Dealing with Depression

[murlough23]

There's no easy way to lead up to this, so I'm just gonna say it. My wife is battling a pretty severe depression. Some days she tells me she's entertained thoughts of hurting herself. I'm not sure what to do about it, because on the one hand, I want to be a supportive husband and not be one more aspect of her life that's putting pressure on her, but on the other hand, I'm kind of tired of the apathy and the "completely tuned out from real life" attitude that she's had lately, and part of me wants to put my foot down and say, "You're hurting our marriage, stop it."

It's gone on for the better part of the year now. She's been a bit unhappy about her work situation, about the fact that she has to go to school, and y'know, have actual responsibilities if she ever wants to have a better working life, for over a year now. Y'all have heard about her frustrations with teaching preschool before and her reasons for getting out of that; she had been pursuing a degree in library science and now she's telling me she's completely lost interest in it and has already dropped one of her two classes this semester and is very close to giving up on the other one. It feels like so much wasted time, and when I ask her the big question - "What do you want to do with your life that will make you happy?" - she doesn't know. Except for being a stay-at-home mom, which requires a kid and a husband who can provide for two of you, and we've been over that one. And even then, honestly, I'm not convinced she'd be particularly happy, because I don't think she's truly fathomed the amount of work and stress involved in parenting.

She's been seeing a Christian counselor since last year, at the recommendation of one of our pastors. She's been taking anti-depressants, and I believe those can work for short periods of time (I've taken them myself in the past) but that they can really jack up a person over the long term. These days she's almost always tired, wanting to sleep through most of the day, more out of boredom than anything else. Even stuff we used to enjoy together doesn't interest her all that much - she never knows where she wants to go out for dinner, what she wants to do with an entire free Saturday that we have to spend together, etc., and we can't watch much of anything on TV together without her dozing off in the middle of it. It's like she's checked out of life, and I don't know if the drugs are doing it or if the drugs are preventing it from being more severe than it already is.

If I've seemed more than a little pissy for, oh I don't know, the better part of the year and a good chunk of last year, then well, this is why. I feel like everything I enjoyed about my marriage (and thus, much of what I enjoyed about life) is being stolen right out from under me, and I don't know how to fix it. I knew I was marrying a person who was prone to occasional bouts with depression when I said "I do", and shoot, I've been through it too, so I figured I could deal with it. But I've never seen it last so long or have such potentially severe consequences. I feel like I'm getting ripped off because she just mentally checked out at some point and doesn't feel like trying any more.

So yeah, I guess we could use some prayers here.

[bethany]

I'll be praying for both of you. I've dealt with bouts of semi-crippling depression in the past, and my husband deals with some acute anxiety - we've both done counseling, and medication, and thankfully the episodes have never been extremely long-lasting or totally debilitating for either of us. I can only imagine how wearing and frustrating it would be to be dealing with it for years, for both of you. No good advice here; just prayers.

[Vlad!]

You seem to be aware of this already, but be very very careful about long-term use of medication. This is one case where the cure is very much worse than the disease when taken over long periods of time.

The articles that served to shape my view on depression are these two; while not submitted to a peer-reviewed journal and probably not scientifically rigorous, a lot of the information provided therein rang true with me back when I was finishing up my undergrad. That advice prompted me to make some lifestyle changes (which I'll describe briefly in a minute) that I think kept me sane through grad school.

I came to the realization that a certain amount of the clinical symptoms we label as depression is probably inevitable given my profession. As this article states, depression is important for those who make their living through sustained thought and concentration because the 5HT1A receptor is one of the brain's mechanism for neurological health and is also a receptor that binds to serotonin. I interpreted this to mean that I needed to take steps immediately to encourage proper mental health. I don't know if my results are typical and recommended, but they worked for me.

First, I kicked caffeine. As I saw it, the best way to make my brain work the way it's supposed to was to eliminate the chemicals that I used to alter the way it worked. After that horrible, horrible week, I set up a regimented sleep schedule. Different people need different amounts of sleep, and I discovered that without caffeine the amount that I needed was above average. Rather than forcing myself into an unnatural sleep schedule just to give myself more time in the day (time which would be spent in a hazy, agitated state), I decided to just roll with it. I discovered that naturally I tend to fall asleep between 11:30 and 12:30 in the evening and wake up sometime between 8 and 9. This schedule is already conducive to a normal (well, computer-science-normal) lifestyle. It's the schedule I have maintained to this day; I rarely wake up to an alarm and I rarely have trouble falling asleep. I also never need or take a nap in the middle of the day.

