I Salute You, My Fellow Traveler

Well, the new year is almost upon us so this will be my final blog for 2012. It is a long one prompted by an email from amazon.com that someone had made a comment on my review of The Noonday Demon: An Atlas of Depression.


I wrote too long a reply to that comment so I thought I would put it on my blog instead of amazon.com. So many times I have thought I should write a posting on my blog when I’m depressed but that doesn’t happen too often so I don’t think I ever have. Well, today comes pretty close  to it as I have been working hard all week getting out of a depression. Yes, thank goodness, I can do that. But since it was so fresh in my mind how I did it, I thought it might be helpful to describe it.

If you want to read all the amazon.com negative and positive comments on my review I have put them all here. Or you can scroll down to the last entry where I describe my bout with depression this week. I’ll try and capitalize that so you can find it easily. Happy New Year to all and to all a good year coming up.    A. B. Curtiss

HERE’S MY REVIEW OF THE BOOK NOONDAY DEMON

The excellent writing in Noonday Demon describes the agony of depression in a profound way. The author is the son of Howard Solomon, head of Forest Laboratories who sells Celexa so there was a lot of big pharma money behind the book. Author Solomon doesn't seem to know a thing about how his own brain works, and basically has decided to surrender helplessly to his own mind. I would rather see mediocre writing describing the joy of how you get out of depression instead Pulitzer Prize poetry about the agony of how you have to live with it.

HERE BEGIN THE COMMENTS ON MY REVIEW

K. M. Kier Comment:
The NoonDay Deman is not a self help book. There are plenty out there if that is what you seek, but his objective was more ambitious. Did you read the book and do you suffer from chronic depression? The answer to the latter must be no, as those who suffer from chronic depression are never cured. It is something that they have to learn to live with. While there may be periods of remission and sufferers have days that are better than others, it is not something that they will ever be able to free themselves of entirely. It's roots are biological and it is organic in nature, just like any other disease. Unfortunately medicines, with their side effects and waning efficacy as time goes on, are not a panacea. Therapy helps, but depression is not something you can talk yourself out of. It helps, and works even better with an effective medication, but you seemed to have missed the point of the book and still don't have a good grasp on how depression affects those that suffer from it. Don't shoot the messenger because you didn't like what he had to say. The sad truth is that the book you were hoping for would have to be categorized as fiction.

A.B.Curtiss Response:
I guess I don't want to argue with you. I wonder though on what authority you insist that depression is uncurable? I used to suffer from what was diagnosed as manic depression but I don't anymore because I have learned to manage my thinking process better. My authority for my comments is that I am a board-certified cognitive behavioral therapist

K. M. Kier:
My basis for it is that I suffer from chronic depression that at times can be debilitating, my mother suffered from it and is now dead by suicide , and her father had manic depression. He had to be hospitalized on several occasions and receive ECT treatments when it was a much more barbaric procedure. My sister also suffers from it. I applaud your certification and the role you play in the Mental Health Care system, but managing your thinking better does not rid one of chronic depression. It may allow one to cope better, as depressed people tend to ratchet things up with ruminations and distorted thinking. However, it sounds to me like you got the wrong diagnosis, which is a prolific and unavoidably inherent problem with mental illness.To be able to accurately classify the personality into clean and distinct categories (i.e. BiPolar 1,2, axis disorders et al) would be nice. It just doesn't fit the real world where everyone falls on a spectrum that encompasses an infinite number of possibilities. If a chemical imbalance is causing the depression, talking yourself into feeling better would be akin to talking yourself out of a hangover, another, albeit decidedly more temporary, chemical imbalance. There are people with Borderline Personality disorder, which walk, talks, and looks like BiPolar disorder but is more a product of environment. BPD responds much better to CBT than a true BiPolar. I am an advocate of CBT but a chronic depressive order is never going to be cured by such methods. I might also mention that because of my issues, I had to leave my post medical school Psychiatry Residency and likely will never return. I truly am glad that you are better, but I would suggest taking what I have to say and applying it constructively to your practice. It would be fallacious and counterproductive to place the same expectations on everyone that you see. Regards

A.B. Curtiss response:
My father and brother were also diagnosed with bipolar and both took medication for years, my father had shock treatments. I refused to take the drugs and studied neuroscience instead where the answer to the chemical imbalance does lie. I place no expectations on anyone else but the cognitive behavior methods I have developed have helped many. A. B. Curtiss, Author of Brainswitch out of Depression.

John S. Bailey:
I'm glad you wrote this post. It shows your own bias in your review of Solomon's book.

