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Saturday, March 20, 2010

Anxiety and Depression Run in My Family

Dear A. B.

I don't know what to say except thank you. Thank you for being willing to correspond with me. Until now, I did not have anyone that I could correspond with that knows the experience of depression. Not to mention someone with credentials! Feel free to set up ground rules as far as length of e-mails etc. If at some point you decide you would like to charge for this, please let me know as I would be willing to work something out in return for your advice/input.

I have attached a history that I wrote up many months ago and update as needed. I wrote it b/c in shopping for a therapist I found it exhausting to relate my story time and again, so I just typed it up. It saves time and energy. You are welcome to read it if you like, though I have no expectations.


LIFE HISTORY OF R. (32 years old)

I grew up poor in wealthy New Jersey county. My mother went straight from an abusive alcoholic father into a marriage with my biological father who was a heroin addict and has schizophrenia. My grandfather was a very depressed person, and treated himself with alcohol. My mother married when she was 18 and had my sister shortly after and me 1.5 years later. My biological father beat her and used heroin the entire marriage, which ended after a few years.

My step-father entered the picture and my mom, my sister and I moved in with him. He was also a depressed person who was very mean and verbally abusive, and his drugs of choice were pot and valium (until later when it became heroin, which killed him a few years ago). Growing up with him and my mom was pretty damn bad. They treated us like absolute burdens; we had no rights and no love, no discipline and no guidance/support. We had a roof and food.

My mom drank and both she and my step dad smoked pot daily. My sister, was also very abusive toward me. She told me I was ugly and weird and would do things at school to make me look bad in front of other kids. School was awful! We were poor kids in a rich county in NJ, and I literally did not have a single friend. I was made fun of for my clothes, never picked for team etc.

Home was hell, school was hell. I was very ashamed and afraid of my parents drug use. The only source of normalcy I had was my mom’s mom who was caring toward me, but I did not get to see her often. My step dad was to be avoided, he was always grumpy with us and he would not allow showers more than a few minutes and when I got to be about 13 and actually started getting phone calls, he would rip the phone cord out if I was on more than a few minutes. He was miserable and we were supposed to be too.

In eighth grade boys started liking me. That was my first positive attention and it was do to my appearance. That sent a pretty strong message. Girls were very jealous and some even invited me to a sleepover for the first time ever. I continued to “date” (be groped by) boys for the next few years. When I was 13 I did actually make a friend. She had an older sister and my friend and I started going to parties with her. I started smoking pot and experimenting w/ acid and drinking etc. I smoked pot here and there from the age of 13-21. I tripped on acid about 10 times between the ages of 15-18. When I came down from acid I was very depressed! So, I stopped doing it.

I did mushrooms and ecstasy a few times too. Come downs were very unpleasant, so I stopped. When I was 16 I met my first real boyfriend. He was a few years older and awesome. He was smart and funny and kind and had a totally different (privileged) upbringing. He had traveled and was very inspiring. I dropped out of high school and moved in with him when I was 17. I started taking college classes (he was in school too) and I really liked it. I began studying for my associates degree. My boyfriend and I were very in love, he was a hero of sorts to me. He was “normal” and I wanted to be with him always. So why did I cheat on him? I told myself it was b/c I was going to spend the rest of my life with him and I needed to “sow my wild oats” so that I would not resent him/us later.

My boyfriend and I smoked pot several times a week, but were responsible in other ways. We had such a close, loving caring relationship; nothing was hidden, except my cheating. I still love this man and in some ways he will always be my best friend, even though he won’t speak to me anymore. I enjoyed the sexual excitement of the cheating, and my attractiveness was reaffirmed by these men who wanted me. After 5 years and 6 or so cheating incidents (one of them his own cousin), I told my boyfriend about the cheating. I wanted to get it out and let him know the “real” me. I had done some cocaine on one of our trips (not the drug for me, I got very depressed/anxious coming down) and I felt very vulnerable and fraudulent and I just wanted him to know. We broke up then. He could not come to terms with who I was. He felt the whole relationship must have been a joke. He was VERY hurt. I was down about it for years. I was 22 at the time.

I wanted to continue my college education and I wanted to do it somewhere cheap. When I thought there was still hope for me and boyfriend, I had moved to Athens, GA as he had and applied to grad school there. I figured after some time apart he’d come around. He almost did. But, while I was living in Athens, I got all lusty and needy for attention again and started dating a guy who I thought would “hold me over” until my boyfriend came down to GA. I figured this new guy could entertain me and maybe even spoil me (which I seemed to want) and take me a trip to CO skiing, and that I would be such a cool person then…blah, blah, blah. Well, when I told my boyfriend about it (I had to) that was the final straw. He just could not believe it. The end.