I also decided to take time to let my mind recover. I took up sitting outside on the steps of my apartment just staring at the trees or the sky. Whenever I was feeling overwhelmed or anxious or in that state of mind where I feel like I need to be doing something but I couldn't enjoy doing anything, I would do this for about fifteen to twenty minutes; not looking at my watch (I'd usually take my watch off and leave it inside) but just letting my mind relax. In addition to this, I resolved to ride my bike more for transportation rather than driving or riding the bus. A bike ride is a slower pace so the mind isn't always on edge trying to keep from dying in an auto accident, there aren't the frustrations of traffic, and a level of low-grade exercise is good for serotonin levels without exhausting the brain and causing adrenaline levels to increase.

It's hard to get out of a depression. This is especially the case in our modern society, because so much of what we do involves around constant brain stimulation, and that's not at all what we're designed for. Watching TV or even reading can be too much stimulation for an already overstimulated mind, but when your brain is all revved up it's hard to do what it is you need the most, which is a slow walk through the park or a quarter-hour rest on a park bench.

The other weird thing that science isn't quite able to explain is how effectiveness rates of antidepressants are plummeting and the effectiveness of placebos is increasing. Yes, in double-blind studies, even established antidepressants like Prozac see only a 5-10% better effectiveness rate than placebos. This isn't because antidepressants are becoming less effective so much as that placebos appear to becoming stronger. Mind officially blown.

What I read into this isn't that you should start feeding your wife sugar pills to ease her depression but that a positive attitude is as important as medication when treating depression.

I've also found that what helps me is, as the Scientific American article I linked earlier suggests, is to enumerate my problems, break them into chunks, and write them all down. I don't even have to come up with solutions (indeed, trying to come up with solutions is often counter-productive at this stage). The mere fact that I have a piece of paper which has a list of everything that's currently going on in my life that's stressing me out helps calm my brain, because it doesn't feel like it has to remember all this stuff--it's there on the paper.

I hope that some of this rambling post has been helpful in some way. I'll include the standard disclaimer that I'm not a professional doctor, psychiatrist, pharmacist, or indeed anything that might suggest I know what I'm talking about. I know that phorumers are already smart enough to take the advice of Random Internet Dude with the grainmountain of salt it deserves, but it's always worth reiterating.

Of course, in addition to all this advice I will definitely give you both my prayers.

[Wildcatblue7]

Bless your heart, David.  I don't have any good advice--I've been in this situation, but primarily in your wife's shoes--but I will be praying for her to rebound and for you to have patience.  I know it takes a double-dose of strength to be the one juggling the emotions of a depressed person. 

Honestly I can't pinpoint one thing that made me leap out of depression.  When I get stressed (i.e. right now) I do tend to feel depression pulling at me.  When I was in high school, I don't know exactly what triggered it or why it got so bad, but I do know that I had to give myself a kick in the pants to break free from it.  It's strange, but you do get to the point where depression becomes part of your identity and it is really difficult to realize that it is not, actually, a friend.

[RedcoatJones]

David - I've been where you are. My wife has had a couple of serious bouts of depression/anxiety. To be honest, the first time she used a mix of counseling and short-term medication (11 months) to break the cycle. It reared its ugly head again when our daughter was born this year (postpartum depression), but we recognized the signs a lot sooner. She still took medicine for about 5 months, though.

We're not fans of the medicine, though. What helped more than anything was her having people she could talk to who had been through depression - or were working their way out of it, too. This was frustrating for me, because I'm the farthest thing from depressed - I'm probably clinically optimist. It's hard for me to understand how depression works, and it took a lot for me to just be there the best I could.

I'll be praying for y'all. I don't have the answer to your wife's situation, and I know how hard it is to be the observer who wants to "fix it." You can't. You can encourage her, but the healing can't come from you. Which sucks.

[murlough23]

Thanks everyone, for your empathy and words of advice and offers to pray. Some specific comments:

You seem to be aware of this already, but be very very careful about long-term use of medication. This is one case where the cure is very much worse than the disease when taken over long periods of time.

