Tuesday, August 10, 2010

Collaring the Black Dog

Let's face it, this blog of mine - supposedly, the one that was going to take off and launch a thousand words a day from me - has been dormant for nearly six months. Every week I plan to write something, then life steps in the way. Because now I have to do Important Things like...

1) Study for the final FCA exam so I can finally be a fancy-schmancy, qualified, bona fide specialist anaesthesiologist. It's just under 8 months away, and I should have started with gusto a month ago already. Oh well, guess this is going to be like rigging Doc Browne's DeLorean with a bolt of lightning... a huge challenge, much sweating and expletives and, hopefully, loads of positive box office reviews from friends, colleagues and family.

2) Paint, rearrange and neatly organise my study to effect (1).

3) Clear up the labyrinthine mess in my study to allow (2) to happen.

(4) Clear up the even larger, frightening mess that is our house before even thinking of starting the above, because at the moment I can hardly find the door to my study, because of (5).

(5) Finish some badly needed repairs and alterations to our house, all of which will increase its value and - more importantly - bring a sense of sanity to our household. These include...

(a) Annihilating the evil empire of rising damp that has been slowly eating away at our house's walls since at least World War II. Two thirds of this is now complete.

(b) Repainting the entire house inside and out once the wife and I agree on a colour scheme. This could take longer than the calculated age of the universe. Hooray for the rise of quantum computing.

(c) Completely redesigning the garden and back yard; especially removing the idiotic mess of loose stones in the back (a geriatric orthopaedic emergency waiting to happen every time my mother or grandmother-in-law come to visit).

(d) Daily pet psychotherapy on frightened cats and a discombobulated dog due to a continuous influx of builders and technicians performing (a) to (c) above.

(e) Knocking down the tragic Heath Robinson construction that is our bathroom and rebuilding it from scratch with a shower rose the size of Mexico and water pressure equalling the Hoover Dam. And a Victorian bath on claw feet big enough for two.

(6) Preserve my fragile mental state by keeping to a strict regimen of sleep hygiene (waahaahaa - you're talking to a lifelong insomniac with cyclothymic disorder at the best of times who is on call twice a week!!) including, but not limited to, bedtime at latest 21h30 (but I have 10 000 pages or so of facts to cram into my brain in the next couple of months), taking melatonin (hey, it might work), as needed doses of zolpidem (I don't care what they say, you still feel like a train rode over you in the morning), meditation and avoiding alcohol (so I bought that case of magnificent Saronsberg Viognier for nothing?!?!)

(7) Effect a semblance of a mental state by remembering to take my medication regularly at the same time, because SSRI withdrawal is a bitch. Yes, I'm outing myself as a sufferer of a mood disorder, if you've bothered to read this far you may as well be rewarded with this dubious soupcon of overshare. Yes dears, I was diagnosed with depression way back in 1996, when my fellow Prozac nation of Generation Y-ers started flaunting our grunge, and now it's been refined to Bipolar Type II plus or minus cyclothymia - just as these are now the diagnoses du jour. What that means is that I get repeated dips interspersed with mild highs (or hypomania). Practically, it's meant that I take a second pill (a mood-stabiliser, in fact an anti-epileptic in low-dose form) in addition to the selective serotonin reuptake inhibitor I've been on for years.

Relax, those of you who know I weld sharp instruments and potent medication as part of my daily living. I've never been suicidal, or addicted to any substances (do cheeseburgers count?) but it's a real risk for all of us who have been visited by the black dog, as Winston Churchill famously called it. While I've certainly enjoyed the thrills of hypomania (life of the party, can finish an assignment in record time etc.) the horror of full-blown mania is always a possibility (waking up in Vegas with no memory, married to a Japanese transvestite Elvis impersonator and blowing all one's money on a container ship full of Korean candy floss, etc.) It makes me take the proverbial long hard look at myself every day.

It's why I had to man up mentally and see a psychiatrist to start untying the Gordian knot of my mood-disordered mind. I also see a therapist (psychologist) weekly. I've been seeing her for nearly four years and the path from gloom to enlightened self-realisation our sessions (really, extended conversations) have effected has been worth every cent. I take an antidepressant (citalopram, if you must know) and a mood stabiliser (lamotrigine) and they've been working just wonderfully. Some people I know think I'm "addicted" to my antidepressants, these include people who would think nothing of downing two sleeping tablets and a stiff drink nightly as a way to round off an evening. Hell, there's nothing wrong with them.

All this is not something I usually blab out to all and sundry, but I'm sick of (a) personality-disordered people who project their insecurities onto others in order to survive while millions of decent people suffer in silence from what is, quite simply, a manageable condition, provided one starts taking responsibility for it (b) the stigma the moral majority attach to it (you mention depression on a life insurance application form and your risk profile multiplies faster than bacteria in a warm petri dish; telling someone with a mood disorder to "pull themselves together" involves the same fuckwittage of logic as telling a brittle diabetic to go ahead and eat that slice of cake, sugar's after all a natural food isn't it?!?!) (c) the rubber-spined leeches who would use a mood disorder as an excuse for everything and make the world their fainting couch, the main reason true depressives and bipolars live in fear and loathing, and, (d) ... the group that makes me froth most of all... the holier-than-thou, tie-dyed alternative medicine harpies who tell people to go off their medication, stop or change their therapists and invest in ugly crystal jewellery and purified vapours/distillates/essences/chanting while passing off the afflicted as victims of the evil global cabal of pharmaceutical giants / Nazi psychiatrists / Illuminati / Reptilian Overlords from the planet Betamax 9. You might as well tell the hapless diabetic I invoked earlier just to stop all the insulin anyway cause it's all in their mind, or, erm, pancreas.

