Desperate to Defeat Depression

It has been almost two months since I last added something to my blog and that bothers me.  Of course, said ‘two months’ were spread across the ‘holidaze’ and it is always easy to get caught up in ancillary activities which usurp time from blogging.  However, this was not the case for me as I enjoyed a fairly low key and relaxed Thanksgiving, Christmas and New Year’s.  No, for me my blogging has suffered, as have so many other activities, from the return of an old nemesis from my not so distant past – depression.  Given this occurred with the advent of winter here in the higher latitudes a number of folks suggested it might be SAD (Seasonal Affective Disorder) and while SAD might be a contributor I do not believe this is the case.  In the first place I love the winter in this area, it is my favorite season.  I live for the cold temperatures and snow events which have, sadly, been rather sparse again this winter.  The longer periods of darkness do not bother me in the least.  In fact, I struggle much more with the absence of a night sky and any real darkness from early May through late August than the deep darkness we see from mid-September through early March.  And, too, I continue to take my daily Vitamin D3 supplement to help ameliorate any SAD symptoms.  So, no, I do not see SAD as the root cause for my lack of interest in anything.

As more and more information has come to light regarding depression and its symptoms, causes and prevalence I’ve come to recognize I’ve dealt with depression since I was in junior high school.  Not continually but rather in sporadic episodes which often lasted for months to even years.  In hindsight, I didn’t even know my lack of interest and seemingly anti-social behavior weren’t ‘normal’ for me until one late summer in south central Wisconsin when I was in my middle thirties.  I’d always suffered from hay fever and the late summer was one of my least favorite times as that’s when the ragweed pollinates and I was doomed to a totally stuffed up head, continually runny nose and sneezing fits until the first hard freeze.  But that late August I never felt the onset of these symptoms and marveled that I saw the first frost without experiencing any hay fever symptoms.  Within another few months I began to notice my overall mood was much brighter and I felt more alive and just ‘lighter’.  It took another few months for me to realize I had been living with depression for decades and suddenly the depression had lifted.  Given this happened at the same time my hay fever disappeared I’m betting my body went through some biochemical shift in my middle thirties and whatever caused my sudden lack of sensitivity to ragweed pollen also caused my depression to disappear.  Since that time depression has often returned – unlike the hay fever which has never again plagued me – but I recognized its beginning and began to learn methods to mitigate its effects.  Across my forties and fifties I was involved in a tug of war with depression; sometimes it would hit me for a week or two but I always won out in the end.

But then came the end of 2017.  In hindsight, I could feel its return in November of 2017 and I prepared to once again do battle.  And it did come on and I tried all my old tricks to minimize its effects and banish it once again.  But this time nothing has worked and, indeed, I’m experiencing what I believe to be serious depression.  Without question, this is as bad as any bouts I can recall and seems to be worse.  Twenty seventeen was a tough year for me with diagnoses of severe hypertension and late onset Type 2 diabetes; because of these conditions I’ve been taking a single med for the diabetes but three meds for the hypertension.  It is possible one or more of these drugs are ‘enhancing’ the effects of this recent re-occurrence of depression.  But said diagnoses also prompted me to begin a much healthier lifestyle; I currently do between 11,500 and 14,000 daily steps (around 5.0 to 6.3 miles) spread across my day to try to keep me in motion at least once an hour.  I do this exercise seven days a week and try to supplement it with some additional exercise like using my fluid resistance indoor bicycling rig.  The diabetes forced me to assume a ‘low carb lifestyle’ which has allowed me to manage the condition (I’m currently working on 78 consecutive days with a blood glucose level at or below 135 mg/dL) through diet and exercise.  In addition, I’ve dropped fifty pounds across the past year with another twenty to twenty five to go.  Both these positive shifts should help mitigate my depression.  But with this latest onset nothing seems able to dispel the dark helplessness that’s settled over my awareness.

Given all this I’ve elected to visit the local clinic and talk with the behavioral health specialist regarding this sudden and intense bout of depression.  Despite having dealt with depression for much of my life I’ve never seen a medical professional regarding the condition.  Early on, as in back in the sixties and early seventies, I knew nothing about the condition and assumed dealing with the ‘dark times’ and lack of interest in anything along with shunning socialization was just part of ‘being me’.  Later, I just soldiered on and began to learn some techniques which often helped like fasting and rigorous exercise.  During my later forties and fifties depression would ‘come and go’ but never felt bad enough nor lasted long enough to seek medical advice.  But this has all changed across the past couple of months.  I’ve never seriously considered suicide but of late there have been numerous times I have wished I’d just go to bed and not awaken.  But when I feel this way I quickly remember my canine companions; I made a commitment when I brought them into my pack and I will fulfill those commitments. 

