They say it’s the brain, but it’s also the body

It's ALL connected
It’s ALL connected

TBI can seriously mess you up in the head. That’s a given.

But it can also seriously mess with your physiology.

In fact, out of all the problems I’ve had over the years, the physical issues I’ve had have far outweighed the cognitive ones – if anything, they contributed to my cognitive and behavioral issues.

  • Fatigue – bone-crushing, spirit-sapping exhaustion;
  • Problems keeping my balance, which messed with my moods.
  • Heart rate increase – or decrease, as well as blood pressure changes.
  • Light and noise sensitivity.
  • Headaches
  • Body aches
  • Sensitivity to touch, which really messed with my head, as well. Imagine never being able to have human contact… it’s not much fun.
  • Constant adrenaline rush that wired me out, something fierce.

When your brain gets injured, it can affect your whole body. Because as we know, the brain is mission control for the rest of the works below the neck.

 

Advertisements

I lowered my heart rate from 90 to 73 in a minute

Last weekend, when I was recovering from a migraine, I checked my blood pressure and pulse:

100/59 with a heart rate of 90
Before… 100/59 with a heart rate of 90

My heart rate was up, for some reason (this was just after noontime), and my pulse seemed a little off. 100/59 might seem awesome, but it seemed a little low to me.

So, I did my breathing and checked again:

95/66 with a heart rate of 73
After – 95/66 with a heart rate of 73

I was able to bring my heart rate down to 73, which felt better, and I raised my “bottom number” on my BP to 66, which actually felt better.  I don’t want my blood pressure to get too low, and I can bring it up with my breathing.

So, I did.

I made the mistake of not checking my bp and pulse while the migraine was setting in. I’ll need to remember that later, so hopefully I can head it off at the pass… before the stabbing pain sets in.  Who knows? Maybe I can head off the other symptoms at the pass: light sensitivity, noise sensitivity, sensory issues, balance, dizziness, etc.

In any case, this is probably a good thing to do on a daily basis, no matter how I’m feeling. It might save me a lot of hassle – and it’s definitely easier and cheaper than dealing with medication.

Migraines have been under control

trepanning - migraine relief?
Fortunately, I have a better solution than this!

Summary: Controlled breathing seems to be helping me control my headaches, especially my migraines. After years and years of having constant headaches, I believe I’ve found a way to control them. This is good news, because constant headaches are no fun, and they kept me from really living my life.

I’m happy to report: My migraines have been under control – The headache part, anyway. Last week, I had a weird couple of days, where I was definitely altered… very strange feelings, colors brighter and higher contrast, everything feeling like it was moving in slow motion… I didn’t take any meds, because I didn’t have a headache, and I wasn’t actually sure if it was a migraine, or if it was just one of those things that comes up.

I will occasionally have bouts of dizziness (well, not occasionally… more often than that). And I will have my bouts of clumsiness and feeling spacey. Especially when I’m under pressure, feeling emotional, or I haven’t slept, it can be a problem, and with the last days of my current job winding down, all three of those boxes get checked off.

So, I just let it ride. And Saturday evening (after my nap, ironically), the headache set in.

But to be honest, it wasn’t nearly as bad as it has been in the past. Certainly not as bad as when I was cutting back on my coffee and went through that miserable withdrawal that lasted for days. And I actually have been feeling pretty good, without the constant headache. I think I must be doing something right.

The thing that seems to have moved the needle, is that I’m actively working with controlling my heart rate and blood pressure with controlled breathing. I can bring my heart rate down from 93 to 73 in a minute, using my technique. And I practice this on a regular basis, sometimes because I need to, sometimes out of curiosity.

It seems to be helping my migraines.

Now, the thing to be careful of, is thinking that one thing leads to another, when there could be other issues happening, too. I have also drastically cut back on caffeine, which supposedly helps headaches. That’s ironic, because I always heard that caffeine will help a headache, and to be honest, the times when I have been really struggling with the pain, having some dark chocolate or a bit of strong coffee really seems to help. If nothing else, they make me feel human again. I’ve also been exercising more regularly — at the very least, riding the exercise bike for 15-20 minutes each morning, and usually lifting light weights to boot. That could certainly be helping.

