What causes depression?

September 23rd 2010

Ever since I heard the expression “Depression is anger turned inward” I have wondered what actually causes depression because that statement seems not only simplistic to me, but it also does not apply to my situation. Finally, I asked my very experienced psychiatrist what he thought, and he listed three major causes of depression: Loss, Genes, and Anger.*

Loss
Look around you and think about how much you could lose and how you would feel if you did. You could lose your loved ones (e.g., death, divorce), your money, your house, your job, your self-esteem, your dreams, etc. You could lose your material items. My grandparents’ house burned to the ground when I was a child, and they lost almost everything—except their photo scrapbooks. When I touched the albums’ charred edges, I understood why my grandfather grabbed them at the last minute despite the smoke that must have been choking his lungs. In that moment, I fell in love with photography because even if you lose a loved one, the camera captures their images and preserves your memories. If our home suddenly went up in flames, I would save the three P’s—people, pets, and pictures—in that order.

Genes
Unfortunately, we have no control over our genes, and our genetic makeup can determine our predisposition to mental illnesses such as depression; schizophrenia; and bipolar, personality and anxiety disorders (to name a few). Sometimes, I feel like I could throw a dart at the DSM-IV, hit a diagnosis, and name someone in my mother’s family. However, many people never develop any mental issues despite their DNA. In some cases though, people who appear to have perfect lives (e.g., no losses) may still develop a mental disorder due to a chemical imbalance in their brains. I am not saying people are not responsible for their behavior, but understanding the cause is crucial to treating the problem especially since our society often self-medicates in order to feel better. (Hope you’re listening, Miss Lohan!)

Anger

Ahh … anger … the cause of depression that I don’t fully comprehend. Sure, I feel angry sometimes, but I don’t walk around hating myself. I may not be perfect, but neither is anyone else. I don’t always make the best decisions. I am often too blunt (you wouldn’t believe how much I really restrain myself), but overall, I possess a good heart. If I care about you, I love you with such depth that if I tried to explain it, I fear my emotion would scare you. However, that pendulum of intense passion swings both directions. Don’t piss me off because I don’t get mad at myself. I focus my anger on the person who upsets me so I didn’t get the whole “Depression is anger turned inward” concept until I witnessed it a few weeks ago.

In a support group that I occasionally attend, a man whom I’ll call Richard has to be the most self-loathing individual I have ever met in my entire life. On an intellectual level, Richard understands his depression, that anger causes it, and the source of his anger. However, he still believes the cure to his self-hatred is the right woman’s love. Now I’m sure his numerous therapists and psychiatrists have explained to him that no one will love him until he loves himself. Richard has attended support groups and self-help meetings for years. By all appearances, he participates in his “recovery.” Although he did give one female shrink an ultimatum that if she didn’t love him, he would leave her. Guess what happened?

I have only met Richard twice; yet, I know more about his personal life than I should because Richard dominates the group. He twists every topic back to his desperate search for love. When I offered that people often meet someone when they are not looking, but there is nothing wrong with trying, he made a snarky comment about me being married. After gritting my teeth and chewing my lip at the last meeting, I realized I had to find another group. If I ever see Richard again and hear him whine about how a woman will fix him, I know the devil in me will say, “Go jump off a bridge already, will ya? I hear no one survives the Golden Gate. I’ll even drive you there.” Terrible, I know, but at least I direct my anger toward the person who deserves it.

I cannot empathize with Richard, but I should sympathize with him. However, my inability to do so reminds me of the many people who don’t understand the cause of my depression. I cannot count how many times I’ve heard “Get over it” or I’ve seen those unspoken words reflected in someone’s eyes when I cry over my sister Adrienne. Nine years? Seems like yesterday to me, asshole.

I won’t return to that particular support group. I mean, who needs chipped teeth and chapped lips? But seriously, I don’t want to be one of those people who says something horrible to Richard. I wonder though, if I angered him, if he could stop being mad at himself—if only for a moment.

