Dirt Bag

The author admits he’s not a very good person when he lets the demons out.

Mood music for this post: “A Rat Like Me” by Motley Crue:

A liar. A hater. Thinking you’re better than other people. These actions describe me pretty well. Not so much today, Thank God. But when the addictions are out of control and the OCD is on full burn, this is who I become. That’s why I have to cling to my recovery for dear life.

This is a collection of entries that dive deep into the darker world I used to inhabit; a world I could inhabit again if I’m not careful.

The Liar’s Disease

The author endeavors to tell the truth about an uncomfortable fact: People with addictive behavior really suck at honesty.

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.

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.

Bad Behavior, Easily Defined

The author turns to his musical hero for some easy-to-remember descriptions of depression and addictive behavior.

Meet My Demon

Why the author treats his demon like an imaginary friend, and how it helps.

A Little Bitter

The author on three of the 12 Steps he keeps tripping over.

The Long Road Through Self Hatred

The author has learned that it’s damn hard to like yourself at the beginning of sobriety and abstinence. The feeling will pass. Eventually.

Prozac Summer, Part 2: Timing’s Everything

The author has a meeting with Dr. Prozac, and learns a couple things about dosage and timing. Turns out the two are connected.

Mood music for this post: “Show Me How to Live” by Audioslave:

So I’m back from an appointment with Dr. Prozac, who I introduced you to this morning. I’m staying at the lower dose of Prozac until Aug. 1, then she wants me back on my winter dosage.

This surprised me. I figured I’d be on the lower dosage until at least October.

But what she said made perfect sense, and I’m kicking myself for not figuring this out for myself last year.

For cases like mine, where mood swings and depression are more likely during winter, the trick is to make any necessary dosage tweaks WHEN THE DAYS FIRST START TO GET NOTICEABLY SHORTER. Technically, the days start getting shorter after the first day of summer, which is the longest day of the year in terms of sunlight.

But the beginning of August is when we really start to notice the earlier sunsets.

That is the ideal time to prepare for winter, Dr. Prozac said.

Last time I didn’t have the adjustment until early January. The result was a game of body chemistry catch-up that left me with some made-for-TV mood swings that hit me all in one day. The next day I woke up feeling fine.

If I time dosage adjustments with the amount of daylight out my window, I can spare myself the mood swings, Dr. Prozac said.

As Spock would say, “Fascinating.”

So that’s what I’ll be doing.

To those who think I’m putting too much faith in an anti-depressant, I refer you back to the earlier posts in this blog.

The truth is I share the skepticism that’s out there when it comes to anti-depressants as a cure-all for everyone and every situation.

I resisted taking them for many years, which turned out to be a good thing because I focused on all the hard mental work I needed first. The first four years of treatment were about developing coping tools and learning to manage the OCD without chemicals. I only turned to the chemical at a very advanced stage of therapy, when I realized I needed it to push through that one last wall I couldn’t seem to crack without the extra help.

For some people, anti-depressants are the first line of treatment, and it ends up not working in the end because the patient didn’t start dealing with how they got the way they are first. For others, like my old friend Sean Marley, anti-depressants and all the adjustments one could make proved futile in the end.

No two people are the same, and that goes for how we respond to medication used to treat mental disorders.

I’m lucky, because I found the right balance. That’s very hard to do.

Now I’m learning that there are balances within balances to work on.

Confused? Me too.

Prozac Summer

The author on the tricky balance between Prozac and sunlight.

Mood music for this post: “Times Like These” by The Foo Fighters:

This post is a sequel to Prozac Winter, which I wrote back in January.

Back then, I was experiencing some hefty mood swings, which is pretty normal for me at the start of winter. I was listening Nine Inch Nails a lot, which is never a good sign.

My therapist and a woman I’ll call Dr. Prozac (she’s the anti-depressant specialist who works with my therapist) upped by dosage by 20 mg. for the duration of winter, which worked remarkably well. On balance, I had a pretty good winter. It turns out that winter, with it’s cold temperatures and shorter spans of daylight, knocks my brain chemistry out of alignment. It’s actually a very common problem. The sun provides nutrients the brain needs to function properly.

Now we’re approaching summer, with longer days, hot weather and all the rays I need. So my dosage is being rolled back to where it was before the winter.