I've told her that I hope this medication isn't something that she'll need to be on forever - the idea is to ramp down as your mood begins to stabilize, to the point where you can safely stop taking the medication. I do know that these things are a bit of a crapshoot - I have a friend who is a pharmacist and who has explained that one body may react differently to a certain molecule than another. So it's a bit of trial and error for doctors trying to figure out which anti-depressant will help their patient - and some do run the risk of making your mood swing even wider than it otherwise would. It's something that has to be monitored carefully, so whenever she expresses some of these extreme thoughts, I tell her to make sure she's reporting this stuff back to her doctor and her therapist.

The articles you linked to are pretty long, so I'll have to take those in later.

First, I kicked caffeine. As I saw it, the best way to make my brain work the way it's supposed to was to eliminate the chemicals that I used to alter the way it worked.

This step is more or less already done - my wife hates coffee, rarely ever touches a caffeinated soda, and usually drinks decaffeinated teas. If she ever takes in any caffeine, it's in the occasional non-decaf tea, or in chocolate, which is a minimal amount compared to caffeinated beverages. She never uses energy drinks or pills to keep herself awake. She's just never been big on most caffeinated things. Given this information, you'd think I'd be the one who was depressed (though a much larger caffeine intake at other times in my life does help to explain some of my bouts with it).

After that horrible, horrible week, I set up a regimented sleep schedule. Different people need different amounts of sleep, and I discovered that without caffeine the amount that I needed was above average.

That's interesting, given that she's not a caffeine addict and never has been. She can easily sleep 10 or 11 hours on a regular basis, though I don't know how solidly she's sleeping through the night. I've heard that women require more sleep than men on average, but this still seems like an extreme amount to me. On a day when she doesn't have anywhere important to me and we don't come up with anything particularly interesting to do, she'll sleep in until 10 or 11, come back in the afternoon after we have lunch out or whatever and take a nap for several hours, and still conk out between 9 and 10 in the evening. Her normal work day is about a 4-hour shift that starts at 8 or so in the morning; she gets up a little before 7 on weekdays to get there on time, and presumably takes a nap most afternoons when she gets off work. It's very rare for her to have a day during which she doesn't complain about feeling tired.

Rather than forcing myself into an unnatural sleep schedule just to give myself more time in the day (time which would be spent in a hazy, agitated state), I decided to just roll with it. I discovered that naturally I tend to fall asleep between 11:30 and 12:30 in the evening and wake up sometime between 8 and 9. This schedule is already conducive to a normal (well, computer-science-normal) lifestyle. It's the schedule I have maintained to this day; I rarely wake up to an alarm and I rarely have trouble falling asleep. I also never need or take a nap in the middle of the day.

She tends to go with the "sleep when tired" approach, as do I. I naturally get tired much later in the evening (computer-science-to-the-extreme, I guess), and wake up much later, and I have my own sleep issues which probably affect my mood at times, too. But my wife isn't usually forcing herself to stay awake well past the point when she starts feeling tired. She feels tired and generally doesn't fight it. I've caught her falling asleep in church (which starts at 11:30, so it's not like we're getting up way early to get there on time) and at Bible Study (which tends to run 7:30 - 10-ish in the evening), so sit her down pretty much anywhere other folks are talking and she's just listening, and she'll conk out if not actively engaged in the discussion.

I also decided to take time to let my mind recover.

I'd love to recommend that she try this; I just don't know where to tell her to go that would be relaxing. Our immediate neighborhood is pretty noisy and irritating, and she doesn't have a car.

In addition to this, I resolved to ride my bike more for transportation rather than driving or riding the bus. A bike ride is a slower pace so the mind isn't always on edge trying to keep from dying in an auto accident, there aren't the frustrations of traffic, and a level of low-grade exercise is good for serotonin levels without exhausting the brain and causing adrenaline levels to increase.

She walks to work and back every day. It's less than a mile. She has a bike and could ride it to work and save time, but for whatever reason, she doesn't.

It's hard to get out of a depression. This is especially the case in our modern society, because so much of what we do involves around constant brain stimulation, and that's not at all what we're designed for. Watching TV or even reading can be too much stimulation for an already overstimulated mind, but when your brain is all revved up it's hard to do what it is you need the most, which is a slow walk through the park or a quarter-hour rest on a park bench.

