Cancer is a cakewalk.
I've had depression forever. When I look back on childhood, I recognize that I've fought with it since before I was aware of myself as a person. I spent huge amounts of my teen years fighting depression and suicidal ideation, with not a whole lot of effective help from anyone much. Lots of people TRIED to help, but were pretty ineffectual about it. Lots more people wouldn't have tried to help even if they knew I was suicidal - as a non-religious teen, I was a strange creature indeed in my southern hometown, nigh unto being some sort of animal. It was hard, I lived through it, I made a very strong clean break with that town and its religious-bigot denizens, and moved hundreds of miles away.
Fast forward 24 years, and I'm successful, very happily married, have a family and friends and plenty of good things in my life ranging from art and music to a good job etc. I've very recently gone through a bout of cancer, with surgery and radiation behind me and a half-decade of Tamoxifen therapy ahead of me. I've had ridiculous numbers of other health problems ranging from after-effects of a car wreck to rare conditions such as bile reflux gastritis. I take handfuls of medication each day, and live with not too much pain on a regular basis. I'm even back in touch with several people from my hometown.
The assorted surgeries for the car wreck injuries and cancer and other conditions have been difficult. It is complex feeding me - between food allergies and the medication schedule for the bile reflux, I have to be very careful with when and what I eat. Radiation was extremely difficult, and I'm not finished with all of its effects yet.
I'll tell you, though, compared to depression, cancer is a cakewalk.
Cancer treatment is not easy. It makes you feel like a patient/chart/walking tumor, makes you feel ugly and tired and stupid and hurt and fragile and delicate and broken. The cancer itself was never much more than a concept, though, for me. I could feel a lump, and it didn't feel GOOD, but it only hurt a little bit. Even if it were much more pervasive, it'd just be more physical pain, and that I can deal with.
Depression, on the other hand, is all-pervasive, all-encompassing, and always there. It'll poke its head up at the slightest provocation, from a "just making sure you don't forget I'm here" fly-by to a multi-month ordeal where just sitting up in bed is the hardest thing in the world. For the most part I haven't had the latter weight of depression such that I'm unable to function, but in a lot of ways, that made it HARDER to see what is going on. Because I'm a functional depressive, I don't *look* depressed. I do manage to get up and get dressed and fed and go to work, and I create things and laugh and make other people laugh.
But. The dark grey cloud is always there. I'm very very good at accessing it, neurologically speaking. I am not at all good at pushing it back down in to its genie bottle. Like most things, good and bad, depression as a neurological skill can be learned and practiced. Unlike learning Spanish or knitting, you don't do it on purpose. Some people are better at depression, some are worse, same as some are better at music. Neural pathways that are used more often get worn in, which is one of the ways of saying that practice makes you better at something.
Depression is like any skill: you need genetic predisposition toward the skill, you need life events that precipitate learning the skill, and you need practice of the skill. For music, you need to be able to hear pitch progression linearly, you need access to a teacher and an instrument (even if it's your voice - if you don't have a voice, you can't learn to sing no matter how much you practice), and you need to repeat over and over the things your teacher has taught you. We've all met that kid who can play an instrument with one or two exposures to it, or the kid who picks up languages with startling ease. For depression, you need the genetic predisposition for your serotonin reuptake to be uninhibited or at least less inhibited in your brain neurons (I don't think anyone has looked at serotonin in gut neurons yet, if you know of someone, let me know?), you need at least one major traumatic event (and/or a history of problem childhood events from a LONG list of possibilities), you might need a predisposition toward inflammation in your body generally, and/or you might need to have had a prenatal environment that was high in certain inflammation markers. The more it gets studied, the clearer it becomes that depression and its cousins anxiety and bi-polar disorder, among others, are physical ailments, with real physical symptoms, subtle though they may be. (The next time someone says to you that depression is "all in your head," you have my permission to punch them in the mouth. In fact, I'd probably post bail for you if you did so.)
The list of traumatic events that can help train you to be depressed is long and unpleasant. There are small repeated acts, large one-off events, and everything in between. But it's kind of like allergies - if you have no genetic predisposition to depression, you are unlikely to become depressed even if you are beaten every night by your parents. If you have no hay-fever, you can sleep in a bed of ragweed every night and never sneeze. If you do have a genetic predisposition to depression and the inflammation markers, some event that can seem fairly mild to the average person can trigger depression.