The thing is, I couldn’t exercise regularly for a number of years, because the headaches were keeping me from it. Nowadays, I still do get little headaches when I exercise, now and then, but when I do my controlled breathing and relaxation, they go away. Pretty amazing, really.

This is how it goes for me, these days:

Exercise: I get on the exercise bike and ride. I set the resistance to about medium, because I don’t want to overdo it. I’ll bump up the resistance and push myself, now and then, but when I do, I will sometimes get a little headache… which in my experience can turn into a big one — and big problems for the day. I back off on the resistance and check my pulse on the handlebars (there’s a pulse monitor there). If it is really high, I will control my breathing and bring it down. And the headache goes away.

Emotional Upset: My spouse and I have always had a “fiery” relationship. Our discussions sound like all-out fights to people who don’t know us. Our actual disagreements literally make other people run away. It wasn’t a problem for me, when I was 15 years younger (we’ve been together nearly 25 years), but in the past years, I’ve been getting more upset by these kinds of exchanges, and I’ve noticed a connection between the upset I feel and screaming headaches that come on — especially migraines. Sometimes I get so upset, I get an 8-out-of-10 headache (complete with light sensitivity, noise sensitivity, sensory issues, balance problems, dizziness, and nausea) that lasts for days. So, I need to find a way to deal with it. Now, when I get upset and I feel something coming on, I immediately “disengage” and focus on controlling my breathing. Sometimes I will go to a dark room and block out all sensory input. I can usually feel my blood pressure and heart rate going way up… but after a little while (maybe 15-20 minutes) of slowing everything down, I can “rejoin the living” and have a logical conclusion to what was probably a silly argument, to begin with. And no headache to speak of.

It’s pretty cool.

And it’s a relief.

Because now I feel like I can live my life without being in constant fear of headaches and migraine symptoms, etc.

Of course, there’s the other host of symptoms that come with migraine. Like feeling like my left side is carved out of a block of wood. But that’s also diagnostic. It tells me I need to take better care of myself, rest, get something decent to eat, and take the pressure off.

Bottom line is, I figured out a way to manage my migraines, and I’m pretty happy about it.

To medicate or not to medicate

Choices, choices

I’m doing my leg lifts a little differently this morning. I’m going slowly, and I’m not holding onto something for balance, unless I need it. I’ve been having balance problems, lately. Or rather, my usual balance problems have been more of a problem, lately. I’ve almost fallen a number of times in the past few months — while standing up from a table and having to catch myself before I hit my head on the table and/or a nearby chair and bookcase… while starting to walk down a flight of stairs… even while just standing.

So, after talking to the neurologist and my neuropsych and making an effort to notice when I’m dangerously off balance, I’ve realized this is actually an issue. And I need to get it checked out.

So, I’m going to get some autonomic system testing done. I know that it’s been an issue with me, lo these many years, and I need to collect some actual data about it, rather than relying solely on my own observation — which tends to be spotty, because of my Swiss-cheesey memory. If I don’t write things down, it’s like they never happened. And I can’t always take the time to write everything down.

It would just start to get a bit hypergraphic, methinks.

Anyway, over the weekend, I also took some Sumatripan (generic Imitrex), which did knock out the migraine I felt coming on. But it also left me feeling drugged and dopey. I felt “off” all weekend, like I had chemicals in my system. It wasn’t like I was looking for that. I will take meds when I have to. The thing was, I was definitely feeling “synthetic” for a few days. Monday I started to feel better, but Sunday it was like I was in a druggy fog.

I can’t remember if I took the migraine meds before or after I had my dizzy spell, but as it turns out, dizziness is one of the reported side-effects of Sumatriptan. And when I looked at the list of side-effects with my neuropsych yesterday, it turns out that it’s probably not a great idea for me to be taking it, due to possible effects on my autonomic system.

See, here’s the big issue I have with meds: They are dispensed from on high, and unless I have access to someone with an advanced database of indications and contraindications, as well as sensitivity to my situation and an understanding of how things might affect me, I’m pretty much a guinea pig for finding out what’s going to happen with me. And doctors (in my experience) routinely prescribe things that they don’t fully understand. They figure they’ll have me try it out and see — essentially turning me into a science experiment.

