Status Update

February 8, 2015 – Dear friends, dear StayOnTop followers:

First of all, let me thank those of you who contacted me with their best wishes (and questions, and all kinds of advice) about my health situation. As you know, I don’t like writing too much about myself. But after months of silence, I feel you’re entitled to some kind of status update.

    Well, in short: I am recovering very slowly, somewhat, but not yet out of the pit. I still do sleep much more than I should and I walk much less than I should; I still frequently feel paralyzed by somberness. The most important thing that seems to be returning right now is a glimmer of hope.

Winter View

Just now, from my desk chair, I took this picture of the view out of my window. Maybe it can serve to illustrate the situation.

My mental landscape is still left barren by the winter cold. Spring is not yet in sight. However… slowly I’m beginning to recognize that in due time spring may return, and that these dry withered shrubs will be green and blooming again. And even more important, slowly I’m beginning to recognize that I actually want to see that happen again.

Lessons Learned?

In the past horrible months I’ve learned at least two things. Or learned… let’s say I was reminded of them.

Psychiatry is still in the Middle Ages

One: we still understand far too little of the complex processes that make up our brain, feelings, and personality. Psychiatry, with all its testing procedures and patented medication, may pose as an advanced branch of modern medical science but in fact it’s still shockingly primitive. When in the past months my psychiatrist had to find some adequate medication to help me, in fact her only option was by trial and error. Just like in the Middle Ages, when doctors had no choice but to fight the Black Death by trial and error.

    Once again I was close to killing myself: so it was obvious that I did need some heavy medication. But what? The first pills she prescribed gave me physical side effects so intolerable that after a month we decided to switch. I will spare you the details. We tried a second option. These pills not only gave me severe headaches: they also made me so dizzy that right when I needed to drive for the first time again (having not driven for the first ten days) I crashed into a parked car. After six more weeks of headache and dizziness I gave up on this medication, too.

    So now, since a week, I’m on my third medication try. A very recent, state-of-the-art antidepressant: the pharmacy people did not even have it in stock yet – they had never seen it before. These pills promise to come with less severe side effects. Miracle pills? I certainly hope so. Will they help me do the trick of curing myself? We’ll see. Maybe time is just as important here as medication.

Patience must be Carefully Dosed

Which brings me to the second thing I learned in the past months: the importance of patience. More specifically the patience of people around you. For when you’re deeply depressed, you are too indifferent, numb and passive to feel much patience or impatience yourself.

    The people who come to visit and help you will sometimes turn out to be far too impatient or far too patient with you. Too much impatience is not a good thing, as it will have an irritating or even demotivating effect. Too much patience is not a good thing either, as it won’t help you in any way to make a few little steps forward.

    So just like with medication, the all-important thing with other people’s patience and impatience is they should find the exact dosage that fits the momentary depth of your depression. This is not easy. Maybe later I’ll post some more thoughts about this.

    For now, please let me ask you for a little more patience. At least by now I do really want to come back blogging again, even though I will not yet be fully back this week or the next.

See You

Thanks for your understanding. Here is a song to listen to: Broken, by Tift Merritt, from her 2008 album Another Country. If you like it and want to explore more of her songs, here is a link to the official Tift Merritt website.

 
Tift Merritt – Broken


10 Responses to “Status Update”


  1. 1 Cathy Feb 8, 2015 at 19:09

    Henk,

    “One: we still understand far too little of the complex processes that make up our brain, feelings, and personality. Psychiatry, with all its testing procedures and patented medication, may pose as an advanced branch of modern medical science but in fact it’s still shockingly primitive”

    ——-

    Wow, I could not agree more with you about this.

    I would also like to say make a few points about depression and Cognitive Behavioral Therapy (CBT), which has become the dominant and most popular treatment of mental disorders over the past 30 years or so.

    For those who don’t know what CBT is I’ll briefly explain:

    Developed by the American psychiatrist Aaron Beck in the 1960s, CBT is based on the idea that our emotions and moods are influenced by our patterns of thinking. The aim of therapy was to “correct” these processes, “to think and act more realistically”. It would allow the patient to avoid the misconstruction of reality that had led to their problems. Rather than focus on the patient’s history – say their childhood and early experiences – like most other psychotherapies, CBT is mostly directed to the here and now.

    Ok, I am not convinced by this or by the current behavior-based descriptions of depression, diagnosed according to a check-list of factors that drugs can shift (appetite, mood, and sleep patterns) or by the cures. People are both much more complicated and far more interesting.

    Depression is not just a set of pre-ordained symptoms, but as multiple and varied as those who are told they suffer from it… Its source can lie deeply buried in an individual’s history and far from present awareness, though the trigger may well be a separation or crisis. At its core is the experience of LOSS: engaging in the difficult process of mourning is what allows us to come through.