Some of the predisposition toward depression can be attributed to something called epigenetics. There is plenty of medical literature out there (and a fair amount of stuff written by people going 'nuh-uh!'), but the basic idea is this - if your parents experience severe trauma and stress BEFORE YOU ARE CONCEIVED, different genes will be activated during your development than would have been otherwise. To put it another way, if your parents were Holocaust survivors, you will have a genetically identifiable stronger predisposition toward certain traits, including anxiety, depression, and a few other diseases. Even if you were born a decade after the Holocaust ended. The tendency for the changed expression of genes can be passed down to grandchildren, too. So. My mom's mom had chronic untreated anxiety. My mom's dad beat her brothers semi-regularly, and was a semi-functional alcoholic. Her older brother raped her. Obviously this all happened long before I was born. Mom presents with chronic anxiety and probably a fair amount of depression too, which is medicated but not treated with talk therapy (and likely never will be - at 72 she is pretty set in her ways). I spent my entire childhood dealing with depression, and the chronic cycle of low self-esteem begets depression begets low self-esteem, to the point where as a teenager I entered in to a two-year sexually abusive relationship with a guy.
At 42 I still have that grey cloud of depression descend over me at least once a week. Sometimes it only stays for an hour or two. Sometimes it stays for a week. I have to fight it MUCH harder in the winter. I hate being cold, I hate when it gets dark earlier in the evening. Last night, snuggling on the couch with hubby, hanging with kid and dog and happily knitting, I noticed that it was entirely dark outside by 8:30, and just that reminder that we're headed in to winter with its 4:45pm sunsets was enough to bring me down for a few minutes. I got out of that funk fairly easily, mainly by reminding myself that it was still summer, that we've got months of fall before it is truly winter, and that I'll have a warm fire, a full bathtub, and a snuggly bed when winter does come, as well as friends, medication, talk therapy, sun lamp, and day-to-day life to get me through it until summer comes again. That was an easy one, fairly quick to release its hold on me. Some days, there's no reason, I just crash. Some days, there's every reason in the world, and I don't crash, but usually if there's even a slight reason, the crash happens.
I recommend to you Adventure in Depression part 1 and part 2, written two years apart, if you have not seen them. There are plenty of epigenetics primers out there, but I haven't got one to recommend at the moment.
I'm sure I have LOTS more to say on this subject, but for now, it's time to go enjoy the sunshine and have a good lunch with friends.
Fast forward 24 years, and I'm successful, very happily married, have a family and friends and plenty of good things in my life ranging from art and music to a good job etc. I've very recently gone through a bout of cancer, with surgery and radiation behind me and a half-decade of Tamoxifen therapy ahead of me. I've had ridiculous numbers of other health problems ranging from after-effects of a car wreck to rare conditions such as bile reflux gastritis. I take handfuls of medication each day, and live with not too much pain on a regular basis. I'm even back in touch with several people from my hometown.
The assorted surgeries for the car wreck injuries and cancer and other conditions have been difficult. It is complex feeding me - between food allergies and the medication schedule for the bile reflux, I have to be very careful with when and what I eat. Radiation was extremely difficult, and I'm not finished with all of its effects yet.
I'll tell you, though, compared to depression, cancer is a cakewalk.
Cancer treatment is not easy. It makes you feel like a patient/chart/walking tumor, makes you feel ugly and tired and stupid and hurt and fragile and delicate and broken. The cancer itself was never much more than a concept, though, for me. I could feel a lump, and it didn't feel GOOD, but it only hurt a little bit. Even if it were much more pervasive, it'd just be more physical pain, and that I can deal with.
Depression, on the other hand, is all-pervasive, all-encompassing, and always there. It'll poke its head up at the slightest provocation, from a "just making sure you don't forget I'm here" fly-by to a multi-month ordeal where just sitting up in bed is the hardest thing in the world. For the most part I haven't had the latter weight of depression such that I'm unable to function, but in a lot of ways, that made it HARDER to see what is going on. Because I'm a functional depressive, I don't *look* depressed. I do manage to get up and get dressed and fed and go to work, and I create things and laugh and make other people laugh.