I’m extremely sensitive to medications, but nobody seems to take that seriously. Meds disrupt my attention and concentration with the feeling they often give me. Unless I am completely laid out by illness, such as bronchitis or some other major infection that I can’t fight off on my own, the cure can be worse than the illness it’s supposed to fix.

I need to figure things out up front as much as possible, not just find something that’s worked for other people, give it a whirl, and then have my life disrupted by exciting discoveries.

Not when I can take another route to dealing with things.

So, as for the autonomic testing, both the neuro and the neuropsych are thinking I could take a pill to deal with the situation. Please. Another medication? If there is any way on God’s good earth that I can find another way to strengthen the underlying structure of my system, and build myself up that way, I’ll do that. I mean, seriously. Say I do go on a med for my balance. Is that going to help me strengthen my body to maintain balance better? People often have falls — especially later in life — because their systems are weakened, they don’t have the muscular control to catch themselves, and their reactions are slowed. If I use a pill to fix my issues, then where is the incentive to strengthen the underlying “framework” that keeps me upright?

The direction I want to take with the autonomic testing is NOT pharmaceutical. It’s structural. I don’t want additional chemicals coursing through my veins, when I can offset the issues I have with strength and balance exercises, eating right, and getting adequate rest. I need to approach this systemically, not have an intervention which may actually weaken me.

It’s pretty irritating for my neuropsych and my neuro to be so pill-happy. I’ve been on this rehab quest for about 7 years now, and my neuropsych says they’ve never seen a recovery like mine. Okay, out of all their other patients, how many of them are on medication?  I’m not. I refuse to be — especially for things that I can address and strengthen myself — or compensate for (by strengthening other aspects of my neurology).

It’s frustrating and alienating for them to be so eager to prescribe meds. Maybe they just want a quick way to relieve suffering. That impulse is noble, but the pharma aspect of it doesn’t sit well with me.

Anyway, we’ll see. I know where I stand, and I can’t let them bring me down.

Well, so much for my new neuro…

The Neurologist by Jose Perez (Oil on Canvas, 24 in x 30 in, 61.5 cm x 77 cm)

Last night I got a letter from my new neuro — you know, the one I had to wait five months to see, because the insurance company wasn’t transferring their credentials from their old hospital, and they didn’t aggressively follow up…

Turns out, due to family obligations, they need to move out of state. They’re leaving at the end of June.

As they say in a crowded waiting room… Next!

I’m not sure how I feel about this whole thing. It’s annoying and disappointing, but it’s also kind of a relief.

On the one hand, I had to wait months to finally get to see them, but I was hoping it was worth it. It seemed like they were someone I could work with. I’ve been wanting to find a decent neuro, and they came highly recommended, so I waited. And I felt like I could work with them.

If I’m going to work with a neurologist, I really need to establish an extended relationship with them, so they can understand me and I can understand them. It’s not easy for me. It takes time. So, having them leave now is a blessing in disguise. At least I didn’t sink a lot of time and energy into that relationship.But the fact that I had to wait five months to see them, is five months of lost time — the whole time I could have spent finding another neuro to work with. And not had them skedaddle.

On the other hand, I’m not sure I want to develop a relationship with a neurologist. That initial visit really took the steam out of me. Covering all the details was draining, and even though I did feel like we got off to an okay start, it’s still kind of thrown me into a tailspin, having to factor in the whole diagnostic adventure. Migraine. Photophobia. Possible dysautonomia. Etc. I’ve got a lot going on with me, and I’m accustomed to managing things myself. So, adding in more input and requirements (especially meds) is pretty disruptive. It means I have to rethink a lot of things about my life. And make some changes that aren’t easy for me to make.

And there’s no guarantee they’re going to actually help me beyond what I can do for myself.

It’s nice to have some Imitrex handy, in case I get one of those crippling migraines again, but to be truthful, I don’t know that I’d even take it. Which is worse? The pain or the side-effects? At least with pain, I can function. Side effects… who knows?

The other thing is, all the doctors I’ve met (including this neuro) seem to have preconceived notions about how people who’ve sustained multiple concussions function and behave. When I tell them my history, they literally look at me like I have two heads, and they talk to me more slowly.

