The OCD Diaries

February 16, 2010

What Kind of Day It Has Been

The author’s day has not gone as planned. He’s OK with that, though he wasn’t always.

Mood music for this post: “Adrift And At Peace” from NIN:

[youtube=http://www.youtube.com/watch?v=iMnv8zrmAyU&hl=en_US&fs=1&]

This day has not gone as planned.

I wanted to be in the office today plowing through some work. But another winter storm forced me to work from home.

Some would say it’s great I can do that, and it is. But when there’s a lot on the plate, I prefer to be in the office. Especially when the kids are home from school for February vacation. At least in the summer I can write from the back deck while the kids play in the field behind the house.

This time of year we’re all indoors and the kids are loud.

A few years ago the snow, the change in schedule and the kids in my workspace would have unhinged me.

I’d get a story written. Maybe three. But I’d be a puddle of lava by day’s end, good for nothing except sleep.

Not so today.

I’m enjoying the cozy chair by my living room window, watching the snow fall.

I’ve gotten as much writing and editing done from here as I would have from the office.

The kids were indeed loud and distracting, but I enjoyed that, too. What used to be stress is now comic relief, especially when Sean tells Duncan he looks adorable when he cries and Duncan responds by pouncing on his older brother, yelling, “Who’s crying now?!”

I smoked one last cigar before Lent begins tomorrow, since that’s one of the things I’m abstaining from until Easter. It was a Cuban stick at that. Thanks to my friend Bob Connors for parting with it.

The coffee is French-pressed and bitter. Just the way I like it.

A much different day than what it would have been five years ago, before I gained the upper hand over the OCD.

Days that don’t go as planned are especially difficult for people with OCD. We do, after all, crave control over everything we can control. And we badly want to control things we can’t, like the weather.

Forget about the small stuff, like checking a doorknob seven times or tapping your feet to the count of 60. A carefully crafted schedule in shambles is the big stuff; hell for a sick mind.

That’s when someone like me turns to the food or the booze to comfort the troubled mind.

But the food is well under control today, and bottles of wine that once taunted me from a kitchen counter rack have gone unnoticed in the corner.

I’m not the same man I used to be.

Credit the therapists, the Prozac, the religious conversion or all of the above.

Whatever it is, I’m grateful for it.

February 15, 2010

No Prozac for These Presidents

In honor of President’s Day, I direct you toward the following posts about past presidents and other leaders I respect for having carried the weight of the world on their heads while suffering from varying degrees of depression and other byproducts of mental illness.

It’s all the more impressive because they did this long before there were anti-depressants and modern therapy to fall back on.

Why Lincoln’s Melancholy Is A Must Read

I’ve always been something of a history nerd and am especially drawn to stories about those who have achieved greatness despite the crippling impact of mental illness. Winston Churchill was a sufferer (he called it his Black Dog). Theodore Roosevelt suffered from bipolar disorder. And Abraham Lincoln’s depression is well documented.

I recently read an excellent book on the latter: “Lincoln’s Melancholy” by Joshua Wolf Shenk. For anyone who has struggled with mental illness, it’s a must read because Shenk goes beyond simply detailing Lincoln’s episodes of depression and outlines the coping mechanisms he developed to get through the fog. In fact, the author argues, those very coping mechanisms fueled Lincoln’s greatness.

OCD Diary: 6 Guys I Look To In Times of Trouble

The historical figures I revere all had to overcome disease, mental illness and personal tragedy through the course of their lives. I look up to them because they dealt with challenges greater than anything I will probably come across in my own lifetime. And they achieved what they achieved despite crippling personal setbacks. I’ll stick with six examples, though there are many more…

OCD Diaries: Someone to Watch Me (A.K.A. Desk Junk)

For all of my professional life, I’ve had a habit of littering my desk with trinkets. It’s a very organized form of clutter. I do have OCD, after all. What might surprise folks is that all this junk serves a very specific purpose. It is, in fact, one of my coping tools.

February 13, 2010

In Defense of Patrick Kennedy

The youngest son of Edward M. Kennedy has often been criticized as a lightweight Congressman who gets away with things other people would get arrested for. But the author salutes him anyway. Here’s why.

Patrick Kennedy, the youngest child of the late Sen. Edward M. Kennedy, announced yesterday that he won’t be running for re-election to the Congressional seat he has held since 1995.

US Representative Patrick Kennedy of Rhode Island announced that he will not seek reelection, capping a 16-year career in politics. Patrick, the son of the late Senator Edward M. 'Ted' Kennedy, said his father's death caused him to do some soul-searching about his future. With Kennedy's departure, this will be the first time in more than six decades the Kennedy family will not have a member in Washington. Scroll through this gallery for a look at how the Kennedy lineage has impacted politics and public life.

Some will tell you it’s just as well. The Congressman, after all, hasn’t done much except for living off his family name and crashing cars into roadside barriers while high on narcotics. That’s often what I hear from my more conservative friends, who hate everything having to do with the Kennedy name.

