Alone after the home run

I thought we would have learned how to live with each other now, this alien band of brothers that have come to visit. I knew it would be an extended stay but now I fear my guests are bent on overstaying my forced welcome. I’ve tried to get to know them all, they who have come knocking at my door. Grief, Depression, Guilt and Loneliness. They’ve hung around for so long I swear their faces had begun to morph into one another. I can hardly tell them apart and it hardly mattered, given that they’ve all wrought the same devastation on my once peaceful spirit. I’ve engaged with them, maniacally so, trying to understand how they’ve managed to convince my husband that he had nothing to live for. As the days passed I’ve come to understand the conversation they had with Beau and where it brought him. But the longer they stay with me I am beginning to dread where I would be, if, when and how I manage to push them to leave.

I’ve let myself go because I could not let him go. I drink too much coffee, smoke too much, exercise too little. I eat nothing but indulgent poison — the most luxurious of desserts, laden with gargantuan amounts of sugar, chocolate and butter; evil disguised in swirls of happy colored icing, beautiful bronze baked goodies that promise familiar highs, only to be sunk back into an even more dismal abyss when the sugar rush disappears. I need a haircut. I’ve moved back in with the ‘rents and need to start organizing the mess of my life which I had brought with me. I am on a deadline, the time I’ve borrowed from sympathetic employers was running out too fast for comfort and I seem to be on pause. Indeed, time waits for no one and life is in an ironic rush. What does it matter that life as I knew it had changed drastically and without warning?

In the beginning I had gotten on that same train of mad, frantic activity. And everyone was there, cheering from the bleachers as I rushed to cover all the bases. And I did just that.

I tried to understand what happened. I researched, read, consulted, conversed and concluded. Beau was a victim of suicide. The end result of a long fight with major depression likely caused by a genetic predisposition. He could have possibly been bi-polar or had borderline personality disorder; complicated by the trauma of losing a father at an age when he was only beginning to learn about the relationship of “cause and effect”. Freud had discovered it, the construct of “learned helplessness” where a child, unable to process the traumatic event, learns that there are things that happen in this world that are beyond our control and therefore, when challenges come up, no matter how small, he would be powerless to fight it. He told me once before that he had watched his father burn. A child watching a cremation is a nightmarish tableau. Whether it had actually happened is of no consequence. For Beau, it was his reality. Had he agreed to seek professional help he would have discovered he was suffering from post traumatic stress syndrome as well. My own therapists say it would have been a textbook diagnosis, what with the death happening the day after his birthday and the constant reminder of his father’s ashes in the family home. There were other reminders, other questions, too private to share, that had left wounds that festered. He had grown into the body of a man and yet, somewhere inside him, an 11 year old boy continued to stare into the flames.

Apparently there had been prior attempts to take his life before I had even met him, usually triggered by a relationship gone awry. He feared rejection and magnified abandonment, attaching all sense of hope to relationships that he perceived in his mind to be all that he had in his life. I had saved him twice he said, having talked him through the demise of two of his past romances. He had always threatened to end his life at the end of his relationships. I had always thought he meant I had saved him figuratively. Now I know better, too late.

Even if I had known his threats to be true, I would have thought marriage would have put an end to the suicide ideations. After all, the promise of forever keeps the threat of abandonment at bay. And for all intents and purposes, as far as I knew, we had been the giddiest kids on the marriage block. But I suppose all marriages have its own challenges, and the monster that lay dormant inside him waited for the opportunity to rear its ugly head.

I had always envied him for his freedom of spirit. I was jealous that he had built a life of simplicity doing what he loved. But even before we had gotten married he had always talked about wanting to do something else, to find his fortunes elsewhere and to keep climbing as a hobby rather than his career. It had been frustrating for him, and I knew that the conservative man that he truly was, he wanted to prove that he could provide for me somewhat. There was never any pressure on this front, at least not outwardly, and not that I was consciously aware of, although I know that sometimes circumstance itself could create them. I had tried to control the situation at any sign of insecurity, although if there were any, he was such master at keeping them from me that despite my vigilance, it was only in the last three months of his life that I recognized any discontent. I had supported him by asking him to simply pursue what he was passionate about. There was much trial and error but in the end he had still hoped against hope that he could make something out of the sport that he loved. I believe it was his failure to make this happen that was the trigger for his last and final episode.