This seems to be more my problem than hers; I'm always looking for something to keep my brain active, and I catch myself walking too fast during what's supposed to be a slow, romantic walk in the park or whatnot because my mind's already on the next thing I'm gonna do that day. She takes life at a slower pace quite well when allowed the time and space to do so. Most days, she doesn't have to rush to get from one place to the next - she may have to get up early for work, but it's a half day and she's got a lot of leisure time before she has to be at her one evening class per week, and plenty of time during the week to get the homework done (though she has a learning disability, so the homework does take her a lot longer than it would most folks).

The other weird thing that science isn't quite able to explain is how effectiveness rates of antidepressants are plummeting and the effectiveness of placebos is increasing.

Makes me wonder if we develop an immunity to these things over time, kind of like how diseases develop resistance to vaccines. You're ingesting a chemical that is designed to correct your brain chemistry in some way, but there are cases in which the problem can come back with a vengeance when you go off of that drug and the system gets thrown off again.

The placebo thing doesn't surprise me - it's a psychological problem, so believing you're taking something that's going to help you may affect the physical state of your brain more than something that actually messes with its chemistry, at least for some people. Probably harder to accomplish that in a skeptic like myself, but then, knowing there's no magic bullet and it's just a process that takes time actually helps me to take time and not constantly berate myself for being in a funk.

What I read into this isn't that you should start feeding your wife sugar pills to ease her depression but that a positive attitude is as important as medication when treating depression.

I usually try to be encouraging, but I'll admit sometimes I'm weak and just sick of hearing about the same crisis day in and day out, and that's when I come down on her and make it about what she's doing to me. That probably isn't helpful, but dammit, I'm pissed.

I've also found that what helps me is, as the Scientific American article I linked earlier suggests, is to enumerate my problems, break them into chunks, and write them all down.

I've sort of recommended this. A whole semester of this class is overwhelming? Handle it one homework assignment and one test at a time. (Honestly, some folks work full-time and go to school - she's down to half-time work and quarter-time school. It's only overwhelming to her because it's any work at all.) Learning to drive is overwhelming? Take it one lesson and one function at a time. (We have a very patient friend who has been giving her free lessons, but she's put that on hold for whatever reason.) It seems to go in one ear and out the other.

I know that phorumers are already smart enough to take the advice of Random Internet Dude with the grainmountain of salt it deserves, but it's always worth reiterating.

You're a Random Internet Dude that I've known for several years now; I weight your opinions a little more heavily than that, without assuming you know everything. I know enough to be sure that the sum of your knowledge is nonzero.

Honestly I can't pinpoint one thing that made me leap out of depression.  When I get stressed (i.e. right now) I do tend to feel depression pulling at me.  When I was in high school, I don't know exactly what triggered it or why it got so bad, but I do know that I had to give myself a kick in the pants to break free from it.  It's strange, but you do get to the point where depression becomes part of your identity and it is really difficult to realize that it is not, actually, a friend.

I too can remember what it was like to get so depressed for so long that I just assume this is my lot in life from now on and I can never go back to the optimist I used to be. It's not the truth, but I know it can look like there's no way out of it when you're in it, so I do keep that in mind.

For what it's worth, I blogged about the subject last night, using the lens of depressions I'd previously been through as a way to empathize with those currently going through it, in a way that I hope was vague enough to not out my wife. Going over my past depressions and trying to pinpoint the things that brought me out of it has been an intriguing exercise. Those times in my life make so much sense to me now, but they seemed so chaotic back then.

http://murlough23.xanga.com/716213625/the-great-depression/

David - I've been where you are. My wife has had a couple of serious bouts of depression/anxiety. To be honest, the first time she used a mix of counseling and short-term medication (11 months) to break the cycle. It reared its ugly head again when our daughter was born this year (postpartum depression), but we recognized the signs a lot sooner. She still took medicine for about 5 months, though.