The beginning of me and my next boyfriend and our six-year pot smoking binge. I was very down about losing my first boyfriend, but the second one was fun, but I was in really in love w/ the first. I even moved up north briefly to try and win him back and it was not to happen. So, I went to the University of GA and got a degree and lived w/my second boyfriend for many years. The whole time with him I kept thinking, some rich, adventurous guy will come along, or better yet, my first boyfriend would come back to me. I was always on the look out for some awesome guy. Not that my second boyfriend was bad; he just did not meet my criteria for this dream guy. So I went to school, worked a little, racked up a ton of debt and did not do much else for 6 years. My dreams of traveling, becoming a singer/actress all passing me by.

My mom had been diagnosed with a degenerative disease years earlier and she was starting to deteriorate. My half-brother from my step-dad, was her primary caretaker. My step dad started getting worse too, he got drug-tested at his job w/ the county, and so he reasoned that he would start doing drugs that would not stay in his system as long, hence the heroin. I was pretty down about the situation. I would tell myself all kinds of negative things about it.

They were all up in NJ and I was not helping and it was a mess. It made me so sad. My sister was a mess too. She just could not keep a job, lied all the time (still the same), and stole from my mom. What an awful mess my family was, so sad. My mom’s condition was very distressing, I would think all the time...how could something so awful be happening. I knew she would not live a long life and that it would be hard in years to come as she lost her ability to control anything. Uggg.

In this mindset, no first boyfriend, sad family situation, I had 2 semesters of college left. I had not made any friends in school, so my life looked like: get up, go to school, come home, and smoke pot.

I never went to school or work high, but if I was home or out doing something else, I was always high. I did not want the relationship with my second boyfriend anymore, but I could not afford rent on my own. He was not awful, we just had different wants. He was not very ambitious. I though about cheating on him all the time but I did not ever do it. I promised myself that after what I did to my first boyfriend, I would never do that to anyone or me again.

I felt I had lost my life when I lost my first boyfriend. The only “friends” I had were pot connections. So, one evening I was at this sort of friend’s house and I thought the couch was moving. Well it was not, it was me, my heart was racing so badly that I was pitching forward with each pulse. I thought…’was there something in that pot? What the hell’?! Well, a few nights later, it happened again. I was at home w/ my second boyfriend, and we had just smoked pot, and my heart just went wild. I told him “my heart is doing that thing again” and we did not know what to make of it. I felt very awful. I tried to go for a jog (something I never did) around the block to see if I could regulate it.

Nothing worked. So, for the next three days I never calmed down. I did not sleep, I could not smile or think anything good, I told the university health care folks that I must be having a nervous breakdown. I knew nothing about anxiety or depression. I did not even know anxiety attacks existed. I thought if people took Prozac it was b/c they were sort of crazy. Well, the health center gave me an Ambien, and then a valium of some kind; both were to help me sleep. Neither worked.

After the 3rd night of no sleep, I asked my second boyfriend to bring me to the hospital b/c I was suicidal. I wanted to die b/c I could not sleep and could not get a break from the thoughts. I thought maybe the acid I did long ago messed-up my brain and I’m stuck in a low. WOW! This happened so suddenly. Like a train hit me.
I was in the hospital for one night, they did not see me until the morning and they were not at all compassionate, it was a very bad experience. The Dr, came in Saturday night and I heard her say with a sigh “So, where is this suicidal girl...I’ll see her in the morning.” That hurt more than I can say, I needed her help, I was so confused. I did not sleep there either despite the drugs they gave me to help. I had never had sleep trouble before.

Next morning the doctor came in and told me I was depressed and put me on Zoloft and sent me home. As you might imagine the next many months were hell. I had a few more anxiety attacks, but I worried about them all the time! They were going to get me! I still have that worry, though this has not happened. By the way, I never smoked pot again after that night. Dropped it cold turkey, I did not want that happening to me ever again.

I stayed on Zoloft for 1.5 years at a pretty low dose. I don’t know what it did for me if anything, except that I gained lots of weight! I went off of it, and I felt pretty symptom free, (except for the constant being scared stiff of its return!) until this past November. After the hospital incident I got by as best I could, I finished school and got a job in a lab at the university. It was okay, but I wanted to move from GA and be out of the relationship with my second boyfriend. I had wanted both of these things for some time, but felt so confused and scared about where to go. So I kept working and being with him. Even he knew I was done w/ him; we just didn’t do much about it.