It’s almost like they expect me to be an idiot, or something. I mean, yeah – I do tend to forget things that people tell me in a matter of minutes, if I don’t take extra steps to remember it. But that doesn’t mean I’m an idiot. Nor does it mean I’m less intelligent.

Argh! It makes me crazy when people equate memory with intelligence or the ability to function. I mean, my resistance to short-term interference is close to the very bottom of the scale — that hasn’t changed in 6+ years of rehabilitation. But does that make me less intelligent or less capable of processing information in different ways? Oh, HELL no!

I simply have a different way of processing things, is all.

So effing there.

Anyway, it’s an amazingly beautiful day, and I managed to get an acupuncture appointment this morning — woot woot! It’s been a while, since I last had one, and I’ve been needing it. Coordinating all this healthcare is a huge pain in the ass. Between neurologists and orthopedists and chiropractors and acupuncturists and neuropsychologists and counseling (which is actually more of a check-in for me once a month to see how I’m doing), plus my day-job, meetings with recruiters, plus all the other things I do with myself, my proverbial dance card is FULL. Sigh.

But that’s changing… I can take the neuro out of the mix. I got my MRI and everything looks fine. I had a neck x-ray this past week, and other than a little arthritis, things are good. Overall, I’m in decent shape, and now I’ve done my periodic check-up for certain key areas that have been concerning me. It’s not any particular disorder. It’s just wear and tear from life. So it goes.

Anyway, since it is such a beautiful day, I’m going out for a walk.

Because I can.

Onward.

Getting off coffee — After the migraine subsides

So, this is interesting. I did something to my system over the weekend, and I came down with a horrific migraine yesterday afternoon. It was the worst one I’ve had in quite some time. I’ve had some of those where you go blind in one eye and the world is spinning and you feel like you’re going to throw up, but I don’t remember the headache and weird feeling and light sensitivity ever being as bad as they were yesterday.

Holy crap.

I really didn’t expect it at all. My weekend was going really well. I was cutting back on the coffee and eating a more substantial breakfast of oatmeal and fruit, along with more fruits and vegetables throughout the day, getting more exercise (I rode the bike a long while on Saturday and Sunday and went for multiple hikes in the woods, up to the top of a nearby hill in our local conservation area), and drinking more water. I felt fantastic, with a lot of energy. I also got some roasted dandelion root tea, to try out as a substitute for coffee. I drank some on Saturday afternoon. It was nothing to write home about, and certainly not a reliable substitute for coffee. But it was worth a try. It was in the coffee aisle at the grocery store, after all.

But I woke up to a screaming migraine after my nap on Sunday afternoon. Couldn’t stand the light, head throbbing, sick to my stomach, feeling dull and drugged. Usually my headaches are just there, but this one was intrusive. Holy crap, whenever I moved, it just thrashed me. Up around an 8.5 – 9 on a scale of 1 – 10. I had a bunch of things I wanted to do on Sunday afternoon, but all I could do was sit in a dark room with my sunglasses on, soaking my feet in a hot mustard bath.

I had half a cup of coffee, ate a banana and a piece of chocolate, took a couple of Advil, and drank water (how’s that for performance enhancement?) and I started to feel better. Not as sensitive to light and not as sick. Still not great, but better than I had been. You do what you have to do.

I suspect this was partly about cutting back on coffee… increasing my exercise… changing my diet… and drinking that tea. All that change was abrupt, even if it was in a positive direction. I have a tendency to overdo things out of enthusiasm, and I think this was one of those times. I’m nervous about the MRI, and my anxiety is really rising. So, to calm myself down, I do things that give me the sense that I have some control over my life — changing my diet, exercising, trying new foods, cutting out coffee.

I’ve done some reading over the weekend about migraines, and they can be triggered by a bunch of things, including changes to diet and activity – check, and check. I know that exercise tends to start a headache with me, and I did start to get a bit of an ache while I was riding the bike — both days. But it’s usually just a headache, not the nausea, crazy feeling, and intense sensitivity to light that had me walking around the house with all the curtains drawn and wearing my sunglasses because even through the curtains, the light was too bright.