This actually brings up one of my worst fears - that my wife will get the one thing she wanted most out of life (to be a mother) and still not be happy. I know giving birth can mess with a woman's chemistry - your body has producing all of these loving, nurturing, bonding hormones for 9 months and suddenly it stops because you're no longer physically connected to your child, and CRASH. Knowing this is supposed to be a huge happy blessing and yet still feeling so hopeless only makes it worse. If normal women who otherwise don't get depressed are susceptible to this, then boy, this is gonna be a doozy for her when the time comes. Personally, I would like to have children but I don't look at it as the be-all-end-all answer to my happiness. I think it'll be a lot of work and a lot of little things that will surprise and bless me, and in the end I'll be glad for the accomplishment of bringing a child up and the relationship I'll have with that little person. But when I have a ton of responsibilities suddenly added to my daily life, that tends to stress me out, so it's really going to me a time that I'll need her to be strong and lead the way. If I can't see that making this dream come true for her has truly brought her some level of lasting happiness, then I'm gonna feel like, "Why did we bother having a kid?" Because my main thing is that wanting her dreams to come true is what will make mine come true. She already married me. That was my biggest dream. So now I just want her to be happy.

We're not fans of the medicine, though. What helped more than anything was her having people she could talk to who had been through depression - or were working their way out of it, too.

A few folks have responded to my blog entry indicating that they've been through it before.

This was frustrating for me, because I'm the farthest thing from depressed - I'm probably clinically optimist.

Damn you. 

It's hard for me to understand how depression works, and it took a lot for me to just be there the best I could.

Honestly, if I hadn't been through depressions myself, we would have never gotten married. I knew she was prone to it, and my mother actually warned me when I mentioned I was considering proposing, saying, "What if you have a baby and she goes into a deep depression?", and I think that would have scared me off if I didn't know what it was like to go through it myself. I made that choice knowing I was committing myself to seeing her through it if and when it happened. Given how bad I was the first few months we were married, I do kind of owe her one.

I'll be praying for y'all. I don't have the answer to your wife's situation, and I know how hard it is to be the observer who wants to "fix it." You can't. You can encourage her, but the healing can't come from you. Which sucks.

Yeah, that's the worst part. I'm more of an empowerer than a fix her - I want to give her the tools to come out of it on her own. Pointing her to other people who can probably be more empathetic than I currently can is probably a good way to go.

[Vlad!]

Ridiculously tired all the time, extremely apathetic towards any sort of work or mental exertion...I assume you've been keeping up with the basics like making sure her iron levels aren't absurdly low? You might also consider sending her to a sleep lab to make sure she doesn't have sleep apnea or some other condition that's keeping her from getting the quality rest she needs.

Other than that, it sounds like you've been handling it at least as well as I would have, and probably better, so all I can do is keep praying for you guys...which I definitely will.

[murlough23]

Ridiculously tired all the time, extremely apathetic towards any sort of work or mental exertion...I assume you've been keeping up with the basics like making sure her iron levels aren't absurdly low?

Didn't know that could cause such things; I'll ask about it. I know that "monthly women problems" can also reduce iron levels, but obviously that doesn't go on for an entire month, which makes me wonder if there's something non-cyclical in there that's bleeding and shouldn't be. (My mom spent a few days in the hospital last year due to a bleeding ulcer that made her feel weak and ultimately pass out; the irony is that she had been taking meds that were prescribed to her to stave off high blood pressure and it made her anemic. Talk about the cure being worse than the disease!)

You might also consider sending her to a sleep lab to make sure she doesn't have sleep apnea or some other condition that's keeping her from getting the quality rest she needs.

I'd love to do that; unfortunately I already found out that my health care doesn't cover it, after asking my doctor about my own likely experiences with sleep apnea, and having her send in the recommendation that I get a sleep study, only to get rejected for the health coverage. So apparently we both need it done, which could be costly. Frustrating to think that we could have to shell out a ton of money just to get a diagnosis here.

NP: "Beware! Criminal", Incubus

[Wildcatblue7]

Has she gotten her thyroid levels checked?  That may not be a factor but I know people get wacked out along with their thyroid.  Worth a shot.

Also, FWIW, my mom is prone to depression, but she didn't get post-partum over both my brother and I--I think it was just my bro, and a lot of that was because that was such a difficult pregnancy.  So, everybody's different, but being depressed now does not necessarily guarantee she'll end up with post-partum.  If you all do plan to get prego I would definitely consult her gyno about that, though.

