The Art of Car Crying

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This one goes out to all the people who can’t cry at home. Whether you are trying to be brave for a loved one or just don’t have the space or privacy to cry at home, I hope this gives you some relief.

Step 1: Park your car somewhere safe, like the edge of a parking lot of a big box store or an off-season community space, such as a pool or tennis court.

Step 2: Be aware of your surroundings. If someone approaches you looking concerned – which has literally never happened to me – don’t roll down your window, just wave them on. They are obviously a carjacker.

Step 3: Let it all out. If you have trouble getting started, listening to sad music usually works. You can also try a crying playlist. This one has 118 songs. 152152149153 This means that if one doesn’t work for you, you can click next until something hits you.  I have included my favorite tear-inducing tunes below.

Step 4: You’ll know when you are done because your mind will start to wander to something unrelated, like if you have enough lettuce for dinner (don’t worry about it; no one really likes lettuce). Also, your breathing will even out.

Step 5: Take ten deep, slow breaths, counting to four as you inhale and six as you exhale.

Step 6: Carry on.

These are my top three go-to songs for crying. The first one completely wrecks me because I always think of my husband Evan. Indie, country, pop – there’s something for everyone (probably).

 

 

 

A new approach to preventing and identifying depression

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Depression is a sneaky beast. It’s the monster beneath the bed, waiting until you’re vulnerable to grab you by the ankles, drag you into its dark, misty kingdom and leave you to wander alone.

I’m just stumbling out of a two month-long bout of depression. I knew I was at risk. In fact, the entire ALS community is at risk according to an extensive list of risk factors 125 complied by the Mayo Clinic.

Chronic illness, major life changes, and stress or trauma are all risk factors for developing depression. Sound familiar? Of course, genetics plays a role, too. My family has a strong history of depression, and I am a link in the chain.

On top of understanding that I was vulnerable on multiple fronts, because this is far from my first rodeo, I know the Mayo Clinic’s official list of symptoms of depression (available here) 126 by heart.

A few symptoms most relevant to my experience are:
1. Persistent sadness
2. Lack of concentration
3. Irritability

Still, despite battling depression for over a decade, I didn’t see the beast coming or even recognized it when it took over my life. The world just grew dimmer by the day. With all of my experience, how did this happen?

I have learned that once the fog of depression envelops a person, seeing the world clearly, let alone recognizing what is happening to you, can be next to impossible. I kept a diary during this round, and looking back, it’s clear that I didn’t link my actions — the way depression manifests in me — to the symptom list.

For example, here is an excerpt from one of my diary entries: “My sadness for my husband Evan is absolutely crushing. If I really think about his situation of watching me decay, if I empathize and imagine myself in his shoes, I feel like I’m dying. Knowing he cries in the car makes me sick. Imagining I’m the one losing him is so unbearable, I end up sobbing to the point that I can’t breathe.”

Read my entire Depression Diary127 if you would like to gain a more concrete understanding and my experience living through a depressive episode.

I knew I felt sad, but even though these fits of crying happened several times a day (meaning my sadness was clearly persistent), it just didn’t occur to me that my feelings weren’t landing in the normal range of human emotion. To learn more about the difference between sadness and depression, click here128 to read Guy Winch’s article “The important difference between sadness and depression… And why so many people get it wrong.”

After a few weeks, I was in agony. I felt like some dark, toxic thing was gnawing through my chest. I have felt like this before — many, many times. However, it wasn’t until my concerned doctor made a house call after I kept canceling appointments that I realized I wasn’t just experiencing difficult emotions. Rather, I was sick and need to be treated. She pointed out that since I was already on antidepressants, a small increase in dose could have me feeling better quickly. Now, I am well enough to reconsider my treatment plan, and I have decided I could benefit from therapy.

My story looks like it will have a happy ending, but there was so much needless suffering along the way. Plus, if my doctor hadn’t come to me, I would still be wandering in the fog of depression, unable to see the landmarks that told me where I was. Knowing that everyone in the ALS community is at risk for depression, I propose a different way to go about identifying and, subsequently, seeking treatment for this disease. Rather than relying on self-insight when our vision is at its most blurry, let’s learn to watch out for each other.