I have to drive an hour to Dr. Prozac this morning so she can measure my progress. She’s done a great job up to this point. While I’m down there, I’ll go have lunch with a dear friend I haven’t seen in awhile.

It’s all good.

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?w=500

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.

https://i0.wp.com/i2.cdn.turner.com/cnn/2009/images/08/04/gall.antidepressants.jpg

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://billbrenner1970.files.wordpress.com/2010/01/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.

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 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 (myfather‘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.

Just a Little Patience

I recently stumbled upon this live version of GnR’s “Patience” and wanted to post it here because it’s always been an inspirational song to me.

Being an OCD-wired control freak with a knack for impatience and  endless attempts at recovery before I finally pulled it off, patience was a virtue I simply did not possess. It would be a stretch to say I’ve mastered it at this point in my life, but I at least appreciate it more than I used to.

I used to drop F-bombs to myself while driving every time I saw those bumper stickers that say things like “Easy Does It,” “One Day at a Time” and “Let Go and Let God.” Already seething in whatever traffic jam I happened to be sitting in at the time, those sayings would raise my anger level into orbit.

Years later, I understand those sayings and appreciate them in a way I never thought possible. My favorite is “Let Go and Let God,” just as the Serenity Prayer is one of my favorite prayers.

Anyway, I hope you get as much out of this song as I do:

It’s a Disease, Not a Choice

An open letter to those who are angry with a loved one whose addictions are off the rails.

Mood music:

This is one of those posts where I’m leaving names out to protect privacy. Still, the person this is meant for will know it’s for them, and he/she will be pissed at me. But that’s OK, because I’m saying something that needs to be said.

Right now, someone close to you has relapsed into alcoholism. This time it’s bad. You’re hurt and mad as hell because you remember a childhood where this sort of thing was a constant.

You might feel like hating this person right now because his relapse feels like a betrayal against you and you alone.

You’re wondering how the hell he could do this when he has so much to live for: grandchildren as far as the eye can see, a lot of the gifts he found a few years back when he got sober. It doesn’t make sense.

Here’s an attempt to explain it from someone who has been there. My problem was binge eating and a growing dependence on wine, further complicated by the variety of pain pills I was prescribed for the aches and pains caused, ultimately, by my bad habits. I was a less-than-ideal husband and dad. I couldn’t be relied upon.

I’d sneak around feeding my addiction and then cover my tracks. Sometimes I would blatantly lie about it. [See “The Liar’s Disease“] I didn’t lie to be evil. I did it because the shame was too much for me to handle.

You might also say I didn’t know any better.

One thing’s for certain: I didn’t wake up one morning and decide it would be a laugh riot to slowly destroy myself and hurt everyone around me in the process.

To you, looking at this loved one who is in relapse, you might feel that way. How the fuck could HE/SHE do this to YOU?

But here’s the ugly truth: Alcoholism — addictive behavior, period — is a disease. Nobody chooses it. They are chosen instead. It controls you like a puppet. You know as you’re doing that addictive action that it’s wrong and you hate every second of it. But your motor skills have taken over and you CAN’T stop.

Sure, we can shake it in time and find recovery, but relapse is a natural part of the disease. In fact, relapse is something I probably worry about the most, because I’ve been relatively lucky up to this point in my 12-Step program.

I know it can creep up on me and regain control at any moment, before I know what hit me.

In one of my favorite TV shows, “The West Wing,” Leo McGarry describes where the mind goes:

“My brain works differently,” he says, followed by,” I don’t get drunk in front of people. I get drunk alone.”

It’s the same way for a food addict. You can’t have just one slice of pizza. It has to be the whole box. I once joked to a friends that I can’t eat just five. And when I really wanted to numb my frustrations in a bag of junk, I always went peddle to the metal out of sight from others; typically when I was alone in my car.

Yeah, the addicted brain works differently.

I guess the point I’m trying to make is this: Don’t hate the person who has fallen into relapse and disappointed you so badly. The person didn’t choose to be this way. He developed a disease a long, long time ago. And diseases have a habit of reasserting themselves from time to time. Sometimes the victim is not able to shake the relapse this time and it becomes the person’s demise.

It sucks. But it’s how it is.

Be mad. Be frustrated and hurt. But try and remember this person didn’t set out to hurt anyone.

