To a Friend: Your Pride Is Killing You

A longtime friend is letting a bout of depression hold him back. He needs a helping hand but won’t ask for it because he’s too proud. This post is for him and anyone else living under the delusion that not getting help is a sign of strength.

Mood music:

[spotify:track:2FEfAIvMfp24ZBRVCZIiBZ]

I know what you’re going through. I’ve been there many times myself. I’ve had bouts of depression that made me lose interest in everything except my addictions. In fact, in those moments the fix of a food binge, the bottle or the prescription pain pills I used to get for a bad back was all I was really interested in.

The biggest things in life — my family, friends and work — remained important to be sure, but giving my full devotion to them was just too much work. I wanted to dull the pain and then hide under a rock. I usually settled for the couch in front of the TV. I lost interest in my own hygiene, forgetting to shower for days at a time, especially in my early 20s. You were around back then and remember how my part of the house stunk to high heaven. Gross Bastard, you called me. And the label fit.

I let it kill relationships. I thought I could cure it by putting all my self worth into work, but that made me sicker and my workmanship eventually suffered.

The difference between you and me is that I didn’t quite grasp that I had depression, OCD and anxiety. I felt it all, but I didn’t see them as legitimate medical conditions. You’ve known about your condition for years but won’t do anything about it.

Why?

Because of pride.

You have this notion that getting help is a weakness and you’re too good for that. Not just help from friends. Help from doctors.

I get it. In your state of depression, motivation and interest go in the toilet. It hurts to think about getting out of your chair and retrieving them.

I just wish you could understand what I’ve learned: that you can regain control of your life and that it’s OK to accept help. You’re not taking from someone when they want to give you a hand up, you’re actually giving. When someone is able to help another person, they feel higher and happier themselves. And down the road, when they are in need, you have the chance to pay it back.

Everyone smacks into times of need. Everyone.

Of course, none of that will happen unless you get your ass off the chair and turn off your video games.

There is nothing brave, romantic or glamorous about being trapped in your miserable head. Cut the pride bullshit and do something.

I’m always here to help.

Your friend,

Bill

Chained Skeleton

Halloween Ho-Hum

Some of my friends go bonkers for Halloween. They run an endless torrent of zombie apocalypse memes on Facebook. They revere the holiday above Christmas and Easter. Good for them. It’s more of a ho-hum holiday for me.

Mood music:

[spotify:track:3iuftv60t76f8Lps5TZPXl]

It would be easy to tell you I’m down on Halloween this year because so many people are suffering this day from the damage Hurricane Sandy left them with. But the truth is that this has never been one of my favorites. For a compulsive binge eater, this holiday and the days that follow tend to be a real nightmare.

I stopped eating Halloween candy four years and one month ago, but when the kids come home with trick-or-treat bags bulging, the temptation remains powerful. If you were a cocaine addict and your kitchen was surrounded by massive mounts of blow, you might feel the way I’m feeling about now.

I do have much to be thankful for. I used to binge on my kids’ candy for days and weeks after Halloween. By the end of November I’d be a pile of waste, bloated and depressed. That hasn’t happened for the last few years, even though my program isn’t quite where it should be.

I guess past memories are hard to shake, though.

Oh, well.

I’m still happy to see my kids and friends taking joy in Halloween. More power to them.

As for me, I just might go back to bed.

Rotten Pumpkin

I’m Stressed About My Stress-Reduction Class

Tonight is the first of eight weekly stress-reduction and mindfulness classes I’m taking. I have to admit the whole thing stresses me out a bit.

It’s not that the description is bad. In fact, it sounds delightful. I’m going to learn how to use yoga and other techniques to keep my thoughts in the present, where they belong. Here’s a little background from the Mindfulness-Based Stress Reduction website:

Dr. Jon Kabat-Zinn developed the Mindfulness Based Stress Reduction (MBSR) program at the University of Massachusetts Medical Center. Since its inception, MBSR has evolved into a common form of complementary medicine addressing a variety of health problems … MBSR is an 8-week intensive training in mindfulness meditation, based on ancient healing practices, which meets on a weekly basis. Mindfulness practice is ideal for cultivating greater awareness of the unity of mind and body, as well as of the ways the unconscious thoughts, feelings, and behaviors can undermine emotional, physical, and spiritual health.