So, I did a number of things differently than usual, and I learned my lesson. I need to take things slowly — gradually — not dive in head-first, as I tend to do. Impulsiveness plus anxiety equals — surprise!

And not a good surprise, either. Right now, I’m fighting back more throbbing pain, keeping the blinds drawn, and reaching for the Advil. I don’t want to take the Imitrex, because I don’t know what it will do to me, and I have to be “on” this morning.

So, I need to take things easy and make change gradually. Not bombard my system like it’s a machine. As much as I like the idea of roasted dandelion root tea as an alternative for coffee, I don’t think it’s going to do it for me. I think it really contributed to the migraine. After the pain subsided to a relatively simple headache of “4” on a scale of “10”, I tried to drink it again yesterday evening. And the headache started up again. So, even if it’s not the sole contributor, it did not make things better for me. Dandelion is a natural diuretic, and it has other properties, too, that are used as home remedies.  I got some to get ready for my MRI on Wednesday, so I can flush out my system and not be poisoned (too much) by the contrast agent. But I just can’t do it.

Well, better I learn now, than later. That’s for sure. I’d rather get this lesson out of the way ahead of time, while I have the time to rest and recuperate. I have a busy day on Thursday, so I need to not get knocked out by the MRI on Wednesday. Most people don’t have problems with it, and they look at me like I have two heads when I tell them I get sick afterwards, but so what? I know what happens to me, and I need to get ready.

So, it’s plain water and healthy foods for me, thank you very much.

Onward.

Dangerously dizzy… but life won’t wait

I’ve been increasingly dizzy, the past few days. My left ear is squishy and has been making its presence felt. Pressure in my head, and fatigue… I haven’t had good sleep hygiene, for the past few weeks, and it’s catching up with me.

It’s a scary thing, because it’s so disruptive for my daily life. I have things to do and stuff to accomplish, but if I stand up too quickly or move too suddenly, the whole world starts to rush and spin and I get very sick on my stomach. It also makes me extremely irritable, so I snap out at every little thing, which makes me very difficult to deal with at times.

The only thing that really saves me, is being totally focused on what I’m doing, and not moving much while I’m doing it. Working at the computer is a perfect solution for me, because I have to sit up straight and stay focused on the screen in front of me.

The only problem is, it’s Saturday… a few days before I take off on my marathon trip to see family… and I have a whole lot to get done. Dizziness puts me in more danger of falling or having an accident. If I’m not careful, I can get in a lot of trouble. The last thing I need this holiday season is another concussion — most of my adulthood injuries have coincided with holidays, when I was running around like a chicken with my head cut off and wasn’t paying proper attention. I was fatigued and disoriented… and I fell or had a car accident. Not good.

Yes,  I need to be very, very careful, in everything I do.

I think a big part of the problem I’m having right now is the impending holiday rush. The prospect of driving through several states to see multiple families, over the course of nearly a week is making me a little nervous, and that’s setting off my schedule and my focus.

I have been doing really well with keeping to my daily exercise, which helps.  I just finished my morning workout, in fact, and I feel noticeably better than I did before it. I worked up a sweat and got my heart pumping, which in turn moved the lymph through my system to clear out the grunge. I love lymph. So basic, so essential, so useful. Without it, I’d be in a heap of trouble, and I count my blessings that I don’t have lymph drainag problems, like folks with edema do.

Anyway, I’m feeling better, and I have a full day ahead of me. But I’m pacing myself. And I’ve blocked off time this afternoon to sleep. I haven’t had a good afternoon nap in weeks, and it’s taking its toll. If I don’t nap at least once over the weekend, it catches up with me — and that’s what’s been happening.

And now I’m really dizzy, with a lot of stuff to do, and I regret doing chores last Sunday, instead of taking my nap. I had three solid hours to myself, to use as I pleased, and I frittered away the time on futzing around and doing little chores that took longer than I expected.

Ah, well,  so it goes. At least I’m aware of my dizziness, so I can accommodate it and work with it. When I’m really, really dizzy, I find that keeping my posture ramrod straight and moving very slowly and deliberately helps tremendously. Also, if I sleep a lot and drink plenty of fluids and avoid sugar, that helps, too. I’ve taken medicine for vertigo, but it didn’t help a bit. Anyway, it turns out the medicine is really just for nausea that results from vertigo, not the vertigo itself — at least that’s what the PCP I had at the time told me. Come to think of it, they could have been wrong. They were a bit of an idiot, by average standards. (And it was a scary six months in my life, when they were my primary doctor.)