Stew Milne/AP Photo

But as someone recovering from OCD, depression, a binge-eating disorder and other addictions, I have plenty of reason to defend this man.

In my view, this fellow has gotten some pretty unfair treatment. Let’s start with Laurence Leamer’s book, “Sons of Camelot.”

In this book, Patrick is described as a spoiled kid who has accomplished nothing in Congress other than repeatedly winning re-election. He’s described as someone who blindly follows the Democratic leadership.

Some of that may be true. But Patrick has done some courageous service for those who suffer from mental illness.

Kennedy has been open about his own struggles with bi-polar disorder and the addictions that go with it. He has been in and out of addiction treatment centers and once noted how his addictive behavior could latch onto anything from pain medication to something as simple as cough medicine.

What’s more, he did one of the hardest things people like us can do: He lived in the spotlight as a public servant, where critics can be cruel and a lot of people like to hate the Kennedys just for the hell of it.

Patrick has carried a lot of pressure being a Kennedy. There’s the pressure to match his father’s towering legislative record and live up to the legendary stature of his uncles.

Some would have dropped to the floor long ago, curled in a fetal position, over the pressure. Some would not have survived. One of Patrick’s cousins, David Kennedy, one of RFK’s sons, didn’t survive the battle with the demons. He died of a drug overdose in 1984.

RFK Jr. also struggled with addiction. So did Christopher Kennedy Lawford, who wrote an excellent book of his own on the subject: “Symptoms of Withdrawal: A Memoir of Snapshots and Redemption.”

I loved Lawford’s book for a variety of reasons. He recounted his sordid tale with humor and was brutally honest about something addicts are all to aware of: When you quit the thing you’re addicted to, it doesn’t automatically turn you into a good person.

In fact, recovering addicts often become big jerks before they find their footing. They’re learning how to behave in public without being drunk or high. A deep depression often sets in because years of abuse leaves the brain with deep chemical imbalances that hit you like a brick to the head once the booze, food or narcotics exit the picture.

Patrick has dealt with all of these realities and still carried on in public service.

He continued to show up for life when life was at its most unbearable.

It gave people like me a little inspiration when we needed it most. So as Patrick prepares to exit the public stage and embark on a new life, I thank him for his service and wish him the best.

It’s easy for people to pass judgment on him for his flaws.

But people who do so often forget about their own flaws.

None of us are truly without sin. But we like to cast the first stones anyway.

January 20, 2010

Have Fun With Your Therapist (A.K.A.: The Shrink Stigma)

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.

Mood music for this post: “Just Another Psycho” by Motley Crue:

[youtube=http://www.youtube.com/watch?v=Ko23M-4AAbg&hl=en_US&fs=1&]

It’s a funny thing when I talk to people suffering from depression, addiction and other troubles of the mind. Folks seem more comfortable about the idea of pills than in seeing a therapist. After all, they’re just crazy “shrinks” in white coats obsessed with how your childhood nightmares compromised your adult sex life, right?

Since I rely on a therapist and medication as two of MANY tools in my recovery, I’m going to take a crack at removing the shrink stigma for you.

I’ve been to many therapists in my life. I was sent to one at Children’s Hospital in Boston as a kid to talk through the emotions of being sick with Chron’s Disease all the time. That same therapist also tried to help me and my siblings process the bitter aftermath of our parents’ divorce in 1980.

As a teenager, I went to another therapist to discuss my brother’s death and my difficulty in getting along with my stepmother (a wonderful, wonderful woman who I love dearly, by the way. But as a kid I didn’t get along with her).

That guy was a piece of work. He had a thick French accent and wanted to know if I found my stepmother attractive. From the moment he asked that question, I was done with him, and spent the rest of the appointment being belligerent.

That put me off going to a therapist for a long time. I started going to one again in 2004, when I found I could no longer function in society without untangling the barbed wire in my head. But I hesitated for a couple years before pressing on.

The therapist I started going to specialized in dealing with disturbed children and teenagers. That was perfect, because in a lot of ways I was still a troubled kid.

She never told me what to do, never told me how I’m supposed to interpret my disorder against my past. She asked a lot of questions and had me do the work of sorting it out. That, ladies and gentlemen, is what a good therapist does. They ask questions to get your brain churning, dredging up experiences that sat at the back of the mind like mud on the ocean floor. That’s how you begin to deal with how you got to the point of dysfunction.

She moved to Florida a year in and I started going to a fellow who worked from his house. I would explain my binge eating habits to him, specifically how I would down $30 worth of McDonald’s between work and home.

“You should stock your car with healthy foods like fruit, so if you’re hungry you can eat those things instead,” he told me.

That was the end of that. He didn’t get it. When an addict craves the junk, the healthy food around you doesn’t stand a chance. The compulsion is specifically toward eating the junk. He should have understood. He didn’t. Game over.