[murlough23]

Has she gotten her thyroid levels checked?  That may not be a factor but I know people get wacked out along with their thyroid.  Worth a shot.

Thyroid and sleep study. I'm starting a checklist. We've both been putting off seeing the doctor - I was honestly planning to go and then I got sick a few weeks back (ironic, eh?) Put it off because I thought, "Either it's a garden-variety flu or swine flu, and either way, they tell folks to stay home and treat it with lots of rest and liquids and not bug a doctor and risk getting others sick unless you suspect serious complications." We're both over the flu, so time to stop procrastinating.

Also, FWIW, my mom is prone to depression, but she didn't get post-partum over both my brother and I--I think it was just my bro, and a lot of that was because that was such a difficult pregnancy.  So, everybody's different, but being depressed now does not necessarily guarantee she'll end up with post-partum.  If you all do plan to get prego I would definitely consult her gyno about that, though.

Good to know. It just doesn't take much to throw off her balance, so I'm not particularly optimistic about her odds during/after pregnancy.

NP: "Priceless", Incubus

[murlough23]

OK, read the articles that Vlad! linked to. Fascinating stuff - I may not believe 100% of it, but I'm intrigued by the concept that it's natural for your brain to deteriorate over time and eventually go into survival mode after too much stimulation or too much stress or any manner of unexpected activities that throw off its usual process. It makes sense that this sort of thing can take a while to recover from, and - most critically in my wife's circumstances - that it takes a hell of a lot of sleep so that your body has time to repair the damage done. I need to be more sensitive to her on this issue, and not berate her for zoning out during a movie and whatnot. I'm pretty self-sufficient when it comes to finding entertaining things to do on my own, so I can be less selfish about time I expect to spend with her if I understand that she needs to rest and heal, possibly for many months. That said, I don't want her to disengage from life completely, so when she seems awake and up to it, I'm going to try bringing out board games or taking her on short hikes or finding ways to slowly start stimulating her intellect and imagination again. I just have to realize that this process could take a while.

NP: "Not Allowed", Copeland

[Vlad!]

I do want to caution that I think the Scientific American article can give the false impression that it's possible to think yourself out of a depression. While it is certainly possible to address depression at the early stages through lifestyle modification, I don't think a full-on clinical depression will just go away with rest. That may have been the case two hundred years ago, but our modern culture is so focused on constant overstimulation that I think without radical lifestyle changes it's impossible to beat a severe or even moderate depression alone.

I do think that you got an important point out of that article, which is that coming out of the depression will take as long or longer as it took to go into it. The other point I was making by linking that particular article is that if it's true about depression being one of the brain's defenses against a stressful or problematic situation, it's unlikely that the depression will go away unless either the situation goes away or the patient has learned to view the situation in a different way so that it no longer triggers stress chemicals. This is why the article focuses on exercises like breaking the problem down into manageable chunks.

[Aaron]

I have no advice or input except that I'm praying for you and Christine, David.

[murlough23]

I do want to caution that I think the Scientific American article can give the false impression that it's possible to think yourself out of a depression. While it is certainly possible to address depression at the early stages through lifestyle modification, I don't think a full-on clinical depression will just go away with rest. That may have been the case two hundred years ago, but our modern culture is so focused on constant overstimulation that I think without radical lifestyle changes it's impossible to beat a severe or even moderate depression alone.

I didn't get that impression; it just told me that the excessive amounts of sleep were likely to do something productive for her and that I shouldn't discourage her from sleeping when she's tired. The counseling, and probably the anti-depressants, are still important elements of her recovery, and since these things are already in place, might as well continue them. The paradigm shift for me was understanding that the sleep was a measure her brain was taking to contribute to the healing process, not a nasty side effect of the drugs that was stealing away hours of her life every day.

I do think that you got an important point out of that article, which is that coming out of the depression will take as long or longer as it took to go into it. The other point I was making by linking that particular article is that if it's true about depression being one of the brain's defenses against a stressful or problematic situation, it's unlikely that the depression will go away unless either the situation goes away or the patient has learned to view the situation in a different way so that it no longer triggers stress chemicals. This is why the article focuses on exercises like breaking the problem down into manageable chunks.