People living with ALS125129, family members, and caregivers should become well-versed in the entire list of symptoms, because each person may have a different set of symptoms. One doesn’t actually even have to be sad to have depression. They may oversleep, gain weight, and lose interest in work and hobbies. If we are all aware of the different ways depression can manifest, we will know that sudden, dramatic changes in behavior may be due to a sicknesses that needs to be treated as soon as possible.

Every day, we fight an epic battle against ALS. If we have any hope of achieving a high quality of life in the midst of this struggle, we need to keep our minds mighty and well. As in every aspect of this war, we can only succeed if we watch over each other.

This piece was originally published by ALS News Today in my mental health column, “The Mighty Mind.” In my next column with ALS News Today, I will discuss different types of treatment options for depression

My Depression Diary

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Trigger Warning!

Forward:
When just over a month ago I sensed that my mind was changing, I was overcome with a frenzied need to record everything I thought and felt. Even before I understood that I was depressed, I realized I was going somewhere that outsiders could never truly visit. I became consumed by the need to write a message from the inside that could maybe serve as a map or even just a sign that says “Keep Out! Here Be Dragons!”

Not so long ago, sharing my diary with strangers online never entered my mind, not even in my worst nightmares or wildest dreams. It was that impossible. However, that was before ALS. The same rules – even my own most personal code – no longer apply. I am braver because I am a soldier now. I take risks because that’s how you fight. This way, even if I die before the cure comes (and it will come), I’ll go knowing I made the path less lonely for my fellow soldiers and just a little easier for those who come after me.

I didn’t sign up for this war, but my enemy means to kill me, so I must give everything I have and am in this fight. Privacy is a luxury long gone. I will share my most secret thoughts and vulnerable moments in service of my fellow soldiers and the people who make my life worth fighting for. Right now, that means showing you what it’s like inside the beast that senses we are battle worn and easy prey. My hope is that if you read my diary and recognize yourself or a loved one in these words, you will realize it’s time to call for reinforcements, whether in the form of a psychiatrist who prescribes antidepressants, a therapist who talks you through the climb out of the pit, or a priest or pastor who provides solace and guidance.

To learn more about preventing and identifying depression, read my ALS News Today column12212627122128. I will share a follow-up post in the next few weeks on different types of intervention and how to choose which is right for you.

Now brace yourself. We’re going in.

Entry 1:

I am choking on the strength of this episode. It wraps ever tighter around my throat, just like his hands. As I write this, I am sitting in bed, watching a funny show while checking my email, text messages, and Facebook notifications. It is the middle of the night, a time of terror for me, so I need the safety of the blue electronic light of my devices. I bask in the glow, then I drown my thoughts in sitcom banter and a whirlwind of multitasking.

Burying my dark thoughts is a high stakes game; if I don’t use the right maneuvers, the shadows win. No matter how scared I am now, it is nothing compared to how I will feel if the memories creep in. The memories open the floodgates of flashbacks, which will sweep me far away and back in time to that room where I was raped and nearly murdered.

I escaped with my life, but certain parts of me died there, namely the part that believed no one would ever hurt me. Well, actually I had never really considered that I could be a story on the news as easily as any other human. I held myself apart in the way we all must to some degree if we want to function in the world. Dwelling on our abject vulnerability would reduce us to terrified shells of ourselves.

Like me.

Entry 2:

I can’t close my eyes in the dark. I can no longer write, I can’t focus on reading. All I can do is mindlessly watch TV. I am afraid to sleep because I want to remain vigilant, and I know nightmares are waiting for me. I am resuming therapy, or at least that’s what I tell myself, but I am desperate for a quick fix. I know that no miracle pill exists to give me relief, but I have been living with PTSD for eleven years, never knowing when it will become active and derail my life. I’m exhausted.

Entry 3:

Thinking about “the event” again. I guess writing “rape and attempted murder” became too clunky since I keep doing it again and again. I wish there was a word for that crime.