The therapist I see now is a God-send. He was the first therapist to help me understand the science behind mental illness and the way an inbalance in brain chemistry can mess with your thought traffic. He also provided me with quite an education on how anti-depressants work. Yes, friends, there’s a science to it. Certain drugs are designed to shore up the brain chemicals that, when depleted, lead to bi-polar behavior. Other meds are specifically geared toward anxiety control. In my case, I needed the drug that best addressed obsessive-compulsive behavior. For me, that meant Prozac.

That’s not to say I blindly obey his every suggestion. He specializes in stress reduction and is big on yoga and eliminating coffee from the daily diet. Those are two deal breakers for me. Yoga bores the dickens out of me. If you’ve been following this blog all along, I need not explain the coffee part.

I also find it fun to push his buttons once in awhile. I’ll show up at his office with a huge cup of Starbucks. “Oh, I see you’ve brought drugs with you,” he’ll say.

Thing is, he’s probably right about the coffee. But I’ve given up a lot of other things for the sake of mental health. I’m simply not putting the coffee down right now.

I think part of this is about testing him, too. I can’t help but push the buttons sometimes just to see what I can get away with.

But on balance, it’s a productive relationship that has helped me to find a lot of peace and order in my life. I thank him for that.

He kind of reminds me of Dr. Keyworth, the shrink who counseled Josh Lyman and President Bartlet on “The West Wing.” He took their crap with a straight face, not the least bit concerned that these were powerful, intimidating people.

The main point of this post is this:

There are good therapists and not-so-good therapists, just like there are good and not-so-good primary care doctors; just like there are good cops and bad cops.

But if you feel like you need to talk to someone objective and you hold back for fear of being in the same room as a quack, well, then you’ll never know what you could have accomplished.

I chose to talk to a professional despite my deepest reservations. I’m grateful that I did.

January 2, 2010

Prozac Winter

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

My therapist and I recently agreed that my Prozac intake should go up a bit for the duration of the winter.

I’m doing well for the most part, but there’s a three-hour window of each day — usually late afternoon — where my mood slides straight into the crapper.

The reason is simple: People who suffer from chemical imbalances in the brain are directly impacted by daylight levels. When the weather is dismal, cold, rainy and the days are shorter, a lot of folks with mental illness find themselves more depressed and moody. Give us a long stretch of dry, sunny weather and days where it gets light at 4:30 a.m. and stays that way past 8 p.m. and we tend to be happier people.

There are lessons to be had in the history books:

— Abraham Lincoln, a man who suffered from deep depression for most of his adult life, went from blue to downright suicidal a few times in the 1840s during long stretches of chilly, rainy weather. [See Why “Lincoln’s Melancholy” is a Must-Read.]

— Ronald Reagan, a sunny personality by most accounts, was a man of Sunny California. Once, upon noticing that his appointments secretary hadn’t worked time in his schedule for trips to his ranch atop the sun-soaked mountains of Southern California — and after the secretary explained that there was a growing public perception that he was spending too much time away from Washington — Reagan handed him back the schedule and ordered that ranch time be worked in. The more trips to the ranch, he explained, the longer he’ll live.

The WebMD site has excellent information on winter depression. Here’s an excerpt:

If your mood gets worse as the weather gets chillier and the days get shorter, you may have “winter depression.” Here, questions to ask your doctor if winter is the saddest season for you.

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.

Here’s where the Prozac comes in for me:

As I mentioned in The Bad Pill Kept Me from the Good Pill, Prozac helps to sustain my brain chemistry at healthy levels. Here’s a more scientific description of how it works from WebMD:

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.

I’m convinced the drug would NOT have worked as well for me had it not been for all the intense therapy I had first. Developing the coping mechanisms had to come first.

I’ve also learned that the medication must be monitored and managed carefully. The levels have to be adjusted at certain times of year — for me, anyway.

So next week I’ll start taking the higher dosage and let y’all know how it goes.

December 7, 2009

More On Famous People With Mental Illness

A good list on the subject is available from the National Alliance on Mental Illness, NH branch. A few of those on the list:

Art Buchwald, Columnist

Depression

Drew Carey, Actor

Depression

Winston Churchill

“Had he been a stable and equable man, he could never have inspired the nation. In 1940, when all the odds were against Britain, a leader of sober judgment might well have concluded that we were finished,” wrote Anthony Storr about Churchill’s bipolar disorder in Churchill’s Black Dog, Kafka’s Mice, and Other Phenomena of the Human Mind.

Charles Dickens, Writer

One of the greatest authors in the English language suffered from clinical depression, as documented in The Key to Genius: Manic Depression and the Creative Life by D. Jablow Hershman and Julian Lieb, and Charles Dickens: His Tragedy and Triumph by Edgar Johnson.

Tony Dow, Actor

Depression

Patty Duke, Actress

The Academy Award-winning actress told of her bipolar disorder in her autobiography and made-for-TV move Call Me Anna and A Brilliant Madness: Living with Manic-Depressive Illness, co-authored by Gloria Hochman.

Ted Turner, Businessman

Vincent Van Gogh, Painter

Sol Wachtler, Former New York State Chief Judge

Mike Wallace, Television Journalist