AWW — XoXo

P.S. The photo of the house on fire is not my grandparents’ home, but it closely resembles it.

*These causes of depression are my psychiatrist’s experience, and he listed them in this order of common occurrence: Loss, Anger, and Genes. After some research, I discovered that physical factors (e.g., hormonal changes) can also cause depression. For more information, visit Web MD Depression and the Mayo Clinic.

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Painger—The sixth stage of grief

October 19th 2009

According to psychiatrist Elisabeth Kubler-Ross, there are five stages of grief: denial, anger, bargaining, depression, and acceptance. These stages were initially applied to terminally ill patients, but were later adapted to include anyone who had experienced a personal loss (e.g., divorce, job). People may not go through every stage, and the order is not important. Though the Kubler-Ross model has been criticized, I believe it has merit. However, Kubler-Ross failed to recognize the importance of grieving the end of all meaningful relationships including friendships. Therefore, I would like to propose another stage: painger—that horrible feeling of being so upset that you want to hurt, emotionally and/or physically, the person who has caused you pain, but you still care too much about the person to actually harm him/her.

In many ways, I prefer anger because it’s just easier to hate someone. You can yell. You can scream. You can throw things. You can bitch to your friends. In anger, you find allies. Your boyfriend cheated on you? Your girlfriends will support your mad-as-hell rage. Getting revenge is more fun for everyone (except for the target) than feeling sorry for yourself. Anger encourages empowerment. Carrie Underwood’s Before He Cheats song was a huge hit because she didn’t cry, she got even. Whoever said living well is the sweetest revenge never “took a Louisville slugger to both headlights.” Honestly, I wish I could tell you a fantastic story about how I avenged a personal grievance, but when my crazy ex-boyfriend accused me of slashing “a hole in all four tires” I didn’t do it. Hell, I didn’t even know where he lived at the time.

When someone you love has hurt you, you may also experience emotional pain or depression. And trust me, no one wants to hear about it. After a certain point (other people determine this time for you), you are supposed to “get over it.” Even your best friends will grow tired of your pain because no one likes a pity party. In Sex and the City (episode #25), Carrie’s friends tell her to see a psychiatrist because they can’t listen to her whine anymore about her breakup with Big. According to the latest CDC statistics, more than one out of 20 Americans (ages 12 and older) are depressed; yet people are expected to pop a pill, see a shrink, suck it up, and move on. When someone asks, “How are you?” the only acceptable answer in our society is “I’m fine.”

Then there is painger. Anger and pain meet, they join forces, and they focus their energy against you as if you did something wrong. Their power is unstoppable, unbelievable at times because you feel crazy. The fury causes your adrenaline to increase, which elevates your heart rate; meanwhile, you cannot stop the tears from falling down your face. The faster your heart beats, the harder you cry, as if a dam has broken inside of you. If you think about the people who have upset you and you don’t know if you want to hit them or hug them, then you may be experiencing painger.

When I’m sad, I cry, nap, write, read, bathe, shop, walk Winston, and/or talk to someone. When I’m angry (and I cannot confront the person due to circumstances beyond my control), I exercise, pace, shower, scream, shop, and/or complain to someone. When I’m paingry, I have found only one thing that tempers my rage and controls my tears. I hit balls at the BatCade in Burbank. If available, I choose the slow-pitch softball batting cage #1 because I can’t hit anything else and it’s located on the far side of the property so no one bothers me. I usually pay for the time instead of by the pitch, but either way, I stay until calluses start forming on my hands and my arms are too sore to lift the bat.

I love hitting the balls; they become the faces of the people whose actions caused my painger. This year, I’ve been seeing old friends and an ex-boyfriend soaring toward me as the pitching machine spits them out. With every swing, my emotional pain moves from my heart into my arms and hands. With every hit, my anger transfers from the bat to the ball as if I have slapped those people who have hurt me. When the softball flies through the air, I feel free from the painger; it’s impossible to cry or to be mad when you imagine hitting a home run. I always leave the batting cages feeling depleted but satisfied that I have won another battle against painger. My batting average—.60—isn’t too shabby either.