I certainly qualify for such a program. I have a history of stress-induced maladies — Crohn’s Disease, OCD, ADD, depression, fear and anxiety, migraines — and I’m still in the process of making peace with a lot of what happened in my past.

For my back story, check out “An OCD Diaries Primer“.

I’ve gotten pretty good control over the anxiety and OCD in recent years. Heavy therapy, medication and spiritual growth have all played a role. And work, once the biggest source of stress in my life, no longer rattles me. Having a job I absolutely love helps on that score.  I’m also much healthier in my 40s than I was in my 20s and 30s. Crippling back pain is years into the past, and I’ve maintained a significant weight loss. I don’t eat flour or sugar and weigh just about everything I eat. I no longer drink, and cigars and cigarettes have been replaced with e-cigs. I’m also playing guitar again. Making music has been more appealing to me of late than staring at the Internet for hours, which is another addictive behavior I’ve struggled with.

But I still experience stress. There’s a lot of family drama, including a long estrangement from some parts of the family and an erosion of patience that intensified when my father had a stroke last year and we really began the work of helping our younger child manage his ADHD.

No surprises there. That’s the garden-variety stress everyone experiences. Only the names, dates and circumstances change.

While these things no longer incapacitate me, they still make it difficult for me to keep my mind in the present. When your mind is in the past or the future, it makes it very difficult to listen when people are talking to you in the present. The result is that you don’t retain important information like dates, appointments and the like. Worse — much worse — is that you’re robbing the people you love of your undivided attention.

My therapist once told me that there’s no better gift you can give a person than your time and attention. A lot of what he says annoys me. But on this I think he’s right.

That comment from the therapist is what compels me to take this class. I want to be a better listener and less scatterbrained when the house chores stack up.

So why the stress?

It’s yet another appointment to keep every week, shoehorned into the schedule between all my kids’ Boy Scouts activities and various family check-ups, school activities and an awesome but demanding job.

Of course, that’s me thinking in the future instead of the present, which just makes me more comfortable with the notion that this is the right thing to do.

I’ll report back to you on all this tomorrow.

Which Is Worse? You Decide.

I woke up pissed at the world yesterday. Part of it is that people in my life are acting like idiots, and part of it is my realization that thinking this way makes me a Grade-A hypocrite.

Mood music:

[spotify:track:1GnCH2KszUkpUjXuDP2G3N]

I’m sick of all the ass-hat political posts friends and relatives are putting on Facebook lately. Rather than sticking with issues like our economic well-being and the best way to achieve national security, people are content to post a bunch of memes littered with half truths and outright lies. Democrats and Republicans are equally guilty.

But then I’ve been blogging a lot about how futile these elections have become and how the outcome will have absolutely zero impact on the things that really matter in our lives.

Which is worse? You decide.

I’m sick of people who go on Facebook and complain about everything. They hate their job. They hate their significant others or the lack thereof. They make cryptic statements so someone out there will bite, asking what’s wrong or telling you how fucking special you are.

But then I do something similar in this blog. I never complain about my job or make cryptic statements, but I sure do complain a lot. I’m doing it right now.

Which is worse? You decide.

I’m sick of people who tell you how you should behave, how often you should call your parents and how self-absorbed you are when they can’t get their own shit together.

But then I turn around and do the same things. And I just blog about it afterwards.

Which is worse? You decide.

When I lose patience with people, I can get pretty self-righteous. I take someone down a few pegs, even though I’d make the same stupid decisions and say the same stupid things.

I’ll admit it sometimes, and then go do the same stupid things all over again.

Which is worse? You decide.

Before long I’ll return to my sunnier disposition. But I wanted to take this moment of moodiness and use it as an opportunity to keep it real.

Cinderblock Balloon

Too Many Balloons in the Air

A friend on Twitter asked what a person is to do when OCD, ADHD and other mental maladies produce the effect illustrated in this comic strip on xkcd.com:

ADD

The illustration really hits home for me, having suffered from OCD and ADHD and having a son with ADHD (the alphabet soup alone is enough to short-circuit a person’s mind). All these conditions have one thing in common: the sufferer tries to keep track of everything going on around them, but that stray balloon always takes them off track.