That's the hard part, because it's almost always been true for her that any expectation of hard work = you're putting too much pressure on me = massive stress response. Sorry babe, but we all have to hold down jobs, and those who are fortunate enough to stay home with kids because their spouses can provide for them with a single income have an even harder day's workload to face. So on that count, she's just gonna have to learn to deal.

That said, I'm always willing to help her break the work down into more manageable chunks. The other day she said she felt like a mess, and I said something like, "Well, how do you clean up a mess? You find a few like objects, begin to sort them into one pile, put other like objects in another pile, and before you know it, you've got neatly arranged piles of things and then you have enough space in the messy room to figure out where to store each type of object." It's metaphorical, but it works on a practical level when faced with a difficult homework assignment or whatever. Take it one small sub-task at a time.

[murlough23]

Well, this is about the worst timing possible. My wife took our cat to the vet today after noticing that the cat had been breathing heavily and not eating over the last few days. I honestly thought the cat was just being moody, since she did something similar a few years back and was ultimately fine. But they X-rayed the cat and found some fluid in her lungs. So we had to drive across town to a 24-hour animal clinic and shell out a few thousand bucks for them to observe her overnight. The initial prognosis is either some sort of heart disease, or pneumonia. If we find out it's pneumonia, it's treatable without too much more expense (relatively speaking) and it's a one-time issue, so we'll likely have the cat back by the end of the weekend. But if it's a heart-related problem, that could require treatment for the rest of the animal's life and they'll have to bring in a cardiologist, and God knows how much that's gonna cost. So we could have to make a very difficult decision tomorrow, and it's just a really awful time for the potential death of a beloved pet to come up - the cat's a very faithful companion to my wife and she's doing her best to think clearly and be stoic today, but I know she's gonna crash pretty hard if we have to decide to put the cat to sleep tomorrow.

It is very strange to be put in a position of deciding how much monetary value you place in the life of a pet.

[Vlad!]

Any more news about the cat (or the wife, or life in general)? Anything new we can pray for?

[murlough23]

This cat thing has been hell on Earth. It's day 5 now, and it's looking like the earliest we could take the cat home would be Saturday. Since the day-to-day costs have been lower than the highest estimate, we can give her a couple more days before the cost starts to go over what I was prepared to spend on such an emergency. But putting the cat to sleep would obviously be very devastating for my wife. We literally wake up each day not knowing if we're gonna have to make the decision that day. People say, "You could just get another cat", but I know what that's gonna put us through emotionally.

Ironically, my wife has been a bit stronger through this experience than she was before it. Either that, or I've just become emotionally vulnerable enough that it levels the playing field. But I pointed out to her last night that she was handling this better than expected, and she noted, "I haven't thought about killing myself lately." Maybe she just has an identifiable thing to be sad about now, that she knows isn't going to be permanent? I'm not a psychologist. But I know I tend to be less angry or sad about an identifiable problem than I am when it's just general malaise that I can't put my finger on.

Just pray that we're able to make a wise financial decision here. This cat situation is an awful lot like gambling. I'm trying to avoid the "sunk cost" fallacy where I keep betting on an iffy hand because I figure I'm already into deep and my pride keeps me from folding. But going all the way through to the end and still having a losing hand that I kept betting more and more money on would sure be frustrating. Then again, so would going on with life knowing I gave up on a beloved pet who was probably only a few days away from feeling better.

[leinad]

Do they know yet what's wrong with the cat?

[murlough23]

Do they know yet what's wrong with the cat?

Likely feline asthma, triggered by an aerosol spray that we know never to use again. It's either that or some other sort of toxic reaction to the spray being used in a confined space (her litter box). We're pretty sure the problem isn't repeatable - she could potentially get mild asthma symptoms due to other environmental factors, but likely nothing severe.

[Vlad!]

Found an interesting article in the NY Times weblog section about how exercise can make your brain more stress-resistant. This seems to contradict some of the stuff in the k5 articles I linked earlier, but keep in mind that they were talking about exercising while depressed and this is talking about exercising while healthy. I'm not sure what this means for your situation, but both articles seem to think that gentle, noncompetitive exercise can help in pretty much all circumstances.

(Competitive exercise or strenuous exercise, of course, raises adrenaline levels. What this article seems to be saying is that in a healthy brain this leads to new neurons which are more resistant to those levels, while one might surmise that in an unhealthy brain the creation of new, stress-resistant neurons will not offset the negative pressure of increased cortisol levels in the long-term).