Mostly I’m just tired of struggling with health issues and associated financial concerns.  But I’ve dealt with both in the past and never felt so overwhelmed or bereft of hope.  I’m so hoping western medicine can offer me a means to battle back against this seemingly impenetrable veil of empty darkness!  I really don’t want to take any more pills and I sure do not want a ‘treatment’ which brings new negatives into my existence via the dreaded ‘side effects’ but if I can get a prescription for something which allows me to rise above the daily feelings of isolation, desolation and frustration it could well be a God Send.  I know depression is often stronger and more prevalent in older folks and at sixty four and a half years of age I’m definitely getting up there so perhaps this is part of what’s driving the severity and resolute nature of this latest onslaught?  I just know I have to do something as for the first time in decades I feel utterly powerless to escape depression’s grip and it is slowly wearing me down at a time when I’m not feeling a surfeit of inner strength. 

Routines: Short-Sighted or Salvation?

So many perspectives shift as we age and I was just ruminating about one such shift in my own life; that of the value of routines.  While in college I became deeply immersed in the philosophy of the Don Juan/Carlos Castaneda series of books.  One of the things Don Juan railed against was the human predilection to develop routines within our daily lives.  I remember him chiding Carlos with his apparently very realistic imitation of a factory whistle which signaled when it was time to start work, stop work, take breaks and finally go home.  At the time I found his arguments extremely compelling regarding how routines limited human freedom and the ability to experience new and unexpected things.  I could see how the development and implementation of routines could be viewed as limiting the human experience and even be the product of a lazy mind.  In this perspective allowing one’s self to succumb to routines was a very negative practice to be avoided at all costs.

Fast forward four decades and my, my but my perspective on routines has changed!  Without question the major shift is based upon aging as from an intellectual standpoint I can still see mainly negatives to establishing and utilizing routines.  But the realities of aging have caused me to rely more and more on routines to manage my day to day existence.  Sure, life continues to become more complex and that means more technology which requires more willingness to learn and retain said learning’s but I also cannot ignore the fact my mental ‘edge’ is nowhere near as sharp as, say, fifteen years back.  In response to pieces of this increasingly complex lifestyle I have come to rely on some basic routines.  In addition, I also use routines to insure I undertake activities and events which I might otherwise skip or put off.  A classic example of the latter involves my stepping; I currently take anywhere from 11,500 to 13,000+ daily steps.  Across the first five to seven hours of my day, when I am largely at my system, I also take between 1,000 and 2,000 steps each hour – generally at the bottom of each hour.  This routine forces me to get off my fat butt at least once an hour and perform a bit of exercise.  Because I am, and have always been, a very lazy person regarding physical exercise I really fought against the daily urges to put off my stepping.  But with the advent of my hypertension diagnosis, and then exacerbated by my late onset Type 2 diabetes, I knew I had to become more active and said physical activity had to be on a daily basis.  The only way I knew to virtually guarantee I fulfill my exercise requirement on a daily basis was to turn those first 2,000 to 3,000 morning steps into a routine.  Within about two months I had made getting up in the morning and quickly getting in those initial steps a habit; once I get those steps done it just ‘flows’ into doing the remainder of my quota.

In this sense the routine of arising and almost immediately doing those first 2,000+ steps  is a healthy habit and really helps me get at least some daily exercise.  Across the last month and a half I’ve turned my daily morning blood glucose testing into a routine.  When tracking one’s blood glucose it is important to do one’s ‘stick’ at the same time each day to avoid introducing variability into the measurements.  As I prepared to add the blood glucose (BG) testing to my morning/evening blood pressure measurements it occurred to me I should combine the BG testing with the AM blood pressure measurement.  I’ve now standardized on taking my morning blood pressure around 05:50 and my daily BG test around 06:00.  I also record these values in spreadsheets which help make it even more difficult for me to forget to perform these daily requirements.  Once again, I view these routines as invaluable aids that help me handle some daily requirements which have become crucial to my health.

