A Fresh Look at Depression and Chronic Illness

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by Dr. C |

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When everything was at its worst,
the darkness engulfed me.
I yell out, “I hate my life.”

In 2017, an estimated 7.1% of all U.S. adults had been diagnosed with depression at some point in their lives. It is much worse for those with a chronic disease; up to 50% of those with Parkinson’s experience depression. This means many people did not have noticeable signs of depression before developing Parkinson’s. I am one of those people.

Depression and chronic illness are intertwined. Grief is connected to the losses caused by the disease. There is the feeling that no one can truly understand the intense suffering I endure. Then there is the pain — every day, unrelenting. Add life stressors (such as moving across the country in the middle of a pandemic, and unhealthy habits in response to the stress) and the result is a compost pile fertile with triggers for depression.

To slow the development of depression I changed my reactions to the triggers. Life is quiet in our new home. And work on the new sanctuary is proceeding nicely. I developed a new way of looking at my chronic disease, thus decreasing the grief. Reaching out and connecting to others has soothed the loneliness. Regular exercise and pain management manage overall pain.

After these depression triggers were tamed, I discovered two things: First, there is the physical appearance of depression due to the contortions imparted by the disease. Second, there is a brain stimulus abnormality that creates surges of exaggerated emotion. Both contributed to my falling into the darkness. When I looked in the mirror I saw a stooped old guy, head down, not smiling, not engaging, and grumpy. Here was a depressed man. The exaggerated emotion of frequent sadness festered in the new caricature.

Once I got out of the darkness and back into exercise with healthier habits (such as meditation), I began to question the utility of sadness. Meditation is like standing in a pond. At first, it’s a raging storm, waves lapping up against my legs, fierce wind everywhere, dark clouds, thunder, lightning. There are a lot of signals coming into the brain from many different places so it’s hard to meditate. Acceptance of my map to well-being, healthy living, and practicing mindfulness are all helpful.

Standing in the stormy pond I can watch calmly as the storm passes through me. The surface of the pond becomes as still as polished mirror. It only lasts a few seconds before I have thrown the proverbial pebble. Last time I was there I felt the ripples before the storm, a tickle against the skin on my legs. I looked up and felt a gentle breeze on my cheek. I realized the ripples were driven by the breeze. Then I heard a faint cry in that breeze. We are born helpless and instinctually cry out when in pain or when our survival needs aren’t being met. The exaggerated surges of sadness are tied to this instinctual need to be nurtured.

There is nothing wrong with wanting a little nurturing. I’ve advocated for healing hugs. The problem comes when I let sadness run rampant in my brain — unrestrained, contaminating everything. It leads quickly to frequent sadness, then to overwhelming sadness. I get angry at feeling so sad. Soon, I’m spinning around in a dark place and I can’t find the door. Feeling hopeless, I say, “I hate my life.” I know the term “darkness” may have religious connotations, but I am not using it that way. Think of it more as a brain darkness. The brain is so focused on fight — light — nurture-seeking that it cannot see anything else. One is blinded to all other forms of perception that could be generated by other regions of the brain. In hindsight, I felt blinded. Unfortunately, when in that darkness, I am convinced of my own point of view. It is difficult to navigate well.

Reframing depression as instinctual brain signals designed originally to enhance our survival radically changed my outlook. I clearly see the need to be nurtured is often not connected to anything that anyone can do to change the situation. Asking other people to address my need for nurturing, when there’s nothing that they can do, is ignorant and possibly harmful.

I tore up that depressed old guy caricature. I cut my hair and my beard and I’m exercising my mouth into a smile more often. There is a new guy in town.

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, Bionews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

Mike Hoisington avatar

Mike Hoisington

Thank you Dr. C for your informative post. I know pain and depression are intertwined. I suffer from nerve pain through my entire body. My body “shivers” all day long and I have to clench my teeth to stop chattering. I do suffer from depression. I have been heard saying “I hate this body.” Even if I do not “feel” depressed, my normal face tells a different story and it takes effort to not frown.

The constant pain and depression often leads me to have an insatiable desire to seek relief for the discomfort. Any activity that actually relieves the suffering has been short lived and addictive. I suffer from several nagging thoughts. I want to literally run away from everything and everybody. I want to find some kind of medication that will take away the suffering while allowing me to function reasonably well. My words I have to say to myself is: “This feeling is just my body, there is no actual reason to be depressed.”

I will make comments in the post by Dr. C about what to do with pain and depression in his post: http://parkinsonsnewstoday.com/2020/07/17/tips-managing-chronic-pain

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Jacqueline avatar

Jacqueline

I relate to what you've written. I have GI issues with severe nausea and pain daily - I too shiver all the time and pray for anything that will bring relief. It's hard to fill these long days of discomfort - just doing my best to get through day by day.

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Kellie avatar

Kellie

Author Dr. C beautifully written. That’s exactly how I feel today and everyday.

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Dr. C avatar

Dr. C

Hi Kellie ~ Thank you for sharing your feelings. I am trying to discuss what many PD patients experience, and hopefully, through a series of upcoming columns, identify some good news and suggestions about handling the depression and other emotions. Thanks for reading my column, and keep checking in with Parkinson's News Today for more shared information.
Dr. C.

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Patricia avatar

Patricia

I was very much mooved by this article. I'm only a mother watching all these changes in humor, sadness, feelings of loneliness, even within a family. It breaks my heart to see and know how sometimes my dear relative suffers from all theses feelings of loneliness, sadness, reactions to some people's lack of capacity to understand the LONELINESS and SADNESS is caused by the desease. I believe this is one of the worst feelings caused by the hard hearted family members who just criticize this dreadful illness as "bad temper", lazyness, and other stereotypes.God bless these who are fighting the effects of Parkinson's amidst incomprehencive familys.

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Dr. C avatar

Dr. C

Hi Patricia ~ thank you for that moving assessment of challenges you and your loved one face within family dynamics. Often other people "outside" of the Parkinson's world cannot associate with the emotional feelings with PD. I like how you identified the stereotype and hope you read my column on "Putting Your Best Face Forward". I have some future columns coming out soon on Parkinson's News Today that discuss the exaggerated emotions often associated with Parkinson's. Thanks for reading my columns and for checking in with Parkinson's News Today columns and research.
Dr. C.

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