With contributions from
Bob Feinstein, Dan Molloie, Michael Perreault,
Phil, Larry Roberts, Stephen, and Randolph Warren

Disgaytalk is the online discussion group associated with BENT, where cripgay men talk about the issues that matter to them—funny, serious and everything in between.

From time to time, with the cooperation of the participants, BENT presents an edited version of an exchange we think will interest a wider audience. You'll find older Forums archived.

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Readers browsing the archive will find that depression has been the subtext to many BENT features. Some contributors (notably Danny Kodmur and Don Roy) have attacked the issue head-on. This is our first Forum feature devoted to the subject

 

My recent retirement has not been as great as I thought it would be and it's time for me to stop pretending otherwise. I've been lethargic, tired, and irritable, and I seem to worry about everything. I had to admit that all of those things added up to depression and I finally went to see my doctor. He gave me a prescription for Zoloft, an antidepressant. It was real hard for me to take it. I've always felt that taking a drug for my mental health was a crutch, that I should be able to think my way through it, but I had to admit I needed help.

~Dan Molloie
New Jersey

Dan, the popular belief that "serious depression can and should be solved by toughing it out instead of drugs" is right up there with "severe chronic pain can and should be solved by toughing it out instead of using drugs." Neither belief is supportable by medical fact, and both beliefs are harmful in their ubiquity. They prevent many of us from seeking proper treatment.

Those beliefs spread disinformation, and create stigma and discrimination against those who do seek treatment, as do so many such folksy bits of "common medical wisdom." I'm not suggesting you were intending to do any of these things. I'm simply pointing out the societal ills fostered by such bits of ill-considered but widely believed "common sense."

Sometimes our brains can be triggered into a depression cycle which is neuro-chemical in origin. When that occurs, "thinking through it" won't solve the problem, nor will toughing it out. The only real solution is to "jump start" the neurochemistry back into balance for a while. One way to do this is by using antidepressants, typically a kind known as SSRIs ( Selective Serotonin Re-uptake Inhibitors), such as Prozac, Zoloft, and others.

If your depression is defined as transient, you can often wean yourself off whatever drug you've been taking. One important point: NEVER stop taking drugs like Zoloft cold-turkey. The side-effects of stopping suddenly can be unpleasant and potentially dangerous. Always follow your doctor's instructions.

Those who suffer from chronic neurochemical depression may need antidepressants for long periods. I've been taking Zoloft for about ten years to solve that very problem. Still, as far as drugs go, its side-effects are tolerable (they vary widely from brain to brain), and it can be a treatment with very good success rates.

~John F. Widerhirn
Washington

I couldn't agree more with John's assessment. I spent ten years trying psychotherapy as a means of managing recurrent major depression. Not until I got on medication did I begin to control the problem. In 2001, after about thirteen pressure-sore operations and constant urinary tract infections during a twelve-year practice as an attorney, I was forced to retire for medical reasons. Retirement and a bladder bypass have really worked to alleviate the physical problems.

The endless stretch of free time, however, was at first a very depressing thing to deal with after years of having "people and talk" jobs (I was a service rep and salesman before I became a lawyer). When I lost my career I shut down emotionally. For weeks on end I had no appetite, no desire for sex, and no interest in anything except sleep. When I slept, self-starved, I didn't have to think about reality. This acted as a catalyst for more urinary tract infections and severe pain. Only with an increased dosage of Effexor was I able to finally start living again.

Now I fill my time with whatever I feel like doing at the moment and at whatever pace feels comfortable. I make sure to take the necessary lie-down breaks to prevent further pressure sores, and I've dived into art as a hobby.

Up until retirement the extent of my artistic ambition was to doodle during boring depositions. Once I recovered from my initial bout with depression I bought books on figure drawing and human anatomy. Within two months I was able to draw an exact likeness of the human face and figure. After some basic instruction in painting technique I tried acrylics, then took a course at city college in chalk pastel painting. I have stuck with pastels for the moment because they appear to be the hardest medium and I enjoy the challenge.

Being an artist (even a mediocre one) is more fun than fighting in the trenches of litigation. All in all, I'm starting to enjoy my retirement free of depression.

~Phil
Florida

Because my disabilities were caused by thalidomide, I am particularly sensitive on the subject of prescription drugs. Beginning treatment with prescription medication is a serious matter to be discussed between patient and doctor. Since I am NOT a doctor, I will not make any judgements or recommendation about this course of action, but I would like to relate my own experience.

About three years ago I went into a complete "crash and burn." My whole world was shaken to the core and I felt utterly lost. I cried all the time and experienced panic attacks. After letting myself experience those huge emotional reactions (and running out of tears), I took a course of action that will sound silly to some, but worked for me!

I realized I was dealing with too many things at once, things I wasn't ready for, so I took a page from my pain-management training and decided that distraction would be my method. I had to empty my mind. I did this by doing hundreds of jigsaw puzzles and playing on-line scrabble. Then I popped my head out once in a while and dealt with things (one a time). Yes, it took forever (a year), but it worked for me.

Here's another trick I used. First I let myself be depressed for an hour a week (now an hour a month). I put on the saddest show I can find, or read an old letter, and cry. When the timer goes off, I put on the funniest show I can find, and laugh it out. All of this may be irrelevant to how others find they can manage depression. If it is, my apologies ... just wanted to share!

