There are, in fact, times when feeling bitchy is a sign of progress, such as after spending weeks or months feeling numb, for instance. Call it apathy, lethargy, atrophy or entropy, but that state of unrelieved inertia is one of the hallmark symptoms of depression. Well, at least my depression anyway. When your view of life can be summed up by the phrase, “I don’t give a rodent’s derriere,” mustering the energy to feel irritable is a good sign. It’s a question of degree. I still don’t give a rodent’s derriere, but it’s not as global anymore.
It’s a little odd to write about depression while having depression. That sucking sound you hear is my lingering ehh-ness pulling at me. My blech-itude has dropped recently, but believe me, it would still be so easy to succumb right now. It requires a lot of will power to sit here, typing this, and I LIKE writing! But even thinking about it, assembling cogent thought, is a challenge. Never mind resisting the blahs on a daily basis. Over the years, I have had to develop a large bag of tricks for prying myself out of its clutches. Before the advent of tricyclics, SSRI’s and other tolerably effective drugs, I didn’t have much choice but to try every trick I could manage. Not if I wanted to stay upright and have a life, anyway. My bag of tricks contains such things as caffeine, chocolate (the darker the better), friends who know how to be silly, pets, flowers, dancing my brains out, making art, listening to loud rock-n-roll, and having a rip-roaring romance. Oh, and sometimes counseling therapy. It used to include nicotine, but I finally quit that. Some of these items are easier to acquire than others, naturally, and there are times when I’ve had to employ pretty much all of them to kick myself out of the Big Ditch. But, hey, you do what you can.
Better Living through Chemistry
Of course, all the tricks in the world can only supply temporary relief. After a while, you feel like a mad scientist, trying to figure out ever more and better ways to tweak your own brain chemistry. On the other hand, all of the above things do actually work, because they contain and/or promote the secretion of chemicals that work in a positive way in our brains. Phenylethylalanine is a fabulous substance that is produced when we are in love or in lust, as well as being found in dark chocolate. Chocolate also contains anandamide, a substance that stimulates the same brain centers as marijuana, and flavonoids, the anti-oxidants that are also in red wine. Activities like dancing and hot sex can increase our levels of serotonin and endorphins, substances that play a role in everything from our sense of well-being, to our sleep-wake cycle, to our ability to diminish pain. Challenging physical activity can also act as a ‘good stressor,” promoting the secretion of adrenaline and norepinephrine, hormones that generate our “fight-or-flight” response, which in turn gives us the ability to kick butt. Caffeine is a stimulant, as most of us realize, as well as the basis for several successful corporate franchises. Nicotine promotes the secretion of neurotransmitters that make us feel relaxed, euphoric, and energetic, a uniquely wonderful combination that explains why it’s so addictive. Laughing triggers our endorphins and reduces stress. Engaging in creative activity — or really anything you love to do — rewards us with a shower of beneficial neurochemistry that allows us to focus for hours on end, increase our overall energy and feel a satisfying sense of accomplishment. All of which goes to prove that I’ve been a pretty good chemist all these years, and that sometimes, your cravings are trying to tell you something. If they’re not harmful or illegal cravings, maybe you should indulge them.
On the other other hand, sometimes life is just too freakin’ much. After my mother died, I slogged through almost a year of steadily using every trick in my bag of tricks, and still, I felt like Sisyphus pushing that damn boulder uphill. But by then, there was prozac and zoloft and paxil. So, I tried one. Wow. When you’ve been struggling with depression for so long, your neurons have calluses, SSRI’s are a miracle. Finally, I didn’t have to shoulder the burden all by myself! My new ‘friend’ did most of the heavy lifting for me, so I could get on with having a life.