Here’s something weird: I had actually been in that room before. It had a great view of the Gulf of Finland, so I took a picture. I put in black and white because I thought it made the photo look artsy. During “the event,” I turned my head so I was looking out the window at that same view. I remember making that choice because I wanted to escape my body. Maybe I succeeded because when I look back, I can only remember the black and white photo. The memory lacks color and sound. In fact, that whole night remains in perfect silence, as if I stepped into the photo because inhabiting my skin was that unbearable.

I also sensed if I looked up, I would not survive. I couldn’t articulate it then, but in hindsight, I realized that it I were to look, I would have to confront what he was doing, and I didn’t want that image in my head. If I looked at him, the image would take over my brain like a fungus I saw on a nature show. The fungus commandeers the ant so that it becomes disoriented, out of touch with reality and its purpose. Ultimately, its new biological imperative is no longer survival. It follows the final orders of the sadist in charge by climbing as high as it can. Then, when the ant is paralyzed by vertigo and weakness, it gives in. The fungus cracks the ant and blossoms, sending its spores far and wide, aided by its victim’s lofty position.

Summary: if I looked up him, the images would have devoured my mind until I forgot who and why I was, creating so much pain that suicide started to look attractive.

That kinda happened anyway, though…

Entry 4:

My doctor came to see me. I can’t believe that I didn’t realize what’s going on until she talked to me. It is classic crying, lack of interest in anything, wanting to stay in bed depression. It is not the most severe I’ve had. On a scale of one being fine and ten being suicidal in the mental hospital (true story), it’s a five.

The PTSD fuels the depression by isolating me. I’m so mad at myself. I want to be stronger and fight this off with logic, but everything is scary. It makes me think of Alias Grace by Margaret Atwood. There’s a great quote when Grace says something like, “Quilts are so bright like war flags, I think we put them on beds so you take notice. You see the warning that the bed is a most dangerous place.”

That’s how I feel when I get in bed. I still feel the danger of a crime long since committed against me, so I stay awake on guard all night. When dawn comes, I finally surrender to sleep. The end result of all this fear and hyper-vigilance is loneliness. I am only awake when my friends, family, and beloved husband are asleep. I want to have friends over, go write in the beautiful library, and spend awe-filled hours in the art museum. I perpetuate my isolation by refusing to reach out to them.

I also play this game where I don’t contact them and then wait to see how long it takes for them to contact me. The longer it takes for them to contact me, the less they obviously care about me. It’s a shitty game, but I can’t stop playing.

Entry 5:

I feel like a raw nerve in pain after any interaction. I wish I could read substantial books. My intellectual hunger still rages (a good sign), but my concentration is too poor to make it through even the first page of any appealing titles.

Also, lately the library doesn’t have e-book versions of what I want, and I took this REALLY personally. I reacted as though this was a commentary on how little society values me as a disabled person. I am hung up on that anyway because of all the times President Trump has negated the value of the people with disabilities. From mockery to attempts to gut Medicaid and defund ALS research… I don’t want to let him me this way. It’s just that everything hurts me more now that I am depressed.

Entry 6:

I am starting to think this is happening because I am repressing sadness, which is a pattern for me, which I discussed in the post Leaves in My River, Stars in My Sky123127128123129.” I mean, the major thing that I have been crushing for years is sadness for Evan. If I really think about his situation of watching me slowly crumble, if I empathize and imagine myself in his shoes, I feel like I’m dying in a way ALS has never achieved. Knowing he cries in the car makes me sick. I sob hysterically until I can’t breathe. Imagining I’m the one crying in the car because I am losing him is unbearable, and I am grateful that I am the one who has ALS.

Entry 7:

Evan says to go easy on myself. Getting frustrated with myself does great harm and zero good. I can’t berate myself into ending the episode. I guess it’s time to learn to show myself the compassion I apparently think everyone but me deserves. After all, if I am not on my own team when I’m at my weakest, how will I fight my way through this? I know that logically. Now I have to figure out how to live that truth.

Wish me luck. I need it.