But now I’ve got a pretty good PCP, and I trust them a whole lot more than the last several I went to. Trusting your doctor is good. It simplifies a lot of things, in many ways, not least of which is the office visit experience.

But more on that later. Right now, I need to stay focused on my dizziness.

Tracking back over the past week, as it’s gotten steadily worse, I have been looking for what I’ve been doing differently that has contributed to this. The one thing that I’ve been doing regularly, that is very different from before, is that I’ve been eating pieces of chocolate to keep myself going. Not just chocolate, mind you, but those little Dove chocolates with peanut butter in the middle. I thought that the peanut butter would give them more staying power, but what I’ve noticed over the past week is how much sugar is in those little puppies.

Zoinks! Who eats this stuff regularly?! They’re dangerous! Sure, they give me a little pick-me-up when I need it — like driving home late from work when it’s very dark, I’m very tired, and I’m having a hard time seeing. But I’m finding that when I eat one, I crave another one about 10 minutes later — like I spike, and then I crash and am worse off than before, so I need another “little” piece of candy to keep me going… and my system gets totally fried by all the sudden, extreme ups and downs.

Which contributes to my fatigue… and apparently my dizziness.

Not good.

So, while I’m doing my errands today, I’m going to remove the chocolates from my car — just throw them out — drink more water, eat more fruit, and be very, very careful when I’m out and about.

The last thing I need is another accident or fall.

Yet more thoughts on TBI and mental illness

This morning (6/9/9), I took a gander at the ways people have been finding their ways to this blog since I first started it over a year ago.

  • 38 people got here by looking for info about TBI/brains and anger/rage
  • 86 got here just searching on tbi
  • 156 got here by searching for info on interviewing
  • 39 people got here by searching for brain info
  • 225 people found their ways here by searching on tbi and mental illness

Apparently, it’s something people are concerned about.

And so am I.

I’m worried. Really, really worried. Because this society seems all too eager to label people “mentally ill” when they really have logistical problems — it’s not necessarily that they aren’t thinking properly, ’cause of some inner psychological conflict going on — it’s that they can’t think properly, ’cause their brains have been rattled or somehow impacted.

And our society seems all too eager to prescribe medicines for psychological conditions — meds which may actually exacerbate the issues at hand.

For instance, as I understand it, the irritability and temper flares that come with TBI are often due to a “constant inner restlessness” that takes up residence in your head after a brain injury. That constant restlessness can be directly related to something called “tonic arousal” which (as I understand it) has to do with how awake your brain is. After TBI, certain functions slow down — processing slows down, connections that were once intact are now broken, so it takes the brain longer to sort things out. And with that slowness comes a decrease in tonic arousal… which also can lead to attention difficulties… which can feed into all sorts of problems that can make you nuts and drive you to distraction.

TBI >>> less tonic arousal >>> increased irritability >>> more meltdowns, rage, blow-ups, etc.

Now, let’s say some doctor or psychiatrist gets hold of a TBI survivor and diagnoses them with some anxiety-related condition, or some other “psychological” dysfunction. Let’s say the attending caretaker prescribes one of those “downregulators” that slows down the processes that can feed into manic/anxiety type experiences. What do you get when you downregulate someone who’s already struggling to keep up? Decreased tonic arousal. Which can mean more irritability, more temper flares, more rage, more meltdowns… possibly increased violent acting out? Maybe?

Downregulating meds >>> even less tonic arousal >>> even more increased irritability >>> more and more and more meltdowns, rage, blow-ups, etc.

I’m not a doctor, but I don’t think you need to be one, to get this connection. Maybe not being a doctor helps you see it all the clearer, without the long-term effects of that sleep-deprived-traumatized-resident fog that lots of docs get hammered by when they first start practicing.

This really worries me — had I mentioned that?

And given how many people sustain TBIs each year, not to mention how many vets are returning from Iraq and Afghanistan with TBI’s and PTSD, etc., it really opens the door to a lot of crappy medicine and pain for the families and friends of the folks who have given their very brains in service to this country.