AWW — XoXo

P.S. I want to thank Bones for inspiring this blog. I promise we’ll have that Long Island at Boardners, and we’ll hit some balls when you visit LA.

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Flying the Unfriendly Skies: Part Two—The Lazy Stewardess

September 27th 2009

Note: This blog entry is a continuation of a previous blog titled: Flying the Unfriendly Skies: Part One—The Ignorant Mother so I suggest you read it first to fully understand my disagreement with Miss Sourpuss and Continental Airlines.

The passengers remained quiet after I had confronted the mother regarding her son’s behavior. I don’t know what I expected. I guess I was hoping at least one person (besides my husband) would applaud my courage, but instead, I had become the older, malicious bully who had verbally attacked the younger, innocent mother. I’m glad I waited until the end of the flight to say something because I swear our captain took the scenic route around the Houston/Bush International airport. Finally, our plane found its gate, and I made sure the boy and his mother exited the cabin ahead of us. I thought it was best to put as much distance between her and me as possible. As my husband and I walked off the plane, I told him to go ahead and wait for me. I wanted to speak to our friendly stewardess Miss Sourpuss.

Before I go any further, I should tell you that even though I’m not afraid of confronting people, I don’t make a habit of it. I’ll admit I am the woman who sends back her dirty martini when it isn’t quite dirty enough. I will also return food at a restaurant if my meal isn’t correct (I rarely order straight off the menu) or if the cuisine doesn’t taste good. When a hairdresser once hacked my hair to pieces a few weeks before I had to be a bridesmaid in two weddings, I got my money back. However, until this incident, I had never said anything to a parent on an airplane besides, “Could you please tell your child to stop kicking the back of my seat?” I had also never complained about a flight attendant’s bad service, but there’s a first time for everything.

After all of the passengers had collected their carry-on luggage and left the plane, I approached Miss Sourpuss who was standing next to the co-pilot. I told her that I would like to have a word with her about our flight. With the same “My-life-sucks-I-wish-I-were-dead” expression on her face, she just shrugged her shoulders and said okay. Although I had intended for our conversation to be private to avoid embarrassing her, I started talking since she made no effort to move anywhere. The co-pilot shifted his weight and leaned forward.

“My husband and I were seated in row 10, in about the middle of the airplane. In front of us, a young mother sat with her little boy who wouldn’t stop singing the entire flight. Why you didn’t say anything to her about his behavior?”

Miss Sourpuss’s expression changed. Her mouth opened, her eyes blinked, and I could see her searching for the correct answer in her brain. “I … I … could never ask a parent … I’m just not able to … confront people.”

I already knew she was passive, but the fact that she admitted it surprised me. I responded, “Well, his behavior was inappropriate, and it was your job to do something about it.” The co-pilot looked at her. She furrowed her brow.

“Uh … it’s not my job. People can use their cell phones …” I raised my eyebrow. Right then the captain walked up and joined our group, and Miss Sourpuss realized her mistake. “I meant people can talk as loud as they want on the plane.”

I laughed because the conversation was getting so ridiculous. “Really? So I can yell at the top of my lungs during a flight and you’re not going to say anything to me?” The captain grimaced and looked at Miss Sourpuss who must have been sweating through her uniform.

She replied with as firm a tone as someone like her can muster, “Well, I wouldn’t do it because I didn’t hear the boy at all. And I went up and down that aisle the entire flight.”

“First of all, that’s not true. My husband and I couldn’t find you anywhere when we wanted a refill on our sodas. Secondly, you changed your story when the captain arrived.” I looked at him, then the co-pilot, and then her. “Just so we’re all clear, you went from not being capable, to not being responsible, to sheer denial.”

