Saturday, June 9, 2012

I Miss Me

Over the Memorial Day weekend I drove by the housing addition where Depression first showed itself.  It was house #2.  Ironically in my little berg of a town, at one time you could see house #1 from the yard of house #2 (before more construction).  House #1 memories are full of laughter and fun.  House #2 memories have many of those but in looking back - now I see some of the slippage.  How horrifying to look back in this manner.

House #3 was a short stay and was the same as House #2.  House #4 is where Depression was diagnosed.  But back to house #2.  Looking back over 16 years finds a family flourishing when we moved in.  When we moved out, there was pain for me personally, pain at work and pain in the marriage.  (In psycho-babble (PB), three domains were becoming dysfunctional).  But it is the beginning of house #2 that I compare to the worst (both house #4 & #5).  Who was I back then?

Besides the obvious lack of the symptoms that plague every depression patient, it hit me that my impulsivity was overwhelmingly different.  No second thoughts to doing things spur of the moment nor even volunteering for new projects.  Some of my impulsivity was acted out immaturely as well (but I'll skip the embarrassing mistakes).    Along with the impulsivity came the ability to talk in front of crowds with no anxiety; the ability to 'want' to meet new people; the ability to take on new situations.

From studying motivation theory, I know that our brains are wired for the new and novel.  Some brains are wired more heavily than others and there is also wiring related to risk taking or danger.  People wired heavily for seeking out the new and novel combined with high risk taking are called adrenaline junkies.  In my teen years, riding motorcycles and driving cars at stupid speeds was normal.  My executive functioning was low.  (PB for immature frontal lobe development).  But that immaturity continued well into late twenties, although tempered by 'responsibilities', so potentially lethal impulses were kept at bay.  But at house #2, the decline of the impulsivity (which should have equated to becoming more mature) continued past a certain threshold of 'normalcy' to the point that by house #4 I would find myself crying in the shower not wanting to start my normal day.  New and novel was triggering the danger circuits.  Which then begs the question, was it the New & Novel decline or was it the Danger circuit being over zealous?  (This thought just came to me while writing this - no wonder therapists prescribe journaling for insight).

If I look at financial risk - danger - I was just as risk adverse while playing the stock market at house #4 as house #2.  Flirting while being married didn't decrease either - although that would be an argument for my New and Novel not really declining as much as I think. And at house #4 I bought a 400 horsepower car - definitely a sign that my Danger circuit wasn't overtaking my reasoning.  So I'm back to the New & Novel decrementing being the cause of my dysfunction.  The depression's ability to cause a low mood was tempered with psychopharmacology (antidepressants) and I believe (heavily believe) that memory is very closely tied to emotional states.  (Remember when you got gifts?  But not the day before?)  And my antidepressants suppressed the emotional state in both directions.  Often referred to as raising the floor but also lowering the ceiling in mood categorizations.

So the lack of emotion led to fewer memories overall.  The good times and bad were hampered at the time and the memory circuits weren't locked in as deeply.  I can recall house #2 memories more easily than towards the end at house #4.  Was that Depression or the side effects?  I'll have to go with Depression, because during that period of time I was on SSRIs, SNRIs, and tricyclene medications (not all at once - but my gp would switch when we realized the medication I was on was no longer working). So as the Depression became worse, regardless of the medication, the memories were etched less and less on my brain.  And God I regret that.  When my children bring up memories that should be easily accessed, I struggle.  A few hours later, I can remember more of the moments they were talking about.  (I know - some of this is simply age - but when discussing it with chronological peers, their lack of important memories isn't nearly as severe as mine).

Back to missing ME.  I think in a previous blog, I referred to confidence as being the culprit.  (I'll have to go read my own blog because I don't completely remember!).  But behind the confidence, I now believe impulsivity played a part.  I'm now curious if the Depression circuit, which gizmo is interrupting, is anywhere close to the New & Novel circuitry.  I know gizmo is wired really really close to the Danger circuitry - at least the anxiety response portion of that.

No fear of being goofy.  That's another trait I was thinking about when I drove by house #2.  That is impulsivity but is also part of the Danger (fear response) circuit.  Interesting.  The second most salient trait I was thinking about 2 weeks ago has both components - almost equally.  "fear of" = fight or flight and "being goofy" = impulsive comedic behavior.  Ok, I'm back to the drawing board as to which is affected more by Depression.  (this stream of conscience writing stuff makes me sound wishy-washy and its possible this blog post will make me look goofy - although it's been 2 weeks since I had the impulse to write this down, and haven't acted on it until now - yet I will push save).