[spotify:track:29bzX8jP7wO07FyMdOkYT7]

Since the sky is always full of too many balloons, we have to learn to let the strays float away so that we can focus on everything else that demands our attention. How to get there is a tough one. But I’m going to try answering my friend’s question based on what’s worked for me in the past.

Getting to the therapist’s office on a regular basis certainly helps, because you can spill out all your cares and a good therapist will help you re-sort the pieces into a picture that makes sense.

But that’s not enough. Since the root cause of these conditions is a brain with misfiring traffic transmitters, I need medication to help the transmitters fire correctly. Prozac helps do that for my OCD, and Wellbutrin helps for the ADHD.

All these things together have made life much better for me and those who have to live with me. But these mental disorders are powerful and no combination of drugs and therapy will drive it from you completely. There are still plenty of those balloon distractions.

I still have a bitch of a time keeping my head in the present moment. If you talk to me for too long, my thoughts will away. I’ll get lost in some memory from the past or get distracted with something coming up in the future. It can be some thing important, like a bill that needs paying, or it can be something trivial, like a family gathering that’s not happening for another month.

Next week I’m starting a weekly mindfulness class where the whole point is to learn to stay in the moment. I’ll be writing about the experience on a regular basis, so stay tuned.

It won’t be a cure-all. But if it helps me let go of a few more stray balloons, it’ll be worth the cost in time and money.

Oh, The Guilt

I’ve always been driven by guilt. I used to hide it because with guilt comes shame and with shame comes deceit. In more recent years, however, I’ve tried to use it to become a better man. Results are mixed.

 

My inability to process guilt started at an early age. Growing up Jewish, I’d get Hanukkah gelt (Yiddish for “money”) during the Festival of Lights. Not understanding Yiddish, I thought it was called Hanukkah guilt. “Why the fuck am I being handed guilt as a present?” I’d ask myself. Only in adulthood would I realize how a simple misunderstanding of language would shape my thinking.

Since then, guilt has been the gift that keeps on giving.

Guilt over not talking to my mom for six years. I have it in spades. Not because she’s blameless, but because I know that some of what’s gone wrong is my fault. And while I’ve written about things in childhood that made me unhappy, I haven’t given her credit for what she did right. But that’s a subject for another post.

Guilt over binge eating and other addictive behaviors. There’s been plenty of that over the years. After spending $30 at McDonald’s and another $20 at Dunkin’ Donuts on what used to be a typical binge on the drive home from work, I’d stuff the empty bags under the seats. Erin called them guilt bags, and she would eventually find them. (For more on that, see “The Most Uncool Addiction” and “Anatomy of a Binge.”)

Guilt over being a bad pet owner. In my early 20s, I had two pet rats. They were very loving and gentle. I went on a trip to California and forgot to ask someone to look after them. When I got back, I found them both dead. To this day I feel horrible about that. One lesson I learned from that: Don’t leave the tank you keep your pets in on the floor of your closet, because you could forget they’re in there.

Guilt over money. Guilt has also weighed me down when I’ve mishandled money (math was never one of my stronger traits) or lied to my wife over things I was ashamed of.

Guilt from letting some relationships languish over the years. In some cases, people are difficult and I need to keep my distance for self-preservation. Other times, though, I’m just too lazy to pick up the phone.

Parenthood guilt. I always try to be the parent who’s always gentle, listens carefully to my children’s every word and helps them deal with life’s big issues. I sometimes fail because I’m too tired or too lost behind a computer screen.

They say guilt is a useless emotion, that it causes you to waste all your time worrying about things you can’t control or change. That’s true to a point. But I’ve learned the value of guilt over the years as a tool to make me a better man.

For example, these days I’m trying to spend less time online and more time playing Monopoly and other games with the kids. It’s only a start, but it’s something.

Remembering food guilt has definitely kept me from further binges. And while my money-management skills still leave much to be desired, I don’t spend like I used to.

As for the stuff about my mother, another attempt at reconciling is not out of the question.

In its proper place, guilt is a good awareness tool.