I had a major crush on one of the guys at the lab, but he was married. He reminded me so much of my first boyfriend, he was funny, outgoing, kind, and I never saw him checking out other women or being immature. I get very upset if someone I’m with looks at other women or porn (maybe something we can talk about). This man was lots of things that my second boyfriend was not, a homeowner, a college grad, outgoing, and I just thought he was so funny and so wonderful. Long story shorter, his marriage failed, his wife fell in love w/ someone else. He was devastated.

Then a new woman came along (I was out of the picture) and snapped him up. She was very needy and he took care of her, she proposed, they married. They moved away for a time, and then moved back to Athens. When they came back I decided I would test the waters. This was not a happy relationship from the outside. All of his friends (me included) knew it was less than ideal. So, I went for it! I wanted him and I went for it. He decided he might be better off out of that relationship, so he divorced and I left my second boyfriend and we started dating. Of course, I had been living w/ my second boyfriend…so I had to move out.

So, after a few months I moved into my third boyfriend’s place. We worked at the lab for a short time more. Then he got a job in Atlanta. We were very happy with our relationship. We both felt some guilt about his marriage break-up, but it was so awful that we could not feel that badly about it. He and I both did not like GA, so we planned to head out here. He was trying to land jobs elsewhere and I had begun working at a crappy job in Athens.

This November I decided I could not work at my job anymore, after about 6 months there. My boss was a brat and he treated people like crap and lied to them. So, before I quit, I ratted him out behind his back. Something that still scares me. I hate that I went about it that way, and I was very nervous when I did it. But, I did it. So, I was newly jobless and a snitch.

My third boyfriend and I went out w/ a visiting colleague one night. I do not drink very often, I don’t like being out of control or worried about hangovers etc. This night I drank and did something I’d always feared. I always fancied myself a closet singing sensation. So I drank enough that I tried Karaoke. Athens is a music town and even karaoke is a big deal, the bar that I did it at, is where a lot of local musicians hang out. I had wanted to do it for 6 years, but did not want to blow it.
This night I just did it. I think I wanted the world to change b/c of it, I wanted record execs to come out of hiding and offer me deals, I wanted my friends to gush about how talented I was. None of this happened. Next day I felt kind of down, tired mostly. But, the second day, my third boyfriend and I sat down to have breakfast, and I felt very anxious. I thought “who am I? Who is this person? What am I doing here”? On and on.

So, I went upstairs to shower and the awful feelings continued. And boom, just like that I was depressed, and anxious for the next several months. I went back to my counselor who helped me the first time and started talk-therapy again. After a few weeks I also got on a small dose of Celexa.

My third boyfriend finally landed a job in Oregon and I was not excited. This was something we had looked forward to and fantasized about for almost a year. I had begun to work with him in Atlanta and I continued to do that through those depressed/anxious times. A friend told me about the Feeling Good/Burns book. I liked it and used it, I saw hope in it. I saw the tiny bit of Celexa as sort of a safety net, and I hated the idea of meds. It was below the therapeutic dose, but I could not take more as I could not sleep if I did. I was back seeing my counselor, exercising, studying, and taking the meds….doing all I could.

The holidays were pretty bad. I just felt down and anxious. My third boyfriend proposed to me during this time, and I said yes. We got married on Dec17th by my yoga teacher on her property, it was lovely. Before this particular depression had hit, I was very concerned with my appearance and was not at all ready to marry. My heart wanted to, but some part of me kept saying “being a wife is so unattractive! You need to appear available to be loved. If you marry him he won’t want you anymore”…on and on.

During the depression some things loosened up for me. I decided that I would have to let go of the looks thing. I used to think about when I would get my first facelift etc. I thought I would never marry because it would mean I was an old maid….and besides…what if someone better came along?! What I realized was that I loved my third boyfriend and I wanted to share my life with him. I also realized how severely the looks issue was weighing on me. So, some things loosened up for me in that time.

I was terrified to move here because one of the things that is helpful to me if I feel down is to be among friends, and I had a few in Georgia. We don’t have any here. I thought, “oh boy, I am going to go off the deep end when we move! I won’t have anyone to distract/support me”. I have HUGE fears of ending up in the hospital, and suicidal etc. I was not that depressed during or even after the actual move in January (was it the tiny bit of Celexa, the distractions, the Burns work, all of it?).