He loved bouldering. And the competition which had been named after him was his pride and joy. He had attempted to put up the event a year into our marriage. It had pushed through but at great cost. He had taken it hard, given that I had to step in to bail him out. He declared he was done with the competition, done with climbing in general and moved on. or so I thought. A year after he announced he was going to try to put the event up again and against my better judgment, I supported him once again. This time, despite his constant assurances that the postponements and delays with sponsorship contracts were just minor snags, the event did not push through. We argued about it for a day or two and I thought that was the end of it. But apparently he had again talked to some people about taking his life out of shame and embarrassment. I thought he had gotten over that particular hill, he had decided to embark on a new challenge — to get certified as a personal trainer. But now I know this only added to the weight he carried. He had put all his hope in that basket, telling me repeatedly during those days when his frustration and stress were poisoning our marriage that it was all he had going for him. I tried to refocus his thinking and emotions into positive things, to the dreams we had created together for the future, but he was incapable of looking forward and insisted on collapsing into the past. In retrospect I know now that nothing I said would have made a difference. Unless he was given the medication he needed, he was spiraling out of control towards his own self destruction.

You would think that all of the above would absolve me of my guilt. It does not. A psychiatrist would describe him as a textbook case and any diligent researcher armed with an internet connection and a laptop would agree. The illness is what killed him. It was not anybody’s fault. He was psychologically disturbed and did not have the skills to deal with life’s challenges. Cerebrally it all makes a lot of sense. But as his wife, I look at what happened with different lenses. And what a different story my heart can see.

I remember a man excited for a future. I remember a husband narcissistically proud of a happy marriage. I remember conversations about the children we were going to raise, the trips we were going to take, the long bucket list of things we needed to do. My heart cannot accept what all the research and professional consultations have logically confirmed. I have hit a home run with all the bases loaded. But now the bleachers are empty, the game is over. Everyone has gone on to their homes and life continues on. The numbers on my blog have dwindled. The hundreds of likes and comments of support on my Facebook page have all but disappeared. Very few ask how I am anymore. And I sit in the ball park alone, enveloped in the blackness left by the shut down of the stadium lights.

They wait for me, my unwanted guests. Grief, Depression, Guilt and Loneliness. They took my husband away and now they await me. I am beginning to dread where I would be after all is said and done. Because as of now I am back on first base. Bleachers empty. Alone after a cerebral home run that has done nothing to heal the pain in my heart. Beau is gone. Game over.

The Wailing Psalm by Edward Hays

The Wailing Psalm

“I want to wail and scream in pain,
and not wash my face or comb my hair.
I want to fast from food and drink,
to abstain from music and fun.
I want to kick the walls and beat my breast, and even tear out the telephone.
I’d throw away my mail and speak to no one. but I am ashamed to grieve.

O God, how can I ever be the same again or feel the earth solidly beneath my feet, for ripped to shreds are my daily rituals, my patterns of living, loving and sharing. My heart feels full not of blood but of pain, my lungs filled with screams, not breath. My eyes are blinded to all by my bitter tears, but I am ashamed of my lack of Easter hope.

O God, I know how you felt
on that terrible Good Friday.
So I ask you to say nothing to me now, for nothing can be said.
Only hold me in your love, O God, till the pain passes, if it ever will. And pardon, I pray, my feeble faith

as I mourn like one without hope.”

SOS: A handbook for Survivors of Suicide

Sharing with everyone, Jeffrey Jackson’s entire booklet. It is a concise but rich source of information –practical and realistic, written from a place of sympathy, borne out of a shared experience and spilling with the promise of hope that the pain won’t last forever.

“This book is dedicated to the life of immeasurable value that was lived by Gail Beth Levine Jackson.
May you have found the peace that eluded you when you were here.” – Jeffrey Jackson

If you are a suicide survivor, this is worth your time. Please click on link: SOS_handbook

The Suicide Survivor’s Bill of Rights

I have the right to be free of guilt.

I have the right not to feel responsible for the suicide death.