Definition of guilt

How to Stop Screwing Your Patients in Four Simple Steps

A colonoscopy I was supposed to have today was abruptly canceled over missing paperwork. Normally I wouldn’t complain about something like this because life happens. But I’m hearing a lot lately about medical offices screwing up and making the patient feel stupid instead of taking responsibility.

Mood music:

[spotify:track:79DVDD46pdqwjYucn91fny]

I know people who get scared shitless when they have to go for a procedure. They worry for weeks and just want to get it over with, and when they’re kicked to the curb, it makes their angst 10 times worse.

I used to get that way. I’d obsess for weeks before the colonoscopies I have to have because of the Crohn’s Disease. I’d work myself up into a frenzy about getting the damned thing over with. As a result, a cancellation would send me deep into a depressed fog, and then I’d work myself up into another frenzy for a few more weeks.

Fortunately, I got past the frenzy-depression cycle long ago. I’m deeply annoyed about today’s cancellation, but I’m not in a fog. I was happy to break my fast with an iced coffee from Starbucks and have an extra workday to get things done. But in the process, I’ve had to throw other people’s plans into chaos so that I could get this test rescheduled.

With that, I want medical professionals to understand a few things:

  • If you have to cancel someone’s procedure, it can be traumatic. Don’t be cold and make the patient feel stupid for being upset. Saying “I’m sorry, but …” isn’t good enough. You need to reassure the patient that setbacks like this happen and that everything will work out in the end.
  • Doctors shouldn’t hide behind their staff. If the doctor screws up on paperwork, sending staff to deliver the bad news isn’t enough. The doctor should call the patient and personally apologize. For a patient suffering from anxiety, that small personal gesture can be the thing that helps them reset their expectations.
  • Don’t blame HIPAA. People in the medical profession love blaming everything on HIPPA and other laws. When I noted that the botched paperwork was never necessary before, the medical assistant said new laws had taken affect since the last time I had this procedure. I’ve lost count of the times doctors’ offices held back information under the excuse of HIPPA. I’ve been writing about HIPPA in my day job for eight years, and I know you guys violate HIPAA daily. And there are ways to tell patients what they need to know without violating HIPAA.
  • Don’t save paperwork until the last minute. As I’ve said, life happens. In my case, the specialists couldn’t access needed medical records because my primary care physician was called away on a family emergency. If the specialist had sought the paperwork a week or two ago, this wouldn’t have happened.

If you’re in the medical profession and disagree with anything I’ve just said, tell me why. And spare me the HIPAA excuses.

Doctor's Office

Maybe It’s Time for a New Therapist

Lately I hate going to my therapy appointments. I dread getting in the car to go, and once I leave his office my head goes from slight ache to migraine in the course of an hour. It’s not the therapist’s fault as much as it’s a change brewing within me.

Mood music:

[spotify:track:7rvD6aTf1Aa2OMwzAQbQwO]

I’ve written about my therapist before. He’s taught me a lot about how the brain works, what happens when a mental disorder takes hold and how specific drugs go to work on specific defects. In that regard, he’s been a godsend. I’ve never agreed with everything he tells me to do, especially the bit about not drinking caffeine. To protest that suggestion, I usually show up for an appointment with a Venti Starbucks bold in my hand. But that’s never taken away from what he’s helped me with. In fact, his good humor under my needling has only made me like him more.

But lately I keep feeling like we’ve hit a wall, that he can’t take me any further on this journey.

I’ve been here before with other therapists. They help me move forward up to a certain point, then we start going in circles, covering the same ground over and over again — sometimes simply for the sake of using up the 60 minutes that I pay for.

To some extent you have to retread the same ground in therapy, because the patient is usually dealing with the same old issues. Retracing the old steps is how a therapist checks to see how well you’re managing and using the tools you’ve developed.

But lately, I’ve had less and less patience for covering the ground I know all too well.

It could simply be that I need a fresh face to dump on every few years, and there’s nothing wrong with that. I used to hate having to change therapists because in my mind it meant I would have to tell someone the whole back story all over again. What I’ve learned, however, is that I can tell the backstory through a fresher mindset, one that works differently now that I’ve significantly improved my ability to manage the demon.