I think the only thing we can hope to do is educate people — not so much the doctors, because how many of them are listening? It’s about educating “the people” — the patients who look high and low for help (if they ever figure out that they need — and can get) help. Making sure people have access to truthful and accurate and independent information — and giving them easy and useful ways to wield that info as they defend themselves from the quacks of the world, not to mention Big Pharma.

Ultimately, it is up to each and every one of us to fend for ourselves, but a little help would be nice, now and then…

Reverse-engineering my “depression”

I’ve been thinking a lot, lately, about whether or not I’m depressed. I posted yesterday about how someone asked me if I wanted to end it all, and how I said NO, in no uncertain terms.

I’m getting ready to go see my doctor in a little bit, and the first time we met, they thought I might be depressed. They told me so, the second time I went to see them.

Here’s the thing: Going to see a doctor who thinks you’ve got a problem, and who is in a position to “do” something about that supposed problem puts me in a precarious position. I’m not a big fan of pharmacological solutions for emotional issues — some people are chemically and clinically depressed, there’s no disputing that. But if I’m not chemically or clinically depressed, but I’m medicated as someone who is, might that not complicate things even more for me – even more than they already are?

I mean, I have a hard enough time keeping up with my life without my senses being dulled and my processing being interfered with by meds. Plus, some anti-depressants have been shown to produce suicidal behavior in some folks. That’s about the last thing I want.

In my seemingly eternal search for what’s going on with me, what — if anything — I can do about it, and how to best make the most of my amazing life, I have found it quite helpful to first seek to understand the underlying facets and aspects of my situation, before coming up with a solution for what appears to be wrong. I’m an engineer by nature, so in order to move forward with courses of action, I need to understand what all is involved, what the different considerations are, and what my desired outcome is.

Here’s what I think about the “depression” that others seem to think they’ve observed with me:

The first time I went to see my doctor, I was in a pretty wary state. I have not had a lot of luck with physicians over the years, and I have a lot of trouble communicating. I am very aware of doctor-patient power dynamics, and the situation tends to make me nervous. I haven’t the faintest idea, sometimes, how to behave in a way that makes a doctor believe I’m a nice person — I get agitated, and when I do, I can get defensive, combative, argumentative, passive, aggressive, non-verbal… you name it. When I perceive myself to be in danger — and going to the doctor sometimes makes me feel that way — my worst symptoms get triggered and I resort to behavior that is not productive. If I could stop myself or alter that, I would be happy to. But when I perceive my personal safety and self-determination to be fundamentally threatened, well, all bets are off.

Anyway, when I’m in this place, it’s not good. And I’m keenly aware of it. So, when I went to see my current PCP for the first time, I was bound and determined to be on my best behavior. My relationships with my 3-4 prior doctors (I’ve had at least that many, over the past 10 years) ended on sour notes, all across the board, and I didn’t want that to happen again. I HAD to at least try to get off on the right foot with this doctor, who was recommended by someone I really trusted (a rare thing). I did not want to completely screw up my new relationship. I wanted to build a working partnership that could really work.

Needless to say, I was a bit stressed, going into the office. I was on high alert, trying like crazy to make sure I didn’t say or do something that would completely irritate, antagonize, and alienate this individual. It was almost like holding down a wild animal … trying to hold back a large, aggressive dog on a leash… All the past failures with doctors kept running through my head, and all I could think was, “Don’t screw this one up… Don’t screw this one up!”

I thought the conversation I had with the doc went really well. I liked them and they seemed really on the ball. Engaging and compassionate and highly intelligent, not to mention a little intuitive, which can be helpful when I’m at a loss for how to communicate to someone. I wasn’t rude, I didn’t say or do something that was completely inappropriate, I didn’t lash out, I didn’t make a snide comment about something that alarmed me, I didn’t make myself look like a total fool. I was poised — I thought — and polite and coherent. I was really happy.

But when I went back, the second time, the doc said they thought I was depressed.