    CBT can certainly be helpful for some people. But it is crucial to distinguish the question of whether a therapy works and HOW it works. For any therapy to get started, unconscious belief systems need to be mobilised. Human belief is a very powerful thing and no external authority can tell us what to believe in.

    Just to be clear: I don’t think CBT is completely without value. It can definitely help some people to become aware of and to correct one’s irrational biases in thinking or with anger issues. But I think it’s impossible for CBT theory to take into account the complexity and contradiction and detail in human life.

    With CBT the psyche has become like a muscle that needs to be developed and trained. There is no place for complexity and contradiction here: the modern subject is represented as one-dimensional, searching for fulfilment. The possibility that human life is aimed at both success and failure and never simply at wealth, power or happiness no longer makes sense. Suddenly the world of human relations described by novelists, poets and playwrights for the past few centuries can just be written off. Self-sabotage, masochism and despair are now faults to be corrected, rather than forming the very core of the self.

    In today’s outcome-obsessed society, people must become countable, quantifiable, transparent. And this leads to a GROTESQUE new misunderstanding of psychotherapy. Therapy is now conceived as a set of techniques that can be applied to a human being. This makes sense if we see it as a business transaction with a buyer, a seller and a product. But it totally ignores the most basic fact: that therapy is not like a plaster that can be applied to a wound, but is a property of a human relationship. Therapy is about the encounter of two people, and the real work is done not by the therapist but by the patient. As the psychoanalyst Donald Winnicott observed, the therapist provides a space in which the patient can construct and create something. The therapist encourages and facilitates, but whether a therapy takes place or not depends entirely on the patient.

    The patient’s own reality has to be taken very seriously by the therapist. To explore it, to define it, to elaborate it and to see where it will go. No outcome can be predicted in advance. With CBT the divided self has vanished, along with the recognition that grief, despair and frustration strike at the heart of our image of self-possession and fulfilment.

  2. 2 lensgirl53 Feb 8, 2015 at 20:20

    Thank you so much for the update. My daughter has been through the labyrinth of medication and all the side effects on top of having an auto immune disease. I feel your frustration only because of her trials. I pray you will find the answer in the new meds.

    I love the view from your window. I think there is a message of hope in the seasons of change…..even beauty, including the grey dismalness of winter. Probably because I know the spring green of life follows!

    Love and peace to you, Henk.

  3. 3 Philip Rhoades Feb 9, 2015 at 11:06

    Henk,

    Good to hear from you again and good to read the responses to your words. I have just moved out of Sydney to the Central West of NSW and we are having a bit of a heat wave! – it would be nice to be cool ATM. I also like your photo for some reason – maybe it is because it is a picture of part your life . .

    Regards,

    Phil.

  4. 4 philiprhoades Feb 9, 2015 at 11:10

    Henk,

    Good to hear from you again and to read the comments from other readers. I have moved out of Sydney to the Central West of NSW and we are having a bit of a heat wave! – it would be nice to be cool right now . .

    I also like your photo – maybe because it shows a part of your life . .

    Regards,

    Phil.

  5. 5 Evanston Therapist Feb 12, 2015 at 15:09

    Great post, Henk. I wish you the best!

  6. 6 scottsmess Feb 15, 2015 at 03:37

    Well – psychiatrists may use trial and error but at least they don’t use leeches!! And we know a million times more about the brain than we ever did during the Middle Ages so to day that modern psychiatry is Medieval is a little harsh I think. Primitive – maybe as well. In it’s infancy – yeah – that might be a better term in my, but it is a wonder and a good thing in my estimation that we do know anything biologically about the brain and that’s a great starting point. It know it’s extremely frustrating though, when you are trying to overcome something like depression.

  7. 8 markpbeale Feb 17, 2015 at 12:14

    Henk…Your journey to take you up to a place where you feel comfortable to face your external world again….fully functioning and enjoying the simple pleasures has been torturous for you…in the past i have been on a that same journey.i am glad that you are now finding pin pricks of light that are exposing the woods from the trees.May your blogging continue as you find more light in yourself. Bonne Chance….

  8. 9 Saskia Feb 28, 2015 at 15:56

    Thank you for your blog, I recognize so much. I’ve been dealing with depression for many years and it’s very bad again. I’ve had all the different kind of pills and ECT, it just doesn’t work. I feel very desperate but I know just what you say, patience is important. I really hope the best for you too

  9. 10 BJ Hollenbeck Apr 2, 2015 at 11:02

    Thank you for your blog! I stumbled across it during my research to find some way to help my niece. She suffers from kidney disease, Lupus, arthritis, chronic pain and, not surprisingly, depression. Her physicians are experimenting with her ‘cocktail,’ but have yet to find a workable combination to treat all her ills. My husband and I have also been treated for depression, though I have not been as far down that dark rabbit hole as our niece. It is a complex, frightening disorder. I applaud your excellent posts which so well describe the day-to-day trials with which we live.


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