I suppose I could set schedules on my cell phone and/or network regarding these important functions but is not doing so the same as making them a routine?  As an older human being I find comfort in my routines; they offer me a degree of ‘consistency’ in what appears, at least to me, to be an increasingly inconsistent world.  And they are also rather like ‘old friends’ who’s presence is somehow reassuring and pleasurable.  But mostly, they insure I perform activities and handle events that are a necessary part of my existence; events and activities I might otherwise forget or forgo.  In the latter sense my routines are making up for a lack of real commitment and willpower on my part.

Given all this I have to admit to really shifting my valuation of routines based mostly upon my aging.  But I remain vaguely uncomfortable with the whole concept because I can still recognize that to rely on routines more and more does, indeed, begin to limit one’s ability to really ‘push the envelope’ and be willing to try new things.  Without question, this entire topic is one which really evokes a sense of ambiguity within my soul!  Most likely, the best way to resolve this ambiguity would be to accept that with age some ‘routine reliance’ is a good thing and probably healthy but – as with all things in life – needs to be used in moderation.  The real trick is understanding what said ‘moderation’ involves and then living it…



The trap of routine behaviors

Accommodating Aging…

In a way I feel profoundly unqualified to write this piece for although I am 63 years of age I am continually discovering just how ill-prepared I am for my advancing years.  In hindsight I largely behaved as though I was ’18 and invincible’ until a foolish misstep on March 27, 2015 yielded a severely fractured left radius and ulna and forced me to recognize my own mortality.  Thirty eight thousand dollars and a session of major orthopedic surgery later I began to learn just how unprepared I was for life as a sexagenarian.


Serious hardware required to repair my left elbow and left radius and ulna!

Looking back my preparations for aging were not helped by almost perfect health across my first five and a half decades; I suffered nothing worse than ‘pleurisy of the diaphragm’ – something that sent me to the hospital emergency room three times in my life – and the infrequent bout with the flu as well as a few cases of what could only have been potent staph food poisoning.  As I aged I watched so many of my peers start to struggle with back, neck and joint issues while I just continued to march forward.  I’d always struggled with my weight although I’d managed to remain perhaps eight to twelve pounds heavier than I should have been for most of my working life.  But, regardless, I cannot damn a life of great health especially as so many out there would probably kill to experience what I did in terms of a lack of health issues.

The aforementioned accident in March of 2015 really forced me to re-evaluate just how I was living in so many ways.  Because it left me with virtually an artificial left elbow along with a plate and six bone screws in my left forearm I was forced to give up any activities which involved impacts of any kind.  Sadly, the one exercise I truly enjoy is splitting firewood; that is now just a fond memory.  My left arm is probably 85% of what it was before the accident but for some unknown reason my left wrist – apparently uninjured in the fall – became very painful in June of 2015 and remains so to this day.  I proceeded to learn the truth of something a friend had shared with me; “You do not want to be of ‘interest’ to Western medicine!”.  I spent another $5,000 plus on tests including a bone scan but nothing revealed any cause for the pain.  At this point my left wrist is maybe 50% of what it was before the accident and hasn’t really improved much since it first began to ache.  This may well be as much recovery as I’m going to see.  My surgeon gave me two choices; learn to live with the situation or undergo another surgery to remove the plate and screws.  The latter is totally unknown; he cannot guarantee this will help and cannot even guarantee the operation wouldn’t make the arm/wrist worse.  I’ll wait until March of 2017 and then re-evaluate my healing.  Hopefully, by then, I’ll be able to make an informed choice.

But much more has changed since that March day in 2015; I still bear the mental scars of taking such a sudden, nasty fall and it has forced me to be very cautious when it comes to uncertain footing.  Given all the ice we’ve experienced across the past two winters this means I rarely get outside from November through April unless I put on traction ‘slip on’s’ and use my walking staves.  Even then I cannot escape a sense of dread whenever my feet slip.  I also believe something happened regarding my sense of balance which was never all that great; nowadays I’m much less steady on my feet and I’m flat out unwilling to put myself more than a few feet off the ground be it on a ladder or similar.