I suppose on the surface it might look that way — apparently low energy,flattened emotional effect, slow responses… Over at The National Institute of Mental Health, they say:

Symptoms include:

* Persistent sad, anxious or “empty” feelings
* Feelings of hopelessness and/or pessimism
* Feelings of guilt, worthlessness and/or helplessness
* Irritability, restlessness
* Loss of interest in activities or hobbies once pleasurable, including sex
* Fatigue and decreased energy
* Difficulty concentrating, remembering details and making decisions
* Insomnia, early–morning wakefulness, or excessive sleeping
* Overeating, or appetite loss
* Thoughts of suicide, suicide attempts
* Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment

And on the surface, it looks like a lot of them could have applied to me.

But check it out — I didn’t have low energy. I had extremely HIGH energy. And I was just trying to keep it reasonably bottled, reasonably civil, reasonably managed. I was irritable and restless, yes, but hell, I was trying to establish a new relationship with a person who ultimately has a fair amount of sway over my life — and in ways I’m not always comfortable with. Plus, the difficulties concentrating, remembering details, and feelings… hello, can we say TBI symptoms? I mean, come on… not every mental challenge is psychological. Sometimes there are logistical and physiological reasons for what goes on with me.

Now, the thought occurs to me that the fact that I’m a long-term multiple tbi survivor could make my anaylsis suspect in the eyes of the experts. After all, I supposedly am brain-damaged or something like that… (to which I reply, “Who isn’t?”)

But if there’s one thing I know, it’s my experience, and as much as the established experts may disagree with my habit of self-assessment and analysis, and they may say I have no standing to diagnose my own condition, the fact remains that there’s a whole lot in my experience that I cannot now — and perhaps never will be able to — express verbally. There is a lot inside me that may never get out. And the people who have the power to medicate me, commit me, lock me up, or tie me down, can never know the full spectrum of feelings and thoughts and experiences inside this singular head of mine.

Anyway, I’m getting all agitated, and I want to chill out before I go see my doc again.

So, I’ll quickly talk about my therapist, who the other day asked if I wanted to end it all.

NO, I didn’t want to end it all. I was tired, I was taxed, I was coming off a neuropsychological testing session that brought me nose-to-nose with some of my most persistent issues and made me feel like crap. Plus, I was having major sensory issues — with my hearing and my vision being so sensitive, they were driving me nuts. And my familiy situation has been tense, off and on, with money being something of an issue, and my job situation being under the gun. I was trying to sort things out in my head, trying to keep my balance, trying to just get clear on some things, and I was feeling physically low. I was also concerned about my safety, since I was driving home later at night, and I’ve been having some problems dealing with the headlights of oncoming cars.

My mind, quite frankly, was really over-taxed with trying to figure so many things out and trying to come to terms with a lot of stuff in my experience that hasn’t been pleasant, but has been… there. If anything, I wasn’t depressed — I was over-stimulated, and I was trying to sort things out. I was trying to just stay chilled and not freak out over all the unknowns in my life. I wasn’t depressed — I was busy thinking things through and trying to keep my balance. Trying to keep civil. Trying to be productive and pro-active. And I was tired.

I think the big reason I get freaked out over the idea of anti-depressant medications, is because the last thing I want/need when I’m in a place like that, is to have my brain slowed down and interfered with. I need ALL my faculties to figure out my life, sometimes, and if I introduce medication that mucks with my mind — even if it makes me feel a little better — then my most important coping tool is compromised. The very thought of slowing down my thinking or interrupting the natural flow of my brain — even if that natural flow is uncomfortable or “depressing” at times — really concerns me, and I feel like my very survival is being threatened.

I can’t just jump on the pharmacological bandwagon, in hopes of patching up little bumps in the road. I need all my faculties, even if they are impaired in some ways at some times, to get by in the world. And if I spend my energy — or divert it — to smooth over the little issues, then the bigger core issues may be overlooked and never constructively addressed.

For those who are in need of anti-depressant medication to get through life… who are otherwise incapacitated by depression and are in danger without intervention, I say “Mazal tov and good fortune to you.”

But when I just seem a little “down”, I’m not necessarily depressed. Could be, I’m just working really hard to keep my head clear and function in a productive, polite, pro-active manner that doesn’t pose a risk to myself and others, because my brain sometimes misfires when it’s under pressure.