Day 23 – What’s something your doctor taught you or you taught your doctor?
The, dare I say it, positive experiences I have with medical doctors (MDs) could probably fit on a very small piece of paper, so as I was trolling around my brain on a different topic altogether, I was delighted to remember something that an MD once taught me that was invaluable in coping with depression, and it’s something I’ve carried around with me in the 13 years since then.
At the time, I rigorously avoided having a regular medical practitioner. The general physician that I liked had done a lot of testing for the source of my mysterious inflammatory illness, and while he confirmed that it was going on, he hadn’t really been able to do anything for me. I was coping with major depression as well as extreme fatigue that was worsened by my daily ride to work, yet I persisted as I remembered that exercise was meant to be the key to beating depression.
As an aside, while exercise helps, I think it’s a crock of shit (pardon the vernacular) to think it’s the cure. It’s just another thing we can beat ourselves up about when the bike riding, circuit training or – insert your physical poison of choice here – does little to treat the depression, and frankly makes those with chronic illness feel worse because then we don’t have energy for anything else. Just call me a bitter old woman on that point and let’s be done with it. I never liked exercise, and I was never good at it. I had trouble breathing (even as a relatively healthy teen), as my one effort at a cross-country race proved when I collapsed on the finish line and nearly tossed up a lung. No one mentioned to me that maybe an inhaler would have helped. So, exercise, much like physical education at school, was just one of those Things that are Good for Us that we have to do but generally just really sucks.
Getting back to doctors, as I said, I had a habit of visiting my local clinic and seeing whoever the locum doctor was at the time. It was rather amusing that the practice consisted of a group of male MDs, who seemed to permit a female MD into the practice for 6 or so months until presumably they got tired of her. I met some very capable female doctors (male doctors always made me feel like I was getting the ‘look’ from my Dad), and I hope they went on to be very capable doctors in their own practice without absorbing too many of the prejudices of their profession.
One of the last of this line of locums I saw was around 1998-1999 just before I left Australia. Unlike many of the doctors, she seemed genuinely interested in my protracted and barely managed depression and showed a lot of compassion towards me where depression was concerned. Indeed, she once proposed the rather radical idea of going on 2 weeks’ stress leave from work to help me rest and recover enough energy to assume better control of my depression. It was, as I said, a radical prescription to me at the time. I never realized that anyone considered mental health serious enough to entitle one to sick leave. The prevailing opinion of most employers is that if there are detached limbs or stuff spewing from your bodily orifices, then you might be entitled to claim sick leave. As far as mental health, well, you were really off your rocker if you considered that an employer would treat that as a serious illness! As an aside, I have since then been heartened to realize that many doctors are prepared to write medical notes for mental illnesses. Unfortunately, there are still not many employers who are happy to accept them.
In one of my final appointments with Teresa – at least I think that was her name but I was confounded by my previously mentioned anxiety about how to address doctors, which was further compounded by the fact that I liked her enough to call her by name and not the traditionally grudging and deferential ‘Doctor’ – she sat me down and challenged me to write a list of all the things that brought me comfort when I felt depressed. I dutifully complied and presented the list to her at my next appointment. She had me read it to her and nodded in approval.
What I’ve since realized is that Teresa was trying to get through to me that when you are depressed, it’s the worst time to try to think of what brings you comfort and joy. If you write down your list ahead of time, then you have an amazing resource to go to when you are down in the pit. Some people go further and pack an emergency kit with necessary supplies for this eventuality, which is even more awesome. She gave me a truly amazing gift.
Over the years, in my reading of many other inspirational and practical books on living with depression, I picked up another concept called ‘joy breaks’. I can’t remember the source of this concept, but it was a small aside packed into a book with many other suggestions. The beauty of joy breaks was to similarly make lists of things you could use to bring you moments of joy when dealing with a gruelling day of work, studies, or – I now realize – chronic illness.
Joy breaks as I read about them were also a rather radical concept. In our society, we’re subtly conditioned (aka brainwashed) to believe that we should be happy all the time and walking around in an elevated state of joy. Anyone who has read about a Tony Robbins ‘event’ will call to mind a large mass of people shouting and jumping and punching the air. The whole concept relies on maintaining this state of nirvana 24/7. Sadness or even quiet reflection seems to be thrown out with the bathwater as a waste of time.
I don’t know about you, but honestly folks, even when I wasn’t depressed, I wasn’t running around punching the air and shouting, “Hallelujah!” For people with depression, the absolute feeling of inadequacy – the impossibility of reaching a fraction of this frenzied state for even an hour, much less all day – is just another reason to feel like a failure and feeds back into what Tara Brach calls the trance of unworthiness. It’s not sustainable, and I’m sure it’s not even desirable to have a nation of Pollyannas.
What is achievable for people with depression is to experience moments of joy and peace. Whether these moments last for a few seconds, a few minutes, or more, the significant thing is that people with depression can and do experience moments of joy. Not as many as we might like at first, but if we cultivate them and stay present with them, each moment restores to us a sense of much-needed mastery.
Like the self-comforting list that Teresa asked me to write 13 years ago, I made lists of ‘joy breaks’ I could take for 2 minutes, 5 minutes, or 1-2 hours to help me experience moments of joy. I later expanded the concept to include things that gave me feelings of peace. Initially my ‘joy break’ lists included things like blowing bubbles, colouring pictures and watching movies that made me laugh. Now, they might include stepping outside and taking some deep breaths and just appreciating the fact that I am alive. I think of things I am thankful for, but not in the kind of checklist way where you measure your success by whether you have a spouse, family, job, friends and so on. Sometimes it’s as simple as being thankful for breathing (and not tossing up a lung) and watching the birds at the feeder.
So, I invite you to give yourself this assignment. Sit down and make a list of the things that bring you moments of comfort, joy and peace. I was delighted to find that I still have the list I made in 1999, thanks to a very wise MD named Teresa.
Things that comfort me
– talking to Carmen (who later became my wife!)
– listening to music
– a bath (if I had one)
– cuddling my teddy bear
– watching the sun rise and set
– playing the piano
– visiting parks, forests and the sea
– flowers and trees
– when I let myself relax
– writing without censoring each word
– going to the movies or a play
– the beach and the gulls
See if it inspires you to make your own list. The next time you feel overwhelmed by depression, bring out your list and start doing some of the things on it. Give yourself permission to experience as many moments of joy each day as you can. It’s a gift you deserve, and is a much more achievable way to restore a sense of mastery over depression.