I felt pretty good for the first 8 weeks or so here in Portland. I would try to clean the house a lot so that I could feel worthy b/c my husband was bringing in all the money. I stopped taking my 5mg of Celexa b/c I had being feeling fine and reasoned that I had jumped the gun by getting on it anyway. About the first week in March, I started feeling down. I told myself it was b/c I did not have enough structure (job) etc.

The fact is I had been looking for jobs, but not putting much effort or time in. I could not go out and get just any job b/c of this belief I have about how “bad” jobs make me miserable. I could just wait for a good job in my field to come along. Well, as it turns out I got pregnant in March…which might have been part of my mood trouble (hormones). I found out on April 1st that I was pregnant. I was devastated! I have not decided that I want kids, I’m not sure yet. My husband does, but I’m not sure. I had had abortions before, and had decided that if my husband and I got pregnant we would keep it. So, I told everyone that I was pregnant; I wanted people to make me feel excited about it.

That did not work. I got more and more fearful. All I saw was this depressed pregnant lady and then depressed mom. I had visions of myself friendless, and jobless in this new city and saddled with a baby who I did not want, my husband at work all day and me home doing nothing.

It was not a happy vision. I told myself I was not going to follow in my mother’s foot steps. After telling everyone I was pregnant, I had decided I wanted to terminate the pregnancy. I started feeling worse. We did in fact terminate the pregnancy. I had so many reasons and I hoped they were good. I had just gotten married, just moved across country, changed job situations…I was overwhelmed. Truth be told I am fearful as hell about giving birth! I am also afraid of PPD, and of post partum psychosis. I wish I was not so afraid, b/c a baby would be sweet I think.

That particular spell of depression cleared up for the most part in June. In June I was hired full-time as staff scientist. Maybe I just got busy with work etc and forgot about mood for a bit. The fear was still there, still is.

In October, right about the time season field work was coming to an end for me…I felt a bit down. I worried that my first winter here in Portland would be hard, without much sun. I also worried b/c 2 of the past 3 Octobers had started cycles of depression for me. So what may have been PMS turned into what I am going through now. A few weeks ago my family Dr. put me on 10mg/daily Lexapro. I don’t like the idea of meds, but was so tired and afraid that I figured it was time to try them again.

I have seen 4 therapists in Portland. A few were somewhat helpful, but I feel I have not found a good fit yet.

I have read David Burns, Cheri Huber, Marty Seligman, A.B. Curtiss, Dr. Edelstein (three minute therapy) and several others. I am trying distraction, disputation, mood logs. I am exercising daily and meditating some. Taking tons of Omega 3’s.
My recent negative self talk looks like:

Anxiety and depression run in my family, I had a bad upbringing and on top of that I probably messed my brain up w/ acid and other drugs. I don’t have a solid core, I don’t like or trust myself. I am not safe from my mind. I am going to have a thought/mood that will not pass and I will end up hurting me or someone else. I am going to end up in the hospital. I seem to be too weak to control this negativity on my own. My problems are too complex for CBT to work. I probably sabotage the process. Even if I do feel better at some point I will always be afraid of this happening again, so this is hopeless. I will always be on the run from this. Any day now, I will go crazy for good. Life is just not good enough, I am not good enough. What is the point? R.

Dear R.

The reason that therapy so often fails today is both the therapist and the patient don't really "get it" that most of what occurs in the counseling office is that the patient is trying to fix their history. They are still mad about being shortchanged and want to be somehow reimbursed. No kind of reimbursement is possible. Which is why therapy takes so many years. The patient is still using the process of blame to avoid seeing their fear and then, as a result of seeing their fear, addressing it so they can make more positive behavior choices.

Both the therapist and the patient believe the patient is trying to fix the patient's daily life. But if that were true, they would not need to go over the patient's past background. Child abuse has nothing to do with adult choices except that it is harder to form new patterns of behavior than to fall into habitual use of old ones.

Old poor behavior patterns have no power to limit one's use of good behavior patterns. This includes former crazy behavior as well, which is not often thought of as a choice. But a person has to realize this fact. Once they do, then they can simply put all their energy into practicing new behavior patterns until they become dominant over the old poor behavior patterns.

The old behavior patterns will still exist in the memory banks but as new ones take precedence, the old ones cease to be used as often. This is due to the brain’s plasticity, its ability to create new neural patterns as a result of new behavior and new thinking.