Everyone is aware as we age our faculties tend to become less sharp and are ‘off line’ more often.  Our physical prowess also tends to fade with the years as does our ability to fight off illness and especially to quickly recover.  For some of us this means we begin to lose faith in ourselves and our abilities; needless to say this is not good.  However, refusing to acknowledge aging can and does remove the ‘mind’s edge’ is also rather unhealthy as it leaves one vulnerable to making perceptual or memory related mistakes and then exacerbating them by refusing to consider one might be wrong.  This is a very fine balancing act and one I’m really struggling to find that point of parity.  I sense my accident and its fallout truly pushed me too far in the direction of self-doubt and uncertainty regarding my abilities.  Such a shift was probably good in terms of what I was willing to physically undertake and/or endure but not so good regarding my mental faculties.  With respect to the latter I feel I must come to embrace the idea that while my mental abilities may not be what they were ten or even five years back they are far from useless especially when factoring in experience.  And I should be pleased I’ve learned the surety of my youth hasn’t translated into me being unable to accept the lessening of my mental capabilities.  In the end a bit of healthy respect for memory ‘slippage’ and/or perceptual incongruities becoming more evident with my passing years is most likely a very good thing.

While I’ve been saying more and more often ‘this aging thing isn’t for the faint of heart’ I also recognize that regardless of its problems it does beat the alternative.  It is so very important to remember these concepts on those mornings when just getting out of bed after the previous day’s exertions can be a painful process.  For those of us lucky enough to live into our sixties, seventies and beyond inculcating a sense of celebrating our lives becomes more and more important.  As with so many other things in life if we allow ourselves to become mired in the minutiae we lose touch with ‘the big picture’ and this never produces a positive effect.  As stiff or sore as I might be some mornings I also know there’s a gel cap of Naproxen sodium in the bathroom medicine cabinet that will ease most of the pain.  Regarding my slowly declining mental facilities…well, I still function and the longer I live the more experience I have to call upon!  And, too, I continue to develop even more memories involving life in ‘The Great Land’…


Solo and Sick

Although normally a very healthy person suffering only from the usual age related infirmities (i.e. weakening eyes, forgetfulness, morning aches, weight gain, etc.) at the start of February I contracted some illness which apparently is burning through this region as well as many places in the lower 48.  It is rather unusual in that it begins with a sore throat, low grade fever, a sense of overall weakness/lack of energy and slowly mounting cough; by day two the cough is a deep, hacking repetitive monster settled well into one’s lungs.  By day four the fever and sore throat are gone but the cough remains in full force although one can begin to feel it lifting its locus from the lungs into the throat.  By day seven all symptoms are gone except for a general weakness and the cough.  I am now into day twelve of this illness and it continues to tease me with feelings it is disappearing followed by kicking my butt if I so much as try to start acting normally.  But across this entire situation I’ve experienced no congestion in either my lungs of my head, something that’s very surprising given the cough.  From what I’ve been told the cough requires around three weeks to completely disappear.  I was quite impressed with the fact this organism was capable of knocking me flat on my back for the first five days; all I did was sleep, drink gallons of water, sleep, try to hold down some soup and sleep.  In the first 96 hours of this battle I believe I sent 78 hours in bed.  As the fever and sore throat departed and the cough moved up into my throat my need for sleep has diminished although I’m still making sure I get at least ten hours a night.

All told this has been a most unpleasant time and it has caused me to reflect upon myself as a patient and my lifestyle as a single human being.  I’ve known since childhood I am a lousy patient and my demeanor is directly proportional to how bad I feel; in this case imagine an old grizzly bear awakened abruptly from hibernation only to find snow and cold outside his den suffering from severe hunger and possessing a fuse maybe a sixteenth of an inch in length.  I feel so bad for my dogs as although I honestly try they still get the brunt of my negativity and Heaven knows they do not deserve it!  In fact given my largely comatose condition across the first five days and their almost non-existent exercise they have behaved wonderfully.  Yes, I did get up to let them outside three times a day and made sure they had food and water but that was about as much as I could muster yet they responded by being perfect family members.  Really makes me proud of how I raised them but much more so proud of their intelligence, patience and loyalty.  It always put a smile on my face when I’d finally awaken in the morning and find Qanuk’s favorite tennis ball by my head; he ‘gave’ it to me just in case I might want to awaken and play a bit.  Anana is the classic Mal; endless patience broken only by random periods of her need to ‘talk’ up a storm.  I love the Mal vocabulary of howls, grunts, wheezes and similar and thus I’ve always encouraged her to be vocal.  As I’ve improved I’ve been able to get them outside; I’ll often load them in my Escape and drive around handling important chores.  Upon finishing I drop them on a back road a few miles from the house and allow them to chase me back home.  A real advantage to living rural is the complete lack of traffic on the back roads!

