Dx: Depression Consequent to Fatigue

Dick Gottlieb, the social worker from Grand Rapids who engages people in empathetic therapy, and I, who have a diagnosis of type two bipolar disorder, have been having some conversations, most recently centered on what the heck is wrong with me and what we can do about it.

I maintain that the basis of good treatment is a good diagnosis.  He says the basis of good treatment is a real relationship devoted to one person’s growth and happiness.  Since he and I are of about the same age and intelligence, and both pretty straight shooters, the dialogue is interesting and rarely involves violence exceeding the level of a misdemeanor.

One of the things we agree on is that sadness and depression are two different things.  Depression is a condition in which the function of all vital organs takes a downturn.  This is not what your physician will tell you.  Physicians are busily diagnosing sadness,
dejection and all sorts of other things as depression and then prescribing damaging drugs to combat it.  Sadness is normal in
this life.  For example, when somebody you really care for dies then you get sad—that’s life, not depression.

Depression is when your body and soul take a nosedive to an unsatisfactorily low level of functioning.  Now the question is whether you can acquire emotional depression from physiological depression, or does all depression stem from relationships that block growth and happiness?  I maintain that a sick body can cause a sick mind.  I wouldn’t presume to tell you what Dick maintains, but he can write his own position and I’ll gladly post it here.

Basically, I have been real depressed and I suspect a physical cause, whereas he is looking for the origin in a relationship gone sour.  In a way, we both might be right and this brings us to Amelia the Amiable, who is my home health aide.  Amelia had a staggering month, including breaking up with her boyfriend, moving to a new apartment, going home to be in her sister’s wedding, going home again for her grandmother’s illness, organizing and producing a craft festival, and going home a third time for her grandmother’s funeral.  Amy should spend the next month lying in the sun, taking long naps, and eating lots of fresh fruits and vegetables, otherwise she’s probably going to get sick.

The reason I say this is because the immune system carries the stress load and what happens is that the immune system rises to meet a stressful event then, after the stress level drops, the immune system signs off.  It says, “Okay, I’m not protecting you from any
more viruses or scorpions or rifle bullets.  There’s a limit to what I can do—do you understand that?  I can’t protect you forever so now you’re going to get sick, so there!”  This is why your pastor makes it through all the stress of Lent and Advent and then comes down with a bad head cold just before dessert is served at Christmas or Easter dinner.

The immune system is the link between mind and body.   They know this because a couple decades ago they looked under a microscope and found central nervous system cells holding hands and behaving in other intimate ways with immune system cells.  Major autoimmune diseases often present as psychiatric disorders.  Muscular dystrophy, multiple sclerosis and lupus all carry with them some component of depression or psychosis:  the immune
system and the nervous system are working together to make you crazy.

My immune system is (you’ll pardon the expression) fucked.  Somewhere along the line, psychiatrists prescribing antidepressants blew out my immune system, which is now so hyperactive that I am allergic to cats, dogs, birds and tigers (the allergist advises that all I can do is try to avoid tigers).  I can’t take drugs, wear makeup, or eat
shellfish.  I am also really, really tired, which is the presenting symptom of immune dysfunction.  I am so tired that I can’t do regular stuff like wash dishes, cook or take a shower.  I should also mention that I have a dozen chronic illnesses and am the poster child for drug damage.

Which brings us back to Amelia the Amiable—she done gone and left me alone too long, which meant I had to rise from my wheelchair, wash a coffee mug, shell some peas, and take the occasional shower, as required by the apartment building
management.  All this stress overloaded my immune system, which sent frantic messages to my central nervous system, which fast-forwarded them to my brain, which threw the switch.  Most people’s emotions are modulated by a dimmer switch; they can dial their emotions up and down.  However, people with bipolar disorder have emotions that are controlled by a toggle switch:  you are either on or off, nothing in between.

            My diagnosis is that I am depressed as a result of becoming over-tired.  If that is the correct diagnosis then the correct treatment is some serious bed rest.  What say you, Dick Gottlieb?_____________________________________________

To the person who is using multiple names to send me a single nasty message:  Be advised that you are engaging in cyberharassment.  Do it one more time and you will be reported to the IC3, which is mostly the FBI.  Your emails will be traced and you will get a visit from a guy with badge.  Be nice or shut up.

About annecwoodlen

I am a tenth generation American, descended from a family that has been working a farm that was deeded to us by William Penn. The country has changed around us but we have held true. I stand in my grandmother’s kitchen, look down the valley to her brother’s farm and see my great-great-great-great-great-grandmother Hannah standing on the porch. She is holding the baby, surrounded by four other children, and saying goodbye to her husband and oldest son who are going off to fight in the Revolutionary War. The war is twenty miles away and her husband will die fighting. We are not the Daughters of the American Revolution; we were its mothers. My father, Milton C. Woodlen, got his doctorate from Temple University in the 1940’s when—in his words—“a doctorate still meant something.” He became an education professor at West Chester State Teachers College, where my mother, Elizabeth Hope Copeland, had graduated. My mother raised four girls and one boy, of which I am the middle child. My parents are deceased and my siblings are estranged. My fiancé, Robert H. Dobrow, was a fighter pilot in the Marine Corps. In 1974, his plane crashed, his parachute did not open, and we buried him in a cemetery on Long Island. I could say a great deal about him, or nothing; there is no middle ground. I have loved other men; Bob was my soul mate. The single greatest determinate of who I am and what my life has been is that I inherited my father’s gene for bipolar disorder, type II. Associated with all bipolar disorders is executive dysfunction, a learning disability that interferes with the ability to sort and organize. Despite an I.Q. of 139, I failed twelve subjects and got expelled from high school and prep school. I attended Syracuse University and Onondaga Community College and got an associate’s degree after twenty-five years. I am nothing if not tenacious. Gifted with intelligence, constrained by disability, and compromised by depression, my employment was limited to entry level jobs. Being female in the 1960’s meant that I did office work—billing at the university library, calling out telegrams at Western Union, and filing papers at a law firm. During one decade, I worked at about a hundred different places as a temporary secretary. I worked for hospitals, banks, manufacturers and others, including the county government. I quit the District Attorney’s Office to manage a gas station; it was more honest work. After Bob’s death, I started taking antidepressants. Following doctor’s orders, I took them every day for twenty-six years. During that time, I attempted%2
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