First to consider, I suppose, is the age-old question: the chicken or the egg: which came first? An interesting intellectual exercise, no doubt, but isn’t the energy expended in trying to decipher this dilemma rather futilely spent?
How about if we let folks with more time on their hands tinker around with this particular debate, ok?
Next up: Nick Hornby asks, in his thought-provoking novel High Fidelity, when considering some of his favorite songs (“Only Love Can Break Your Heart,” “When Love Breaks Down,” “How Can You Mend a Broken Heart,” “I Just Don’t Know What to Do With Myself,” etc.): “[w]hat came first—the music or the misery? Did I listen to music because I was miserable? Or was I miserable because I listened to music? Do all those records turn you into a melancholy person?” (pp. 24-25)
Again, more of life’s great questions that I think I’ll leave to the pundits and amateur therapists & philosophers out there who focus on our popular culture.
All of this is just a weak lead-in to where I’m really going with this self-reflective, self-indulgent discourse today: my own questions about chronic pain and depression. In a 2003 Stanford University study, not surprisingly, the correlation between chronic pain and depression was found to be quite high: sufferers of one likely needed treatment for both. “The question now is which comes first: the depression or the pain,” they asked. Of course, I think it likely works both ways. For example, just as depression is common among individuals who suffer from lower-back pain, it also appears to be true that depressed individuals can develop lower-back pain.
In my case, I have lived rather my entire life wondering about such issues. After approximately 40 years of chronic physical pain (beginning in my early 20s), the downturns to my physical self are quite typically mirrored in a mood decline. And, then again, when an outside entity or event exerts a change to my emotional well-being, my body almost always follows. The peaks and valleys for my affective state completely parallel my physical ups and downs.
I was reflecting today on the myriad of Thanksgiving Days I’d spent alone, and on some that I’d spent with special people in my life. One of the most memorable was twenty years ago today: Thanksgiving Day 1986…isn’t it amazing how time flies.[ohmygod: Ronald Reagan was president on that day!] It was surely an entirely different world for me then.
I was living in Corvallis at the time, as I had for the previous 16 years. I had moved there to go to grad school in chemistry at Oregon State University (OSU) during the summer of 1970, and continued to reside there after I finished up that advanced degree; it had become home more than anyplace ever had. Although I arrived in Corvallis as a college graduate, I actually did a whole lot of my “growing up” in that town during my 20s and 30s. I was divorced there in 1978. I started my own path of personal growth and development in a serious way there when I entered therapy with Linda Carroll in 1980. I began the OSU master’s degree program in counseling in 1982. I went through an alcohol diversion program there in 1983-84 as part of my DUII experience. And I met J there in 1985.
Linda and J are two of the (top three) people that have had the most influence on my life’s path. With J, it was in the form of a significant-other relationship that lasted a couple of years, encompassing that Thanksgiving Day twenty years ago.
J had just separated from her husband in late October that year, and ended up living in the same apartment complex as me. When she left her marriage the nature of our relationship dramatically changed, and we were in a very close and intense phase by Thanksgiving. As I recall, we rented about six or eight movies to watch that weekend; it was in the time before we even owned our own VCR, so, I remember, we rented the machine to play the movies as well. (Ah, the good old days!) I only remember one of the movies we watched that day, namely Sophie’s Choice. Very moving.
It was a gray and wet and cold weekend outside, but it was a close and intimate one in: characterized by a level of comfort and care and celebration that I have rarely found in my life, before or since.
In my most recent entry regarding the experiment with low-dose Naltrexone (LDN), I mentioned that there seemed to be some improvement in my CMP (chronic myofascial pain) symptoms, though I had, at the same time, developed some additional pains after 12 days on the drug. Here’s another report on my LDN experience.
I believe the LDN trial was probably worthwhile, but, for me, it just didn’t work out. The additional pain symptoms overtook any possible gains I was noticing just one day after my last report. So, after 13 consecutive nights on the drug, I discontinued it for the next two. Amazingly, after backing away from the medication for just that short period of time, the tendonitis symptoms in my arms began to recede. I had been reading on the LDN listerve that some individuals need to start LDN at an even lower dose (1.5 mg per night) than I had been taking (3 mg) in order for the body to adjust. So I started back on the drug, taking one pill every other night for the next two weeks (another 7 pills). All told, I took 20 of the 30 pills I had been prescribed, though I have now stopped altogether.
I am completely distressed to report that I am in worse shape than when I started; the last pill I took was six nights ago and I’m still looking for an improvement in the new and additional pain symptoms that ultimately resulted. Although my arms have seemingly recovered, I am now experiencing more back pain than ever before, and in new locations. It has me rather scared about what I may have done to myself, though the dose of the drug was so low and the time period so short, I’m hoping that if these new symptoms are at all related to the drug (and not to the hugely increased stress in my life in the last week), then I can look forward to the pain backing off in the next few days. However, as of yet that has not happened, and the pain level is really getting in the way of normal life. I took a day and a half away from work this last week because of it, and I’m likely going to need some more time away tomorrow if I can get in for an appointment with my chiropractor in Eugene. I have decided that I need help to deal with this.