This is as ill as I’ve been in many decades and it really did cause me to reflect upon my choice to be living solo with just my dogs in a rural setting.  Because I am still relatively new to south central Alaska I have yet to build up a robust network although I must admit I was surprised and pleased by so many genuine offers to walk the dogs, make store runs and similar!  I knew Alaskans are known for being caring, sharing people but even so I did not expect this level of support.  Yet this remains quite different from what so many folks have in terms of support be it a significant other or close by family.  In working through my desire to relocate to this area I was painfully aware I would be putting thousands of miles between myself and my family and friends.  I was very concerned about this concept but saw no resolution if I went ahead and made the move.  To be honest once my folks passed my closest sibling was in Chicago (240 miles to the west) but he soon moved to Albuquerque (NM).  My sister has almost always lived in Colorado and hence she was well over a thousand miles to the west.  I have some loosely held connections with cousins and Aunts but they are mostly 500+ miles to the ESE.  So as far as family the move didn’t really involving making a separation but rather exacerbated that which already existed.  This was not the case with my network of friends in Michigan and this caused me the most angst in deciding whether to move so far afield.  In the end I was chasing a 16 year old dream and I couldn’t not say ‘Yes’ to the opportunity.  I sometimes have second thoughts but then it was a huge lifestyle shift and it only occurred 19 months back.

But this current bout with whatever illness I’m still locked in battle against did give me some long, sleepless periods during the coughing spells in which I could review my choice and my situation.  No surprise many of these times were rather negative as I struggled with trying to quell the cough and the up-welling of illness induced concerns about caring for myself as I age and illnesses become more impactful.  Sometimes it was downright desperate in nature although I also realized the sickness was skewing all my thought processes in such a negative direction.  I did realize it was much better for me to be alone with this illness given just how close to ‘Hell on Wheels’ I was in terms of my overall personality.  No one should have to be subjected to me when I felt that bad!  So this was a good thing.  In addition I was aware that despite how devastated I felt during those first four days I was also still capable of rational thought as I set it in my mind that if the cough remained in my lungs by Monday I was going to break down and visit the Sunshine Clinic just three miles from here.  In addition I had the phone numbers of two neighbors who would gladly have come by to check on the dogs and me.  So all in all I was ‘okay’ for the short term while I monitored my own progress and reacted accordingly.

Of course as one really ages – such as crossing the 60 year old mark – I believe it becomes paramount to begin to recognize one’s infirmities and to plan ‘round them such that one’s abilities are not too diminished while living safer.  My stairwell is narrow and steep in this place; from the time I moved in I started training Qanuk to never, ever be on the stairs with me.  He is far too excitable and energetic; I could easily see him knocking me down by accident and me ending up at the base of the stairs with a broken ankle or leg…or worse.  If there’s outside work that requires getting up to the second floor or higher I’m paying to have it done; I’ve recognized my balance isn’t as good as it used to be!  There are a plethora of other ‘concessions’ I’ve made with plans on how to minimize their impact on my lifestyle.  I do not want to ‘wall myself in’ with so many restrictions I cannot enjoy life; this would be a travesty.  But I do want to live a little smarter and safer; in pursuing this goal I recognize I should shy away from things I may have done without a second thought at age 50.  Part of my leanings in this direction stem from watching my folks refuse to accept age related infirmities and pay for their denials.  Seeing Dad on a ladder at his place cleaning out the second floor gutters when he was 90 years of age scared the daylights out of me.  And I saw the results of Mom climbing up a short ladder to fill a bird feeder and losing her balance.  These were extremely healthy octogenarians plus yet the infirmities of age negatively affected their abilities.  I am in nowhere near as good shape as them but I do recognize that I just cannot do some of the things I did when I was 45 years of age nor should I try.  That’s life…

Learning to accept that age often means a lessening of one’s abilities particularly in the extremes is a part of aging and something I feel is necessary.  In one sense I suppose one could make a case for me holding myself back based on these beliefs.  But in another I accept the fact that I can ill afford a major injury like a broken leg when living my lifestyle.  Because of this I’ve adopted a simple approach which has served me to this point:  I accept I do have some age related infirmities which will restrict some areas of my life but I do not dwell upon them or bemoan them; they simply are a part of my aging process!