I have the right to express my feelings and emotions, even if they do not seem acceptable, as long as they do not interfere with the rights of others.

I have the right to have my questions answered honestly by authorities and family members.

I have the right not to be deceived because others feel they can spare me further grief.

I have the right to maintain a sense of hopefulness.

I have the right to peace and dignity.

I have the right to positive feelings about one I lost through suicide, regardless of events prior to or at the time of the untimely death.

I have the right to retain my individuality and not be judged because of the suicide death.

I have the right to seek counseling and support groups to enable me to explore my feelings honestly to further the acceptance process.

I have the right to reach acceptance.
I have the right to a new beginning. I have the right to be.

In memory of Paul Trider, with thanks to Jann Gingold, M.S., Dr. Elisabeth Kübler-Ross, and Rev. Henry Milan. Reprinted by permission of JoAnn Mecca, Center for Inner Growth and Wholeness, 123B Wolcott Hill Road, Wethersfield CT. ©1984 JoAnne Mecca. All rights reserved.

A tale of 2 young women: Why suicide survivors should not feel guilty

There were two young women who died by suicide, both about the same age, both after a years-long battle with depression. Each had made several suicide attempts. They would refuse professional help and stop taking their medication just when it seemed to begin helping.

Fearing for her life, the first woman’s mother had her committed — against her wishes to a psychiatric clinic for treatment. While there, despite being on “suicide watch”, the young girl asphyxiated herself with her bedsheets.

The second woman’s mother constantly urged her daughter to seek professional help. However, fearing that she would worsen her daughter’s depression, she refused to force her into any kind of institutionalized care. One day, she killed herself with an overdose of medication.

Afterwards, both mothers blamed themselves for not preventing their daughter’s suicides. The irony is that each blamed themselves for not doing exactly what the other one did.

The first mother felt that if she hadn’t isolated her daughter in that institution, she wouldn’t have lost her. The second was sure that if she only had committed her daughter, she would’ve been saved.

We often fail to realize that, even if we could turn back the clock and do things differently, it wouldn’t necessarily change the outcome.

Biological Depression: We feel with our brain, not our hearts

If Stanford Professor Robert Sapolsky were asked to define Major Depression in one sentence he would say that it is a BIOCHEMICAL disorder with a GENETIC component where EARLY CHILDHOOD experiences influence why a person cannot appreciate sunsets. Amazingly concise. Amazingly accurate. And amazingly true.

Sapolsky states that we humans have an astounding capability to derive pleasure from the most unlikely domains. So what could be more devastating than a disease whose main symptom is the inability to experience pleasure?

Major Depression is characterized by the following symptoms:

1) Anhedonia – The inability to feel pleasure

2) Grief and Guilt – Not your ordinary grief but the kind so severe that it takes on a delusional quality. This does not necessarily mean hearing voices but means that there is a propensity to obsess or focus solely on what is negative. A person who is in normal grief will grieve the loss but is able to see beyond the loss. Grief associated with Major Depression just obsesses over the loss and nothing else.

3) Self-Injury or suicide

4) Psychomotor Retardation – The inability to do anything due to severe exhaustion. Everything feels like it requires too much energy. When a depressed person is in this state there is little risk of suicide because even planning a suicide takes too much energy. it is when they start to lift from this state and begin showing some improvement that suicide presents a real threat.

5) Vegetative Symptoms:

Sleep: This does not necessarily refer to the inability to sleep but to the disruption of normal sleep patterns. A classic sign of major depression is waking up too early. In the brain of someone who is in Major Depression the whole structure of sleep and its patterns are in disorder.

Decreased Appetite: Normal tendency for run of the mill depression is to compensate by bingeing in order to fill the feeling of emptiness. In major depression there is no effort to fill in the loneliness and the void.

Stress Hormones: Stress hormones are elevated because there is a constant activation of the stress response. The Sympathetic Nervous System is constantly agitated resulting in the release of hormones such as Adrenaline and Cortisol. These hormones cause increased metabolic rate, increased muscle tone and raises activity inside the body. This is why depressed people feel so tired all the time.