My advice to anyone trying the LDN approach is to be very watchful and mindful of what you’re doing. At the first sign of unpleasant side effects (which are supposed to be practically non-existent, but in my case was not so), critically evaluate what you might be doing with/to your body. LDN was not approved for many of the things it’s being used to treat. Be careful out there.
I’ve previously written about my struggles with “fitting in.” This has been another one of those weeks, and especially one of those days, when I’ve re-engaged with that issue. I’m in a pretty much “glass-half-empty” kind of space tonight as I contemplate a few indicators of a life that’s not working all that well at the moment. So, here they are: how you might tell your life could be in better shape…
Losing a job that you’d had for nearly a decade. Being ignored, unappreciated and unceremoniously dismissed in the process.
Spending the best hours of every day on the downhill side of life working and looking for work. (Well, and writing the occasional blog entry.)
Worrying about health. Worrying about safety, security, and stability. Worrying about worrying to death.
Finding work that is merely temporary. Being treated like a temp.
Having (or at least taking) no time to stop and smell the roses. Having no time to produce art. Having no time to read a novel.
Barely enough energy to get out of bed, lots of times, just imagining the difficulty level of the day ahead.
Constant, chronic myofascial pain, accompanied frequently by headaches and symptoms of irritable bowel syndrome. Other strange aches, pains & afflictions and occasional infections.
Coming home after work and always finding that it’s another evening alone. And, consequently, anticipating that dying and death will also come very alone.
Spending part of every evening taking a hot bath, trying to soak away some of the pain. Easing into the hot water, being overwhelmed with hopelessness. Feeling, fighting, the inclination to sob.
Feeling the large part, of most every day, like a misfit.
It wasn’t that long ago I went to the movies almost every Saturday afternoon. In recent times, though, that behavior has all but disappeared as the product from Hollywood seems to be more and more drivel-of-the-mindless-type all the time. Until Friday (two days ago), the last movie I saw in a theatre was sometime early last summer before I moved south.
But when I was in Eugene on Friday, I decided it was time, again, to take in a first-run film…so I went to see Stranger Than Fiction on its opening day. This was a rather odd choice of a movie for me, as anything with Will Ferrell in it is bound to be rather juvenile, isn’t it? I mean, after all: Talladega Nights: The Ballad of Ricky Bobby ? Give me a break!
Despite these thoughts, though, I had seen the movie trailer and it seemed oddly intriguing. Also, it had other interesting cast members such as Dustin Hoffman and Emma Thompson, actors that generally appeal to me. So, given that I was in the mall right across the street from the theatre, I said, what the heck…
This movie tells the story of Harold Crick (Ferrell), a single guy, who (rather like me, I’m afraid) “lived a life of solitude. He would walk home alone; he would eat alone. When others’ minds would fantasize about their upcoming day, Harold just counted brush strokes…” (well, no, I don’t count strokes as I brush my teeth, thank you very much).
The passage, in quotes above, is from the voice (Emma Thompson’s) that Harold begins to hear in his head one morning while he is brushing, a voice that narrates the events of his life as they happen, a voice that speaks, according to Harold, “about [him], accurately, and with a better vocabulary…”
The incessant voice is quite annoying, and it was heading in the direction of totally immobilizing him (as it was the only way to stop the running narration). That is, until one day, the voice observes, “little did he [Harold] know that events had been set in motion that would lead to his imminent death” … an observation that, naturally, tips Harold over the edge. He’s going to die? Imminently ??
Having already sought help from a psychiatrist (played by Linda Hunt) – who simply wants to medicate him – Harold then decides to seek assistance of another type, this time literary help in the form of literature professor Jules Hilbert (Dustin Hoffman). The dominant questions become, after Jules finally decides to pursue the investigation:
is Harold’s life a comedy or tragedy? and
what are the possibilities, among living authors, for the identity of the narrator’s voice?
Naturally, as it turns out, Harold is the character in a novel being written by the Emma Thompson character, author Kay Eiffel. And it is Eiffel who must figure out a way to kill off Harold, as all the heroes in all her books always die in the end.
Along the way, however, in a totally romantic-comedy manner (and coincident with the decision that his life is a tragedy), Harold has an incredible thing happen to him. He meets bakery-shop owner Ana Pascal (deliciously portrayed by Maggie Gyllenhaal), and begins to think about her all the time. Although love has (apparently) never been a part of his life before, it becomes a dominant element now.
Despite all this, Eiffel continues to struggle mightily with just the right way to end Harold’s life. As die he, inevitably, must.
As Roger Ebert points out in his review of the film, the question of how (or even whether) to kill off Harold “is the engine for the moral tale.” Ebert continues…
How rare to find a pensive film about the responsibilities we have to art. If Eiffel’s novel would be a masterpiece with Harold’s death, does he have a right to live? On the other hand, does she have the right to kill him off for her work?
I suggest you go see Stranger Than Fiction and wrestle with the issues raised. I don’t think you’ll regret the time you spend engaged in your pondering mode.