Kimchi says:
I know this comment falls in the category of "argumentative" but as someone who has depression with bipolar tendancies and having had a relationship with someone with bipolar disorder, I can tell you there is no "getting out of depression". There is merely awareness, maintenance, education and various therapies and medications. I'm inclined to believe your diagnosis of BPD is correct because I learned that my ex would often think he had control of his BPD by changing his thought processes and self-medicating. It would work temporarily but inevitably, he would fall into hypomania and our "rollercoaster" would begin again. What concerns me is that as someone who claims to have the credentials that you do, you've made comments that I find irresponsible for a therapist. No credible therapist that I've ever seen or know of would make statements about getting out of depression or claim that they've cured themselves of BPD simply by managing their thought processes better. That's not to say CBT isn't effective but I've always believed it to be effective as part of a treatment plan as opposed to a stand-alone treatment. I'm also confused as to how you can acknowledge depression and BPD as illnesses of the brain and then tout CBT as your "cure". Conscious changes in ones thinking simply do not repair synapses or restore chemical levels in the brain. Maybe they can help one cope with the chemical (and as a result, emotional) shifts one experiences but it doesn't "cure" it. I find your claims dangerous and irresponsible.

But wait, maybe I should buy and read your book first before I make those claims...

A. B. Curtiss response:
There is a chemical consequence in the brain for every single thought you think. A fearful thought causes a production of stress chemicals. Peaceful thoughts cause a lessening of the production of stress chemicals. Thinking also grows new neurons in the brain otherwise we could never learn a new skill. Just because you have no empirical evidence that you have been able to alleviate BPD by changing your thinking is not the same thing as having empirical evidence that it cannot be done.

Paris Tofino:
A.B. Curtis said: "I refused to take the drugs and studied neuroscience instead where the answer to the chemical imbalance does lie."

What is your statement intended to imply? Specifically, what insights have you gained about depression from your study of neuroscience?

A.B. Curtis also said: "The cognitive behavior methods I have developed have helped many."

It is well know that many people recover from depressive episodes without treatment and that many benefit from placebo treatments. Is there research evidence that has found that your CBT methods result in improvement in symptoms that is superior to placebo treatment or no treatment at all?

VisaCard Reader:
I am not a fan of "Big Pharma" and also suffer from depression - and have taken anti-depressants for over 20 years with varying results. My criticism of this review is the casual way in which its author claims that "there was a lot of big pharma money behind the book." To convince me and others of her claim, Ms. Curtiss owes readers objective evidence to support it.

Tricia Love:
K.M.Kier (Tricia is responding to this person's comment above)
I feel very brave to be responding to your post since I am not qualified in any way to discuss this matter. So from an impartial observer who happened to read the review of this book when it came out I just want to say that it seems to me, people with depression have to learn to live with it the best way they can (just like an amputee or a paraplegic for instance). The horrors people have related here about hereditary depression are depressing in themselves. It must be very scary knowing that several members of your family suffer or have suffered from chronic severe depression.

My comment is not meant to be taken lightly. A. B. Curtiss has found a way to live with her condition which has made an improvement in her life she wants to share with others. There is certainly something to be said for positive thinking (if you can manage it) A. B. seems to have been able to manage it. There is a form of self-hypnosis (don't scoff) called guided imagery, if it can be mastered by controlling the mind it is very helpful to some people. Perhaps there is hope, not of a cure yet, but of a better life. John Nash seemed to be able to find a way.

I know it's not just a matter of "pulling yourself together" it is not something you can shrug off. But if everything else about you is functioning fairly well, perhaps there is a good case to be made about a herculean effort to stand up out of your wheelchair and take a few steps - away from your chair. Steeping oneself in the subject, reading everything available, constant analysis and mixing with depressives, perhaps is not the best way forward, which after all is the journey we are all taking the best way we can. I feel A.B. Curtiss is to be commended in the work she is doing to help others, there are always the nay sayers.


HERE BEGINS MY LAST COMMENT

Thanks for your comment Tricia, I had some disturbing news this week and got hit with a terrible whack of depression that I struggled with, on and off, all week. So I had to take my own medicine so to speak. Therefore I am fresh with the practice of working to get out of depression instead of allowing myself to succumb to it which is hard, hard, hard. I won’t deny that it is hard. And I will say this, when I get these bouts, my heart goes out to all those who suffer because it is just agony, agony, agony.

I found myself saying over and over, “I can’t stand this. I can’t stand the pain.” And the pain in my gut was hard like cement. “How can anybody stand this? I thought.” Then I caught myself in this destructive thinking since my habit is to do something, anything, except to fall into the unmitigated despair and just succumb to depression without a fight.