I’m not the anxious, fear-filled introvert who first walked into a therapist’s office in 2004 when I first realized I had big issues that were making my life unbearable. Today I’m a lot more outgoing, sure of myself and at ease with who I am. But I’ll always need therapy to ensure that I’m still using all my coping tools the way I’m supposed to. Besides, life is always changing, throwing new curve balls my way. Through the normal challenges of life, I need help keeping my balance.

Maybe that’s part of my current dilemma: I’ve gotten better to the point where I’ve become too comfortable with this particular therapist. In life, we’re always searching for the comfort zone, but sometimes being in the comfort zone makes you forget what really needs to be discussed in that 60-minute block.

I could be imagining all this right now. It could be that I’m looking for excuses to stop talking about things I actually need to talk about. Taking the necessary medicine is often unpleasant.

But for now I have that feeling in my gut, telling me that something isn’t working like it used to when I first step into that office.

Time for a change? We’ll see.

Fatherhood Saved Ozzy, Eddie & Me

Yesterday I watched the “God Bless Ozzy Osbourne” documentary, which focused heavily on how his addictions maimed him and his family over four decades. Though my addictive behavior pales by comparison, it still struck a chord.

Mood music:

[spotify:track:6xb9RiyqpDXWF4wUYPDwI2]

What hit me deepest is how Ozzy finally decided to get real sobriety after his son Jack had kicked drugs and alcohol. It took his son to show him the light.

There’s a similar plot in the recent comeback of Van Halen. Armed with the knowledge that he’d be able to make music with his son if he cleaned up, Edward Van Halen finally got sober a few years ago.

The son showing dad the light theme is an old one. It’s the whole “Luke Skywalker helping Darth Vader find his good side again” story. Only in the real life examples, the fathers get to live after having their epiphany.

In the documentary, we see Ozzy changing into a different, crazy person who continuously brings heartbreak to his family — especially his children. The daughter from his first marriage is asked point-blank if he was a good Dad. Her answer is a simple “No.” We learn — though it’s not really a surprise, given how incoherent he was in all the episodes — how his alcoholism was at its worst during the run of “The Osbournes” and how his youngest kids started using in that period. Finally, we see his son Jack deciding to clean up, inspiring his father to do the same.

Like I said, my addictive personality didn’t come close to the levels of Ozzy Osbourne or Edward Van Halen. But it was bad enough that I can relate to things like being useless on the couch when my kids needed me. I was never that way all the time, and I’ve been a pretty active Dad more often than not. But I am guilty of those bad moments.

But what I relate to most is how it took becoming a parent to drive home the need for me to be a better man and reign in my demons — the OCD and addictive behavior    that was a byproduct of constant fear, anxiety and exhaustion.

It wasn’t an instant thing — Sean was almost 4 and Duncan was was barely 2 when I realized things were not right in my head — but the cattle prod was definitely my hunger to be a better parent.

So yeah, I have to say I’m inspired by these rock n’ roll stories.

‘Fixing OCD’ Article Is Badly Misleading

An article in The Atlantic called “5 Very Specific Ways to Fix Your OCD” blows it from the start — in the headline.

OCD sufferers know damn well that you can’t fix OCD. You can only learn to manage it and make it less of a disrupting force in your life.

Mood music:

[spotify:track:74gJqWYjsfTyG4tSjhkoh7]

Knowing that as I do, I’m dissapointed that the writer would give OCD sufferers false hope, followed by five pieces of advice that are not totally unhelpful, but also not very realistic.

I still write some clunkers with the best of ’em. All writers do, especially when you produce articles daily. But here, I think the author was mislead by Concordia University psychologist Adam Radomsky, who spelled out the five strategies.

What follows are portions of the article in italics and my responses in plain text.

Re-examine your responsibility. Many of the symptoms of OCD can be caused and/or exacerbated by increases in perceived responsibility. The more responsible you feel, the more you are likely to check, wash, and/or think your thoughts are especially important. Ask yourself how responsible you feel for the parts of your life associated with your OCD, then take a step back from the problem and write down all of the possible other causes. For example, someone who would likely check their appliances repeatedly might feel completely responsible to protect their family from a fire. If this person adopted a broader perspective, they would realize that other family members, neighbors, the weather, the electrician who installed the wiring in the home, the company that built the appliances, and others should actually share in the responsibility.