But. The dark grey cloud is always there. I'm very very good at accessing it, neurologically speaking. I am not at all good at pushing it back down in to its genie bottle. Like most things, good and bad, depression as a neurological skill can be learned and practiced. Unlike learning Spanish or knitting, you don't do it on purpose. Some people are better at depression, some are worse, same as some are better at music. Neural pathways that are used more often get worn in, which is one of the ways of saying that practice makes you better at something.
Depression is like any skill: you need genetic predisposition toward the skill, you need life events that precipitate learning the skill, and you need practice of the skill. For music, you need to be able to hear pitch progression linearly, you need access to a teacher and an instrument (even if it's your voice - if you don't have a voice, you can't learn to sing no matter how much you practice), and you need to repeat over and over the things your teacher has taught you. We've all met that kid who can play an instrument with one or two exposures to it, or the kid who picks up languages with startling ease. For depression, you need the genetic predisposition for your serotonin reuptake to be uninhibited or at least less inhibited in your brain neurons (I don't think anyone has looked at serotonin in gut neurons yet, if you know of someone, let me know?), you need at least one major traumatic event (and/or a history of problem childhood events from a LONG list of possibilities), you might need a predisposition toward inflammation in your body generally, and/or you might need to have had a prenatal environment that was high in certain inflammation markers. The more it gets studied, the clearer it becomes that depression and its cousins anxiety and bi-polar disorder, among others, are physical ailments, with real physical symptoms, subtle though they may be. (The next time someone says to you that depression is "all in your head," you have my permission to punch them in the mouth. In fact, I'd probably post bail for you if you did so.)
The list of traumatic events that can help train you to be depressed is long and unpleasant. There are small repeated acts, large one-off events, and everything in between. But it's kind of like allergies - if you have no genetic predisposition to depression, you are unlikely to become depressed even if you are beaten every night by your parents. If you have no hay-fever, you can sleep in a bed of ragweed every night and never sneeze. If you do have a genetic predisposition to depression and the inflammation markers, some event that can seem fairly mild to the average person can trigger depression.
Some of the predisposition toward depression can be attributed to something called epigenetics. There is plenty of medical literature out there (and a fair amount of stuff written by people going 'nuh-uh!'), but the basic idea is this - if your parents experience severe trauma and stress BEFORE YOU ARE CONCEIVED, different genes will be activated during your development than would have been otherwise. To put it another way, if your parents were Holocaust survivors, you will have a genetically identifiable stronger predisposition toward certain traits, including anxiety, depression, and a few other diseases. Even if you were born a decade after the Holocaust ended. The tendency for the changed expression of genes can be passed down to grandchildren, too. So. My mom's mom had chronic untreated anxiety. My mom's dad beat her brothers semi-regularly, and was a semi-functional alcoholic. Her older brother raped her. Obviously this all happened long before I was born. Mom presents with chronic anxiety and probably a fair amount of depression too, which is medicated but not treated with talk therapy (and likely never will be - at 72 she is pretty set in her ways). I spent my entire childhood dealing with depression, and the chronic cycle of low self-esteem begets depression begets low self-esteem, to the point where as a teenager I entered in to a two-year sexually abusive relationship with a guy.
At 42 I still have that grey cloud of depression descend over me at least once a week. Sometimes it only stays for an hour or two. Sometimes it stays for a week. I have to fight it MUCH harder in the winter. I hate being cold, I hate when it gets dark earlier in the evening. Last night, snuggling on the couch with hubby, hanging with kid and dog and happily knitting, I noticed that it was entirely dark outside by 8:30, and just that reminder that we're headed in to winter with its 4:45pm sunsets was enough to bring me down for a few minutes. I got out of that funk fairly easily, mainly by reminding myself that it was still summer, that we've got months of fall before it is truly winter, and that I'll have a warm fire, a full bathtub, and a snuggly bed when winter does come, as well as friends, medication, talk therapy, sun lamp, and day-to-day life to get me through it until summer comes again. That was an easy one, fairly quick to release its hold on me. Some days, there's no reason, I just crash. Some days, there's every reason in the world, and I don't crash, but usually if there's even a slight reason, the crash happens.
I recommend to you Adventure in Depression part 1 and part 2, written two years apart, if you have not seen them. There are plenty of epigenetics primers out there, but I haven't got one to recommend at the moment.
I'm sure I have LOTS more to say on this subject, but for now, it's time to go enjoy the sunshine and have a good lunch with friends.