To understand the disease, one has to understand its biological component, its psychological roots and how the two can be connected. Let’s start with biology.

An idiot’s guide to BIOCHEMISTRY ( as understood by another idiot)

Our brains work by sending chemical signals from Neuron to Neuron. The space between neurons is a liquid filled space called a Synapse. Messages are brought from neuron to neuron across the synapse by Neurotransmitters. There are hundreds of neurotransmitters that are passed from neuron to neuron, each with a different function. Three neurotransmitters have specifically been associated with Major Depression – norepinephrine, dopamine and serotonin.

The first proof that depression can be caused by a chemical imbalance is the discovery that depressed people do not have enough Norepinephrine in their system. Normally, norepinephrine is recycled or destroyed as soon as the “message” is fired in the synapse.  Medication for depression can include medicine that stops the recycling and destruction of the norepineprine so it stays in the synapse longer and is able to send its message to the next neuron repeatedly, compensating for the lack in Norepinephrine in the system. Norepinephrine has been described as the “pleasure pathway” in the fifties. it was believed to be responsible for the feeling of pleasure. But they soon discovered that norepinephrine was only a minor player in the pleasure pathway. Scientists discovered that Dopamine had an even more significant effect in the pleasure pathway. It is no surprise then that Cocaine and Met amphetamine, which act directly on the Dopamine system, have become highly addictive and abused drugs. In the late 80s, Prozac was invented. Prozac is an SSRI or a selective serotonin re-uptake inhibitor was discovered to make depressed people better. Serotonin was therefore also discovered to be very crucial in the level of pleasure or happiness that a person can feel. To be insanely simplistic, what scientists discovered is that too little Dopamine can cause ANHEDONIA or the loss of pleasure, too little Norepinephrine had something to do with the PSYCHOMOTOR RETARDATION and the absence of Serotonin had something to do with the obsessive feeling of GRIEF; all of which are major symptoms of Major depression.

Psychic Pain is just as real as Physical Pain

What is also very interesting is the discovery of the neurotransmitter called Substance P. Substance P is an important element in pain perception. Substance P is what transmits pain information to our central nervous system. Substance P is what tells us that we stubbed our toe or that our whole body is burning.  It was discovered that when medication which reduced Substance P in the body is given to depressed people, it makes them feel better. This suggests that psychic pain is not just a metaphor but that it is actually regulated by the same neurotransmitter than transmits information about physical pain. The pain depressed people feel is REAL.

The Limbic System: The part of the brain that regulates emotions

There is evidence that the Limbic System which is the part of the brain which is responsible for our emotions (fear, lust, anger, rage, love etc.) can affect our reptilian brain, which is the part of our brain that controls our “regular plumbing”. The reptilian brain is what regulates our blood pressure, makes our limbs move this way and that, basic operational stuff in our bodies. The cortex,which is the biggest part of our brain is responsible for our logic — it is what we really use to THINK. When we are physically hurt such as when we meet an accident and get hit by a car, the cortex activates our body’s stress response. Simplistically speaking, in a depressed person, the cortex convinces the rest of the brain that the sad thoughts and feelings are real, as real as if we were hit by a car or gored by a wild animal. And because of that the body physically reacts the same way and triggers a stress response.This is why in extreme cases where every type of therapy has already failed, there is Cingulotomy, where the connection between the cortex and the limbic system is severed. Unfortunately, while this relieves depression, it also robs the person with the capability of experiencing pleasure.

Hormones and their role in Depression

People diagnosed with Hypothyroid have low levels of thyroid hormones and people with this disease always go through major depression. 20% of major depressions are undiagnosed hypothyroid problems. The thyroid regulates metabolism and people with lack of thyroid hormones tend to feel sluggish, gain weight easily and have difficulty losing weight despite increased activity.

Women are twice as likely as men to have depression and many instances indicate that these also have to do with hormone levels. Women tend to have major depression at particular periods when their hormones are going haywire — PMS, Post partum depression etc.

All of these… neurochemistry, the structure of the brain and hormonal changes all scream biology. The physiological connection to depression is irrefutable. It truly is as much a biological disease as diabetes and cancer.

(Psychological Aspect of Depression to follow in the next blogpost)