One by one I’d pick up one or another of the dumb exercises I habitually use. I don’t consult my book which has hundreds of pages of exercises because they seem to pop up just when I need to remember them. (The exercises are in my book BRAINSWITCH OUT OF DEPRESSION, my first book DEPRESSION IS A CHOICE is more of a philosophical look at depression).

So I did the mind exercises over and over during the day. I sang nursery rhymes to myself. I prayed. I especially like the 1st Psalm so I said that a lot. I used the scales exercise (on a scale of one to 10 how do you feel, then look at some small thing and be grateful for it, even a piece of colored plastic on the ground, and do that until you go up the scale of good feeling)

I remembered to change my thinking, when I fell deeper into it, from being subjective (thinking about how I felt) to being more objective and looking at the physical details of the world around me—my walls, the newspaper on the breakfast table and concentrating on the small details, like the veins in the flower petals.

This is not easy to do. It is hard, hard, hard to make yourself turn away from the paralysis of fascination with depression. But everything positive you do, or every neutral thought you think lessens the pain. After I’d so an exercise, I’d start on some or another project and then begin to concentrate on that instead of how I felt. I did start to feel better after a while. I went to the gym and worked out and swam.

During the last couple of days I continually used Emile Coue’s hypnosis: “Everyday, in every way my thinking is becoming more joyful and grateful. Soon my thinking will be only joyful and grateful and will continue to be only joyful and grateful for the rest of my life.” I did that over and over, especially as I was going to sleep or just waking up.

So for several days I got waves of depression throughout the early part of the day and pretty much faded each one out after 10 minutes or so by my doing some mind techniques and then from the mind techniques I would ease into to taking on some project or another. I would now and then experience small tendrils of joy creeping into the darkness. By the afternoon each day I was perfectly okay and noticed I was again joyful and grateful, and then I might get hit in the morning. I kept telling myself it was okay to acknowledge and mourn one’s losses but it should not turn into depression.

The main thing I kept telling myself when depression would cover over me is that the terrible depression I felt, whenever it came, was something to be ignored and stepped out over into something, anything more productive. I would do anything except allow myself to think about depression.

I was encouraged to find that no matter how bad the hits came, I never slipped back into my old habitual depressive practices that I was stuck in as a young woman by speaking in a low, sad voice, or taking to my bed and pulling up the covers and otherwise disengaging from the world around me. I eagerly sought to re-engage wherever I could, with the clerk at the grocery store, joke with my husband, setting up lunch with a friend so I’d have something to look forward to.

I sometimes thought of all the other depressed people out there and wished them well and promised I would not add to the universal despair, that I would take on my share of the burden and move forward with my day and perhaps that might help lift them as well in some way. We don’t know everything, do we? We don’t even know what it is that we don’t know. And don’t the mystics say we are “all one.”

Right now I can see both sides of the coin. I can look on the side of despair but I don’t stay there. I choose to look forward to small things I can be grateful for, a nice breakfast, my dogs greeting me, my writing, my husband. I’m just finishing my first science fiction novel for young adults. I want to send that out to see if I can get a publisher. The publishing world has changed so much I hardly know where to turn. So I can look forward to working on that.

I am glad for myself that I did all the work and study of depression for years because I can now avail myself of all of it whenever I need it. I know how my brain works and that anxiety and fear are only in the subcortex and I can move into the neocortex with mind exercises and there is never any depression in the neocortex. And I’m glad I wrote my two depression books and am gratified that they have helped other people.

Isn’t that what we are here for, to connect with one another. To help one another. To love one another. Nothing works except love. Nothing. We need to remember to turn around from despair and look in another direction, even if just for a second. Put out your hand and just feel the table in front of you. Concentrate on moving your hand and watching it. Concentrate on your hand for a few minutes and some of the pain of depression will lessen if you are depressed at the moment.

In the whole universe of chaos isn’t the human hand, my hand, your hand, a miracle? Now, at this moment, I raise my hand and salute you, my fellow traveler, wherever you are on the eve of this New Year. That’s a positive thought. Every positive thought or action takes us closer to where we are supposed to be—perfectly okay.

Rest Yourself in the Unexpected

Everybody, at this time of year, has their sadness, their losses, their failures to hover over and haunt them much like the spirits who visited Scrooge on Christmas Eve. These shadows are not easy to dispel and sometimes they keep you from moving ahead with some joyousness. Sometimes, when I am tempted to dwell upon hurts, lacks, or disappointments, I think about my daughter’s words a while ago.