Needless to say, being treated for cancer has taxed my neurochemistry like nobody’s business. And it’s still taxed eighteen months after my diagnosis. It should come as no surprise to anyone that as many as half of all cancer patients experience symptoms of depression to one degree or another. Mix that with cancer-related fatigue and cancer-related cognitive dysfunction, and it’s a wonder any of us ever reassembles our lives. It should come as no further surprise that a lot of us never get back to normal. This is a hard truth that can be difficult for us, and for our family and friends and co-workers, to grasp and accommodate. Consequently, in addition to grappling with all of the above, I’ve had to forgive myself for taking so bloody long to recover from all of the above. Thus it is that after my most recent descent into the Big Ditch, I’ve been thrilled to find myself feeling crabby lately, because far too often, I wasn’t feeling much of anything at all. Crabby I can deal with. Crabby I have experience with, from all my previous years of enduring peri-menopause, menopause and post-menopause. I can at least blog and blog righteously when I’m crabby. Occasionally, I can even channel it into certain other productive activities like cleaning the house or wallpapering the bedroom.
The problem with being crabby, though, goes back to an assertion I made in a previous blog post. Cancer most decidedly did NOT make me a better person. Dealing with this nonsense has, on top of everything else, made me far less patient and tolerant and energetic, and I sometimes suspect these deficits could be permanent. That may not be an entirely bad thing, but woe betide anyone who expects me to care about stuff that my new sensibilities have deemed trivial. Don’t get me wrong: a little triviality can be refreshing. But it has to be the right kind, the kind that isn’t insufferably annoying or hopelessly pedestrian. So, don’t expect me to care about things like having a perfect lawn, dusting the ceiling-fan blades or getting all the dog hair off the car upholstery. I’m also probably not going to get chuffed about knowing who won the Academy Awards, whether you or I are wearing last year’s fashions, or having fiber optic internet service. As a matter of fact, I don’t even watch TV anymore, thereby avoiding a lot of annoying, insufferable nonsense. If I hear about something good, I’ll look it up online. Unfortunately, ignoring the seemingly unimportant infrequently extends to things with potentially bothersome consequences, like strict adherence to the speed limit. However, I can usually talk myself into that one by reminding myself of another important fact, which is that if I get a ticket, my car insurance will cost more. After all, one has to know when to restrain one’s attitude and when to let it rip.
It May Not Look Like It To You, But I’m Doing The Best I Can.
The arena that most consistently upsets my crabby meter is work. I don’t have a hard time with my patients, even when they’re whining. They’re usually entitled, having just had major surgery or a heart attack or something. Besides, I can relate to their crabby-ness. It’s the administrative folderal that goes along with the endless documentation that goes along with working in health care that makes me want to spit bullets sometimes. I mean, I just helped teach this woman to walk without pain for the first time in a year, so excuse me if I don’t lose sleep about whether all my documentation is turned in by the crack of dawn every day. As a kind of antidote to all this, my esteemed employer held this lovely dinner the other night to recognize employee longevity. They give us these tasteful pins for every five years that we last on the job. Somehow or other, I’ve managed to survive in this gig for ten years, so I got to eat some good grub and take home a pin with a little sapphire in it.
These kinds of employee things can seem a little hokey, but really it was quite nice. It’s fun to see how well your colleagues clean up, and most of my colleagues are delightful folks who are genuinely compassionate, which is why they like working in home health care in the first place. Plus, a free meal always makes me happy. So, we toasted one another and ate shrimp and prime rib and warm brownies with ice cream, and recognized each other’s competence and perseverance. Personally, I think I deserve an award for continuing to function at all for the past year-and-a-half without being crabby all the time. But you know how it goes with these things. You get recognized for what you’ve done, not for what you haven’t done. So, I didn’t get any points for not being crabby. But, you know, when I think about it, my crabby meter just reflects something I’ve believed in for a long time now. As we go through life, we really do need a way to distinguish between actual matters of life-and-death importance (like surviving cancer, for example) and those things which do not materially or directly improve anyone’s life (like checking and answering my work email fifteen times a day).
So, I think it’s all right that I still don’t give a rat’s tush about a lot of stuff. I just need to get better at figuring out when to keep that to myself. Or not.
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For more information about depression, fatigue and other late and long-term effects of cancer treatment, you may also want to refer to these previous posts:
- Deep Down (part one of this apparent series on depression)
- The ‘F’ Word (cancer related fatigue)
- Almost Normal (’cause I think having a ‘bad’ attitude can be good)
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