Radomsky misses the point — OCD sufferers usually know the reality of these situations. But our minds spin with worry anyway. Like the addict who knows he-she will eventually die from their bad habits but can’t help but continue with them anyway, the OCD sufferer knows that he-she shares responsibilities with others, but can’t help but take on all the problems of the world anyway. The brain is constantly in motion, taking small concerns and sculpting them into huge, paralyzing worries.

Repetitions make you less sure about what you’ve done. This is bizarre because we usually check and/or ask questions repeatedly to be more confident of what we’ve done. OCD researchers in the Netherlands and Canada, however, have found that when repetition increases, this usually backfires and may lead to very dramatic declines in our confidence in our memory. To fix this, try conducting an experiment. On one day, force yourself to restrict your repetition to just one time. Later that day, on a scale of 0-10, rate how confident you are in your memory of what you’ve done. The next day, repeat the same behavior but rate it a few more times throughout the day. Most people who try this experiment find later that their urges to engage in compulsive behavior decline because they learn that the more they repeat something, the less sure they become.

I appreciate what he’s trying to do here with the role-playing game, and it can be helpful to try tracking how much you repeat an action and what it does to your memory.

But he again misses the crucial point: We OCD sufferers already know these repeated actions fuck with the memory of what we have or haven’t done. One of my OCD habits has always been going over the checklist for what I need to do before leaving for work the next morning. Clothes laid out? Check. Coffee maker programmed? Check. Lunch made and in the fridge? Check. Laptop bag stuffed with all the necessary work tools? Check. Then, even though I know full well what I’ve just done, I run through that same check list over and over. I’m not as bad as I was before treatment, but it’s still in me.

Treat your thoughts as just that — thoughts. Intrusive thoughts are normal, but they become obsessions when people give them too much importance … Spend a week making this distinction between your OCD thoughts (noise) and thoughts associated with things you are actually doing or would like to be doing (signal). See what happens.

I’ll tell you what happens: Your thoughts continue to run wild despite the exercise. Not that you shouldn’t try it. For a few people, it may help. But one of the very first things we learn is that we are not our thoughts; that thoughts and reality are not the same thing. But this is like the responsibility example above. We keep thinking because we can’t help it.

Practice strategic disclosure. People with OCD fear that if or when they disclose their unwanted intrusive thoughts or compulsions, other people will judge them as harshly as they judge themselves. This sadly often leaves the individual suffering alone without knowing that more than nine in 10 people regularly experience unwanted, upsetting thoughts, images, and impulses related to OCD themes as well. Consider letting someone in your life who has been supportive during difficult times know about the thoughts and actions you’ve been struggling with. Let them know how upset you are with these and how they’re inconsistent with what you want in life. You might be pleasantly surprised by their response. If not, give it one more try with someone else. We’ve found that it never takes more than two tries.

This piece of advice is sound, but gets buried beneath the unhelpful material.

Observe your behavior and how it lines up with your character. Most people struggling with OCD either view themselves as mad, bad and/or dangerous or they fear that they will become such, so they often go to great lengths to prevent bad things from happening to themselves or to their loved ones. But ask yourself how an observer might judge your values based on your actions. If you spend hours each day trying to protect the people you love, are you really a bad person? If you exert incredible amounts of time and effort to show how much you care, how faithful you are, how you just want others to be safe and happy, maybe you’re not so bad or dangerous after all. And as for being crazy, there’s nothing senseless about OCD. People sometimes fail to understand how rational and logical obsessions and compulsions can be. Remember, your values and behavior are the best reflection of who you are, not those pesky unwanted noisy thoughts.

This too is sound advice. But it leaves out something incredibly important: You can’t review your character and reconcile it with your OCD habits in this simple step he lays out. It takes years of intense therapy  — and for some, like me, the added help of medication — to peel away the layers and get at the root of your obsessions.

You can learn to manage OCD and live a good life. But it’s a lot of hard, frustrating work. And that work is ALWAYS there, until the day you die.

Know that before you dive into the search for simple solutions. If it looks simple, it’s probably too good to be true.