Bob Feinstein, Dan Molloie, Michael Perreault,
Phil, Larry Roberts, Stephen, and Randolph Warren
is the online discussion
group associated with BENT, where cripgay men talk about the
issues that matter to themfunny, serious and everything
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.
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
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, 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
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.
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
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.
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!
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 problemslike
not being able to remember the sequencing of even a simple number
of taskswhen the implant was at the low end. All of that is
now on the mend since I returned to injecting six weeks ago.
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 BBCyes
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 inall 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.
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.
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.
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.
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.
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.
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