Don't get me wrong, I'd be the last person to advocate that medicine be a purely cold clinical robotic profession. Hell no. It's a very human profession. Just don't tell me that a vial of million-fold-diluted essence of rat spleen is going to cure cancer. (Like the extract of duck liver diluted to the nth degree, sold to millions of unsuspecting users as a flu medication for more than R90 ($11) a course.) It won't work, not even if you are a fruitarian raw food vegan who practices colour therapy and is doing an MA in Socio-economic polemics in amateur haiku poetry by civil servants in the Indonesian Foreign Office from 1970-1974: a Marxist review. No offence meant to any raw foodists out there - I know two lovely ones personally, although catering is always a challenge.

If your body is hurt, most people would see nothing untoward about you seeking medical attention (let's not mention group (d) above). But try to do that when your mind is hurt... we're still in the 19th century as far as public opinion is concerned, I'm afraid.

So why shouldn't I be cured then, if I believe in the traditional triad of medication, psychology and self-care (exercise, rest, stable relationships, cats etc.). Uggggghhh. Do I have to invoke the diabetes example again? Ok, one more time.

Let me put it in an algorithm.

Dear sufferer of [A]. You need to do [B] regularly , take [C] as prescribed and see [D] regularly while following a regimen of [E]. In this way you can live a full and healthy life, although it will require self-discipline and you may still experience fluctuations in your condition from time to time...

where [A] could be diabetes or asthma or hypertension or... shudder... depression.
and [B] could be measure your blood sugar or peak flow or blood pressure or... shudder... consider your mood by reflecting and confiding in people you trust before making judgements on yourself or those around you.
and [C] stands for insulin or salbutamol or enalapril or... shudder... citalopram...
... do I have to be any more basic people?!?!?!

and finally, yes, let's zoom out back to the original intent of this post,

(8) Try and KEEP FOCUS. Sigh. What started out as a simple list recounting the obstacles in my path, became a polemic on the condition that has been part of my life for over a decade now. Possibly my whole life. But it is me. And while this black dog visits me from time to time, and now and then decides to wear a fluorescent orange jersey with hallucinogenic patterns on it before eventually howling its mournful song, I'm taming it... I've bought it a collar and identified it, hell, it even goes for its shots. Most of this Exemplary Behaviour (TM) (and yes, the Ironic Capitalization is due to me having recently re-read Winnie the Pooh) is credit to the ceaseless and tireless support from my lovely, lovely wife (pictured here in all her technicolor glory). I wouldn't be here - breathing easily, laughing at the world - without her.

Oi vey.

It's 4 am and I'm actually on call. Weird. No emergency cases since 22h00. Go figure that on the one shift that I could sleep, I'm up vomiting out my innermost thoughts to all of you.

So there.

Sunday, March 28, 2010

Marriage: The Final Frontier?

It’s been a while but I have the ultimate excuse... I got hitched!
Forgive the self-satisfied tone of this post but I had the most wonderful wedding day ever. Granted, being the groom, my duties essentially involved pitching up on time and looking reasonably neat, which is already not difficult given that I am bald.
My beautiful bride – perhaps the clichés are clichés because they work – was a vision in pink, the summer afternoon in the Stellenbosch winelands forming an exquisite green backdrop as we said our vows in front of our treasured family and friends under the old oak trees of Nooitgedacht Estate. For one who is given to worrying I was slightly disbelieving how every detail dovetailed the bride and groom’s world views so magnificently. There was an African choir and a string quartet. There were pink sequins and formal nuptial blessings. There was Benedictus and Mazel Tov. There was Pablo Neruda and Shakespeare and the Beatitudes and Mendelssohn and Ella Fitzgerald. And, everywhere, were the beaming smiles of dear friends and family.
Ultimately, a wedding is a celebration, and judging from the way everyone partied so effortlessly into the night, we couldn’t have asked for a better start to married life. You’re welcome to peruse the official photographs if you like that I’ve posted here on Flickr.
For some it may seem absurd to spend so much time (and money) on an event that races by in just over eight hours. Certainly, our marriage would be just as valid if it were solemnized in a magistrate’s office, or in Vegas with a Japanese Elvis, or whispered in Latin in a chapel with just us and a priest. But for two people whose combined eclecticism sometimes threatens to obliterate the Universe’s dark matter, we saw fit to somehow combine all three options above, while endeavouring to include all our nearest and dearest. If anything, the day was as much an investment in the special people around as as the public declaration of our (take your insulin, people) love for each other.
A few months on, the magic is still there, percolating quietly in the background while the daily tolls of mortgages and bills continue, as ever. On the surface, nothing has changed in our five-year relationship, other than the words “wife” and “husband” are slowly losing their novelty (and my wedding ring has stopped being a source of localised eczema). Internally, though, I feel a subtle crystallisation of “things I never knew but always suspected” taking place, growing more profound each day. I’m starting to understand how my parents weathered 40 years (!) of marriage while retaining their distinct personalities.
Amid a sea of broken relationships that have pierced the hearts of several close friends, we were understandably nervous – and frequently sceptical – about this Sacrament of Matrimony thing. Our minds regularly chanted, “it’s not necessary in this day and age…” I mean, we’d co-habited for four years and had joint accounts and pets.
But, as Edward Monkton says, “Sometimes the heart should follow the mind. Sometimes the heart should tell the mind to stay at home and stop interfering.” The latter definitely seemed to apply. So we took the plunge. Go figure, I’m happy. It’s like I’m 18 again, but minus all that angst and bravado.
So, there you have it folks. I can’t speak for anyone else, but I am pleased to report that I’ve been a husband for four months now… and it’s great.