She said no matter how bad things are, we still can’t just give up. We can’t ever give up. We have to do our very best every day with whatever comes our way. Our very best is all anybody can do. We can rest in that—that at the moment we are doing the best we can. We can rest in the thought that we are just an ordinary person doing our ordinary best. Nobody really cares if we are extraordinary. Even if we aspire to that. ordinary will do, every time.

A couple of people have told me they find this poem comforting when they are teetering on the edge of despondency and are looking for a tree limb of hope to grab onto as they slide toward the black cliff. It comes from a book I wrote called Children of the Gods. I copied and framed it for a good friend for his birthday last month. The book is my least best selling book but I find it even helps me to read it now and then. It reminds me that I always have the power to put things that bother me into a different perspective. There are only two ways to look at any approaching moment, with fear or with love. Here’s the poem:

You have become a prisoner

    of the preconceived,

Your hopes are your insanity.

You cannot plan God, plan reality.

Reality is always a surprise.

The truth you seek is hidden

 by your wish to find it.

You are chained to every pain

  and sorrow

By the desire that it should not

Be happening the way it is.

It is the wanting something else

That nearly kills you.

When you give up all your hopes

You also give up all your fears.

Seek what is at hand.

Save yourself, heal yourself,

  rest yourself

In the unexpected

                                       A. B. Curtiss

Does Anybody Love Me?

I was driving to an appointment yesterday when the most desolate feeling of loneliness came over me. I felt unloved, unworthy, unimaginably isolated and disconnected from the world around me. Christmas lights along the way were not cheering my frozen heart.

Where do you turn for help at such moments of deep despair? I was driving in fast moving traffic down a busy highway. Often at such times I use mental exercises to change my mood or meditations of gratitude.or a prayer of some kind. I seemed unable to choose one. Perhaps this was more of a spiritual lack rather than a problem with depression.

Did anybody love me, I wondered? Did anybody love me?


Ahead, in the distance were some large and lovely trees and beautiful clouds overhead, billowing up for another storm. I found myself talking to them.

“Do you love me, Trees? Do you care about me? Am I acceptable to you? Can you accept me, Trees? Am I okay with you? Please, do you know I’m here? I’m right here. Am I not a child of the universe like you are? Can you keep me company? Do you love me, Trees? Clouds, do you love me. Am I all right with you?

I have been told that we need to surrender and that to whom we surrender does not matter. The idea in surrendering is that you are surrendering to life and therefore, in surrending to life you are no longer separate from life. I think maybe that's what I was trying to do--to surrender myself to the trees and the clouds because I felt so isolated. It was a very healing thing that happened yesterday. Here's how it ended.

I love you, Trees. I love you, Clouds. Thank you. Thank you. Thank you.

Depression is not Present Reality

My own brain chemistry is such that I still wake up almost every morning of my life in deep despair, although it usually only lasts three or four minutes once I employ some simple mind tricks. I am seldom troubled this way by depression in the late afternoon or evening unless I take a nap. Anytime I take a nap, I am also likely to wake up in the “black hole.” But I no longer panic and fear to drown in those black depths.

I simply begin to swim for shore by doing some dumb nonsense exercise, unafraid (because I  carry along any fear, "come on along, fear, I'll save you too"), regardless of the fact that I do not know how deep the water goes, nor how far away the shore might be. I know, now (since I have been doing these exercises for decades) that it is neither the water, nor the shore, nor my fear, but only swimming (doing the exercise) that is the present moment, and the present moment is our only reality.

This is what the dumb little exercises, "green frog," "hippity-hop," "yes, we have no bananas," are. They are a temporary reality of benign thinking that you are substituting for your reality of depressive thinking. Neither are a true reality because both nonsense thinking and depressive thinking are not connecting with with the people and the world around you. By themselves, the exercises do not "get you out of your head" but they are a quality of thinking which does not produce negative chemisty in your brain the way depressive thinking does.

It is easier to simply intrude an exercise upon your depression than to force yourself to be okay when you're, obviously, not okay. One learns in time to "hang in there" with not being okay for a while during your doing some dumb exercise. Then it is easier to move into some connection with the world from the point of nonsense thinking--do some small task, then the next, then the next.

Generally I find that along or about the third task I realize I am no longer depressed. I can then, if I remember to first move into gratitude for the grace of my relief,  move from there into joy and enthusiam for the day ahead.

So here is a kind of dance program for depression

Depressive thinking to

Carry along the feeling of being not okay while doing a dumb exercise to

Continue with the dumb exercise to

Moving into Small tasks

Engage in moving ahead with your day