~Randolph Warren
Ontario, Canada

If you're thinking of taking antidepressants, don't forget that depression may be related to a hormonal imbalance. Unfortunately most GP's would not even ask themselves the question, never mind be able to interpret blood tests correctly and know how to prescribe, what delivery system to recommend unless they are advised by a specialist in endocrinology. Of course, when you need to replace all your sex hormones after removal of the gonads, like I did, you learn more about this than you ever dreamt possible.

I was on testosterone implants for about two years. Although they were the very same compound of four different testosterone esters that I now inject every three weeks, the delivery system screwed up feedback cycles in my pituitary gland. The result was enormous weight gain, immense fatigue, and symptoms of subclinical depression. Never mind cognitive problems—like not being able to remember the sequencing of even a simple number of tasks—when the implant was at the low end. All of that is now on the mend since I returned to injecting six weeks ago.

Unfortunately, the popular media go nearly entirely for the sex angle when discussing testosterone replacement therapy in men of later middle age. I recently saw a crappy programme of that sort produced by the BBC—yes the keepers of the flame of quality documentaries don't always get it right, either.

When it comes to hormone level corrections vs. antidepressants, remember that any kind of hormone replacement therapy takes four to six months before it really kicks in—all those feedback cycles in the brain don't work that fast— whereas antidepressants work in a fortnight. In the US and in Europe we've become addicted to the quick fix, so it's not hard to see why antidepressants win the day. Not only that, they make the drug companies way richer than testo; my testosterone costs maybe 10% of what a friend spends on antidepressants.

~Stephen
Dublin, Ireland

So far everybody has been talking about pretty specific responses to depression, but I want to try and return to root causes, to try and have a broader view of what we all contend with.

Disabled shortly after birth with polio, I came into pre-verbal consciousness already depressed. By the time I was a small child, it somehow got communicated to me that I was "less than," "not as good as." That kind of internalized self-knowledge led me deeper into shame, deeper into depression. After all, how could I be OK if it took so may people working so hard to "fix" me?

Then, subjected to treatment, whether that meant surgery or intrusive therapies of different kinds, I was traumatized again by medicalization, a process that can happen to us even if we become disabled later in life. Whether medicalization happens to us earlier or later, it isolates us. If the experience is sufficiently shaming and repeated numerous times, we can't talk about it even to the people closest to us, maybe especially to the people closest to us.

Another potential for depression in early childhood is when all the other kids are busy getting socialized. My socialization was stunted for the very simple reason that polio kept me from keeping up with my peers physically. Then, when I started to realize I was gay, even before I could name it, I knew I was really, really different.

I can remember feeling sad since the time I was a child and I've carried that same sadness with me ever since. A grade school teacher nicknamed me "Sunshine" because I looked so glum coming into school every morning that no sunshine lit up my face. I felt grateful that an adult noticed something was wrong, but also embarrassed at being singled out. My shy smile back at her didn't make the sadness go away.

Another piece of the puzzle for me is the anger that results from the shame/depression combination. I felt anger at being poked and prodded, medicalized in a dozen ways. Anger, too, at being demeaned, like the time my great aunt pushed me in front of the TV when Oral Roberts did his "laying on of the hands." "Just believe in Jesus and you will be healed."

I was angry in all those circumstances, but expressing anger was too dangerous. After all, I needed those people to take care of me. So instead of letting myself feel the anger, I felt humiliated, physically and emotionally violated. The result? More depression.

My cripgay depression is so deeply entrenched I'm suspicious of most therapy models. I know antidepressants can be helpful under some circumstances, but for me interventions like support groups and other kinds of peer involvement have been critically important. It's my peers I trust and in contributing to this forum I want to make sure that people don't overlook how useful peer support can be.

~Michael Perreault
California

Dan mentioned something that rings a bell with me. Like him, I worry a great deal, and I wonder if this is something that afflicts disabled guys in particular. In my case, I worry (obsess?) about practical things that have an impact on my blindness. I can't cook so I worry: will the neighborhood restaurant that delivers my meals go out of business? What if there's a problem with my apartment? How would I ever find a new place? Who would help me pack and move?

I just found a cell phone that speaks some of its menu functions and has buttons you can feel. As soon as I got it, I started worrying: what will I do if it breaks? What will I do if I need a new battery and can't locate one? I started calling around the country and managed to buy a second phone from a Radio Shack in Sioux Falls, South Dakota. Now, with two, I feel pretty secure, although I was thinking of trying to locate a third for good measure.

I guess I'm a hoarder, but with good reason: the talking clock I love has been discontinued; my talking calculator/clock was discontinued, too, and so was my printer. A lot of new devices just aren't blind friendly. I'm not sure that my concerns add up to depression, but they do make me very anxious, and I know that anxiety and depression are allied.

~Bob Feinstein
New York

Dan, as you can see people have a variety of things to say about depression, Their own experiences with it, its causes, and its possible treatment (underline possible). I have dealt with depression for many, many (many, many) years. Here's what worked for me: psychotherapy, medication, peer support, and a spiritual practice.

I think it also only honest to say that dumb luck played a crucial role in my recovery. I have come to understand that there is no one way people experience depression, no one cause, and no one solution. I believe it is inadvisable to ignore the biochemical nature of much of this, just as I think it inadvisable to ignore the social and personal experiences that lead to our depressed ways of being. I say dumb luck played a crucial role in my recovery simply because many other people have done what I did and never "recovered"—never made a dent in the feelings they dealt with. That's one of the harder things that I had to come to grips with: Whatever this thing is and whatever might help it was going to take a very long time.

~Larry Roberts
New York

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