Most of my posts have links to some good reading.  I have been reading some interesting articles, but don't really want to take the time to go back and find the links again.  In summary, there is a flurry of activity surrounding DBS for depression and the numbers are increasing.  As mentioned before, the Europeans have a study group with 4 leads.  Some of their research is starting to surface.  From my layman's understanding, they've plugged into the same place as both St. Jude's project as well as Medtronics area.  With the working theory that the circuit passes through a number of physical locations in the brain and can be interrupted at various places along the way.

There is also a lot more being published about transcranial magnetic stimulation (TMS).  And the general public is becoming more aware of the use of electrical (and magnetic) stimulation of all of us guinea pigs, with an amazing (to me) outcry of negativity.  Summarizing a couple of people's points in an article that likened my gizmo as a pacemaker for the brain, heart pacemakers work on a muscle and DBS works on a part of the body that we know very little about, in fact we know more about the moon than we do the human brain.

Well, to that I would like to remind people that we put quite a few lives at risk in moon research.  (Some of it could have been done without humans - I get that).  As we map out these circuits, I believe it won't be very long before we can put a person in an fMRI and decide whether to put them on zoloft; attach some low voltage electrodes to their skull; send them to talk therapy; put a magnetic skull cap on 3 times a week; or drill a couple of holes in their heads.  Just like we know now whether to make a person reduce their salt & exercise more; or put them on cholesterol, blood thinners or beta blocker medicine; or have to do open heart surgery followed by a pacemaker.  (I understand the heart is a muscle and the brain is different - so what?  Research may take longer and ethics/research boards may be more cautious, but bottom-line folks, the research has to be done.

Hmmm, after I proof read this and post, I may fire up the 400 horse beast and see what 100 mph feels like again.  JUST KIDDING - the last time I broke 90 mph cost me over $400.  But I am going to be more aware of when I could be more impulsive and actually try to be goofy (in small amounts).  (Physician heal thyself?)

3 comments:

herb said...

Hmmm…interesting posting 278-005.

Without directly discussing it or even referencing to it, I surmise that your depression has subsided as your thoughts are turning elsewhere.

If so, I’m extremely happy for you and your added thoughts of “try to be goofy (in small amounts)”.

In my opinion, while we do age…“I Miss Me”… I do not believe we can ever be as we once were but at times a smile reflecting back upon the hell some of us have endured and survived can be experienced in the joy of where we are at the moment.

I will disagree with you…“As we map out these circuits, I believe it won't be very long before we can put a person in an fMRI and decide whether to put them on zoloft; attach some low voltage electrodes to their skull; send them to talk therapy; put a magnetic skull cap on 3 times a week; or drill a couple of holes in their heads.” I think we are still a long way from putting all these interesting tidbits of research together for a more meaningful understanding of treatments, mood states and dysfunction. Worse yet is the fact that there is no determining basis for who will or will not respond to any of these various treatment options as well as the potential for serious side-effects. Please let’s not forget the current and ongoing debacle of many of the psychotropic drugs once thought to be the panacea for many of these illnesses.

While you may have responded and benefited from your therapy others have not and what is truly important is the continuing encouragement to not give up.

In any event, I once again wish you and yours continued wellness and all those similarly challenged.

Warmly,
Herb
vnsdepression@gmail.com
http://www.vnstherapy-herb.blogspot.com

Anonymous said...

It sounds to me that he hasn't progressed that far if he is still missing parts of himself. I hope he hasn't slid back.

Thank you 278-005 for the posts and the encouragement. It does help others.

Denise said...

Hi,

Thanks for your updates, I'm sure they give a lot of people hope. Are you able to say what the side affects are that you mentioned have been reported by some people on DBS trials? I'm interested because I'm thinking of participating in a DBS trial myself but am still not sure about it. If you don't want to post them on here, could you email me at denise528@hotmail.com. I assure you, I will keep your details completely confidential.

If not then no worries, I understand.

As an additional question, were you able to work or function before having DBS? I do work and can still function.

Denise


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