eventual improvements in symptoms such as sadness, loss of interest, and hopelessness.

But these drugs do not work right away. It may take one to three weeks before you start to feel better and even longer before you feel the full benefit.

And, just as weather can impair the performance of your car engine (my father‘s car went for a swim when Revere got flooded out in The Blizzard of 1978 and never worked properly again), too much bad weather can keep the brain from working properly:

Why do I seem to get so gloomy each winter, or sometimes beginning in the fall?

You may have what’s called seasonal affective disorder, or SAD. The condition is marked by the onset of depression during the late fall and early winter months, when less natural sunlight is available. It’s thought to occur when daily body rhythms become out-of-sync because of the reduced sunlight.

Some people have depression year round that gets worse in the winter; others have SAD alone, struggling with low moods only in the cooler, darker months. (In a much smaller group of people, the depression occurs in the summer months.)

SAD affects up to 3% of the U.S. population, or about 9 million people, some experts say, and countless others have milder forms of the winter doldrums.

So this worsening of mood in the fall and winter is not just my imagination?

Not at all. This “winter depression” was first identified by a team of researchers at the National Institute of Mental Health in 1984. They found this tendency to have seasonal mood and behavior changes occurs in different degrees, sometimes with mild changes and other times severe mood shifts.

Symptoms can include:

  • Sleeping too much
  • Experiencing fatigue in the daytime
  • Gaining weight
  • Having decreased interest in social activities and sex

SAD is more common for residents in northern latitudes. It’s less likely in Florida, for instance, than in New Hampshire. Women are more likely than men to suffer, perhaps because of hormonal factors. In women, SAD becomes less common after menopause.

I’m still learning the science of mental illness, and remember I’m not a doctor. I just share my personal experiences and explain what works for me.

Class dismissed.