Miss Sourpuss pursed her lips. “I didn’t hear him!”

“And apparently, you’re deaf as well.” I looked at the captain. “Thank you so much for getting us to Houston on time, but please tell your bosses, I will remember this incident. By the way, I’m a writer, and I will let people know that it’s okay to sing at the top of their lungs on a Continental flight.”

Okay, so I didn’t say that last part, but now I know how to solve the problem should it happen again. The next time a lazy stewardess refuses to hush a chirping child, I have a plan. I’m going to belt out (and I’m tone deaf) the most obnoxious children’s song I know. My sister Adrienne taught it to me. In fact, she and my (then) boyfriend’s four-year-old son got in trouble for singing it in the car during a road trip. I was driving, and after 15 minutes of Bananas in Pajamas, I told them to pick a different song. When they didn’t, I yelled, “Shut your mouths, or I will shut them for you.” They stopped singing immediately.

After years of teaching, I can raise my already-loud voice over a room full of 100 noisy children so out-singing one kid on an airplane will be easy. My husband is appalled by my idea. He intends to begin divorce proceedings if I should proceed to break into song. I told him that he should pretend that he doesn’t know me or tell people that my “medication” doesn’t work at high altitudes. He didn’t laugh. My theory is that even a passive stewardess like Miss Sourpuss will have to tell me to shut up, and when she does, I’ll point to the child and say, “He started it!”

Who knows? Maybe I’ll incite a sing-along:

Bananas, in pajamas, are coming down the stairs
Bananas, in pajamas, are coming down in pairs
Bananas, in pajamas, are chasing teddy bears
cause on Tuesdays day … they want to catch them unawares!

AWW — XoXo

P. S. I wish I had gotten Miss Sourpuss’s real name so I could file a formal complaint.

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Loss

October 20th 2008

I’m so angry I can’t sleep. The rage courses through my veins like a river that’s been unleashed because some kind of internal dam broke or snapped or crumbled to pieces. And no, I’m not mad about the economy. I’m angry because people who knew my sister seem to have gotten on with their lives—as they should. But despite all of the obvious signs that I have moved forward (Since 2001, I have gained a husband, a dog, a new degree, and more than one new career) , a part of me feels empty. Void. Over it already. I’m so tired of pretending. Most of the time the grief conveys itself as sadness, but sometimes, like tonight, it rears up its ugly head and blows out flames of fury. I have no right to be mad at these people who used to be my friends, who used to be a part of my daily life. They didn’t lose their child; they lost a “niece.” I can’t expect them to experience the same level of loss.

Maybe what hurts the most is that in many cases, I don’t even know why these friendships ended or lessened. I don’t know what happened. I had the opportunity once to find out when one of these people wanted to talk to me again after more than five years of silence. I decided not to speak with him because I knew anything I said would sound angry and defensive. I also know him well enough to know that he probably thought he could apologize, and I would forget—or least forgive him—for his absence. I can fake happiness, but I can’t fake forgiveness.

For years, I lived in this idealistic fantasy land where I believed people were inherently good, that friendships lasted forever, and that karma truly existed. Though some of these childish notions were challenged as I became an adult, they were absolutely shattered when cancer killed my sister Adrienne, who was also like my child since I raised her from the time she was eight years old until her death at the age of fifteen.

I’ve always known life isn’t fair, and I realize my life could be so much worse. I’m lucky to have found some happiness after such a tremendous loss. However, when I have bad nights, like tonight, when I can’t sleep because I can’t stop crying (even after taking anti-anxiety medication) and there’s not one person in my cell phone I feel comfortable calling in the middle of the night, I feel even shittier. What no one tells you is that when you lose a loved one— especially a child—you lose so much more. You lose your child, your relationship, your stepson, your godson, your friends, and … a piece of yourself.

I tell my husband all the time that I have to die before him because another loss will kill me.

AWW — XoXo

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