Go easy on him/her, and yourself.

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:

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.

Pills Can’t Kill Pain at the Source

The author has written much about his binge-eating addiction, but not so much about the pills — until now.

Mood music for this post: “I Don’t Like the Drugs But the Drugs Like Me” by Marilyn Manson:

A fellow addict in OA recently asked me how pills fit into my overall haze before I found recovery. She asked because when sharing my story I mention how taking Prednisone as a kid for Crohn’s Disease started me down the road to a food obsession.

Truth is, I never think of pills as part of my core problems in the past. But in hindsight, they certainly do play a role.

In addition to the mental pain I’ve had my share of physical pain. Migraines have been a frequent companion. So has back pain.

A lot of my troubles on those fronts were in my head; anxiety attacks and depression made me feel all kinds of aches and pains, including migraines  and sensations in the chest I was convinced were heart attacks. They weren’t, but I could believe just about anything when the fear and anxiety took over.

The back pain was very real. One time in 2003 paramedics had to cart me from my house because I was in so much pain that I couldn’t get off the sofa in our third-floor loft. I spent much of that week out of work and on the couch. The OCD and depression were already starting me on the deepest slide of my life and I was missing a lot of work anyway, but that’s the only time I can remember taking a ride in the back of an ambulance.

I would spent a lot of time incapacitated from lower-back pain, and one specialist after another would fail to pinpoint the problem until I found a chiropractor who within a day had pinpointed the source of my problem to three rogue vertebrae in the mid-back that kept closing shut on the nerves that are threaded through the middle. The pain would collect in my lower back, which left other doctors looking in the wrong place.

Since then, I go to the chiropractor every other week. He mashes the vertebrae back into place with his elbow and it’s all good from there.

But during the worst of the back pain I was on all kinds of pain medication. And naturally, they were addicting.

The doctors had me trying so many things I can’t remember most of the names, though one was Celebrex and another was Flexeril. The former was basically the equivalent of four Advils and the latter was a muscle relaxer. Taken together, they send you to la-la land.

At one point, I was on those two pills and a third, the name of which I can’t remember. I’d drive to work before taking them, because I noticed that when taken together with coffee, the mixture was buzz the hell out of me. It was a functional buzz that allowed me to do my work, but like all buzz-inducing fixes I found I needed it long after the drugs stopped working on the back pain.

I gave myself what in hindsight was an amusing panic attack once when, during a morning of house cleaning, I thought it would be an excellent idea to make the best of having to do chores by downing a Celebrex with two glasses of wine. I was buzzing nicely by the time I was scrubbing the counter in the upstairs bathroom. Then I remembered that there had been recent news reports about Celebrex carrying a heart-attack risk.

I freaked out, convinced I was going to be found dead on my bedroom floor. Erin was at her friend Sherri’s house at the time, and I called over there, remembering that Sherri is a nurse. I told Erin what I did and she asked Sherri for an opinion. Sherri said I’d be fine and to get back to cleaning. That’s what I did.

After going on Prozac I had some surgery on my throat to control snoring that was fed more by my obesity than my any problem in the throat. They gave me Vicodin do get through it and I would lie on the couch in bliss while under it’s spell. But I learned something that week: Pain meds can screw with the Prozac and keep the latter drug from working.

That led to a couple bad months of depression that took me into the Christmas season, which always screws with my head without chemical help.

I often wonder how much of the pain was depression induced — in my head, as my father-in-law might say. The reason is that in recovery I haven’t needed any of those pills.

In fact, one day I decided to clean out the cabinet where we keep most of our medication and I found several bottles of the pills I had been given for back pain. One of them had morphine in it, and when I chose to stop taking that one I remember lying on the couch in agony with withdrawal (and that was only after a couple weeks of taking it). The pills I found were mostly expired. Throwing them in the trash was a wonderful thing. It was like breaking out of a cage I never thought I’d be able to leave.

Today I only take one drug: Prozac. Yes, it works for me, though I believe it wouldn’t be working as well had I not gone through all the therapy and development of coping tools first.

Which sort of summarizes the big lesson for me: You can fill the hole in your soul with all the food, booze and pills you can get your hands on and the numbing part feels nice at first. But then you learn that nothing can dull pain that starts in the soul for long.

The only way out is to take the fight directly to the source of that hole.