But this seems too simple. Most people prefer the “cure” for their poor behavior patterns to be complicated so that there is more excuse for lack of success. Why do we want lack of success? It's human nature to settle for the old ways, the known, even if it's miserable, than to risk the new. As the old phrase goes “ better to live with the Devil we know…”

The new ways generally involve dealing with your fear. Repressed fears are extremely painful. The more you are willing to risk addressing your fear, the less need you have for excuse, and the more you will use your energy to take the simple road to instituting new and better behavior patterns and therefore a better life. Hope this helps.

The funny thing is that you could write yourself any kind of life history background and substitute for the real one and take it to a therapist and the change would have no effect on your therapy. The only difference is that your real history explains your fear. But you don't need your fear explained. You just need to address your fear so that it can finish and you can move on. Read chapter ten on getting in touch with your fear.

Dear A. B.

Thank you for this Arline. I can see that the points you make are valid. In fact, I have been reading about types of therapy lately and how dwelling on a patient's history can be not only useless, but even harmful b/c of the negative focus on a bunch of "do not wants". I debated over whether to send the history b/c I did not want you to think that I was ignorant of this, and I also did not want you to think that I wanted to dwell on the past. I sent it afterall b/c hell, it's already written, but I do appreciate your being candid about yours views on it. It so happens I agree!

The past few days I have been using something you mentioned to me and wrote about in DiaC (do you like the abbreviation of your book?). Each time I feel the temptation to dwell on the negative or fall into my pattern of doing so, I think about how it is not helpful to EVER dwell on how bad you feel or how bad things seem.

I picture myself as a salmon swimming upstream b/c that is the good thing to do, not b/c it will mean I will get somewhere and never suffer. This has been helping me. I am refusing to "do" negative thinking once I catch it going on. I am reminding myself that it is a choice, you are living proof and welcome reminder of this.

Dear R.

You are on the right track. For 32 you are quite mature. I suspect you matured earlier than is appropriate due to your home life. This was true of me also. So, like me, you will have to go back and allow those softer parts of you to venture out that were stifled when you were young. It is also harder for people like us to develop the ability to love other people due to our excessive amount of fear and the fact that we didn't have much practice.

This is why we get sex all mixed up with love and can't seem to settle on somebody. We really don't know how to invest ourselves in another person and make them important to us. Mostly we are the most important person to us. But we can develop this ability to relate in a loving way to others. The first thing to do is start to allow the fear to surface so you can acknowledge it and let it go. It takes courage to love someone else because you put yourself in such a vulnerable, belly up position. You can practice making someone's else’s wishes more important than yours. Start in very small ways. You'll be surprised how rewarding this can be to all involved. A. B. Curtiss

Dear A. B.

Man, you nailed it when you said "we can't seem to settle on someone." I never thought I would get married. I was afraid. Afraid it would make to me too unavailable to other people/options. Afraid my spouse would be with me, but secretly want other women (in bed). Thankfully I did get married and I am doing my best to be a good partner. I am very open about my ego/mood etc issues, so nothing is hidden. Poor guy, huh? :)

I frequently have dreams where I am not given enough time to get primped to go some place where there will be other guys to impress. I try and try and my hair and make-up just are not quite perfect, I can't leave the house until I look stunning, they have to want me, they have to see me, they have to need me. When there is an event, I struggle to avoid doing this, needing the attention. If not only b/c...what happens when the beauty fades? What then will I rely on?
Again...the fear. Fear that I will not be appreciated enough in this life.

As soon as someone loves me enough, they lose value somehow...I feel the need to move on and impress other (seemingly more important people). I am very self-centered. I watch myself all the time and catch myself being constantly convinced that other people must being doing so. If I deem that I look perfect, I want them to notice me, if I don't think I look perfect I am pissed that they are paying attention to me. I notice all these things, I have noticed them for years. I think that is the first step. I see them going on. I know that they are fear based. That's a start no?

That's a wonderful start. To be self-aware that you are being self-focused is the very way out of self-focus. Build your life on doing your best everyday, and rededicating yourself when you fail. Don't build your life on how good you feel about yourself because you are a winner. Many of us have tried to win some gold medal, lost and must content ourselves with being good people and making the best out of our day. When you go out and look at the stars, you start to realize that you are a part of something really beautiful. Try to add to the beauty of life by being a beautiful person in your efforts to be an ordinary good person, not a wonderful, self-assured one. A. B. Curtiss

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