The other interesting find that's been going on is that scientists are now suggesting that willpower is similar to a muscle: the more you exert it, the harder it becomes to exert in the future. Obviously the analogy is inexact, but I like to think of it as waking up each morning with an IV full of willpower leading into my brain. If I restrain myself and only eat one muffin for breakfast instead of two, I use a little bit. If I get caught up browsing the web and I have to force myself back to work, that uses a little bit. If I'm hungry and I have to resist walking over to the vending machine to get some expensive, fatty snack, that uses a little bit. If I have a lot to do so I stay late even though I want to go home and I force myself to concentrate, that makes a big withdrawal. When I get home and I force myself to exercise, that uses a little bit. So then when I'm sitting in front of the computer thinking "man I should really update my Firefox extension to be compatible with the new 3.6 beta", instead I go play video games, because I just don't have enough willpower left.

This is also an inexact analogy because it suggests there's nothing I can do in that situation. Obviously if I had to I could man up and do my work, but the more I use the harder it gets.

The corollary to this is that you can overcome this problem by establishing habits. I don't exert any willpower getting up at 8:30 in the morning because I've gotten up between 8 and 9 since I was in college. I don't even set an alarm. I don't exert any willpower to take a shower in the morning because I shower every morning. By making it a routine, it stops making deductions from your willpower bank.

How I feel it relates to your situation (yeah, I did have a point related to your situation in there somewhere) is that a large part of the 'willpower' mechanism requires serotonin (this is why one characteristic of depressive behavior is an inability to accomplish anything: they lack the willpower to force themselves to do anything so they drift languidly from activity to activity).

Thus, if you say to your wife "OK, you're depressed, you need to start riding your bike more and we should go on more hikes and you need to journal your thoughts and spend time bonding with others and this and that and the other thing", you're going to deplete her already sorely lacking willpower reservoir, forcing her to rely on adrenaline (which in turn will just make things worse). So instead, maybe focus on making one thing a habit (journal for fifteen minutes after whenever her regular Bible-reading time is, or after work go sit outside for a while until her mind has become calm) before moving on to something new.

[Wildcatblue7]

in response to what Vlad said, I did two things that I have no proof but which I can guess helped me out when I was depressed:

1) reading the Bible--and I mean the whole thing (this takes time, of course)
2) exercise (of some variety--at the time I think it was a Pilates routine)

And I can certainly attest that I feel infinitely better in the weeks in which I have worked out, and I mean worked up a good sweat, around 3-4 times for 30+ minutes.  I had to work up to building endurance, of course, but certainly exercise has a positive effect on my mood.

Conversely, it seems to have no effect on my insomnia.  Boooo.  Do with that what you will.

[murlough23]

The cat is coming home today.

I'll try to get us out and do something semi-active in the sunlight this weekend.

[Vlad!]

If you're still interested in checking out sleep quality or concerned about sleep apnea, I found something that might help:
Zeo Personal Sleep Coach

It looks like there's a trial period, so you can try it out and see if it seems to help (or if you experience the electrical burn issue that Scott talks about).

Granted, if you do find out that there's a problem, it might put you in a bit of a Catch-22 with your insurance:
You: I need to buy a respirator device to help counter my wife's sleep apnea
Them: We won't cover that without a sleep study
You: OK, I need to have a sleep study done on my wife to see if she has sleep apnea
Them: We won't cover that

[murlough23]

Granted, if you do find out that there's a problem, it might put you in a bit of a Catch-22 with your insurance:
You: I need to buy a respirator device to help counter my wife's sleep apnea
Them: We won't cover that without a sleep study
You: OK, I need to have a sleep study done on my wife to see if she has sleep apnea
Them: We won't cover that

That's essentially what's kept me from getting that study done on myself. I suppose now's the time to research it - I have until January 1 to change my medical benefits if I'm not happy with the coverage I'm currently getting. The thing is, I'm not sure how to find out who will cover it. I feel that it'd be worth the investment in potentially more expensive health insurance.

My wife's disposition appears to be clearing up, though. She's aware of having felt a lot less depressed since the cat came home. I'm not saying everything's happy, but she doesn't seem so absolutely exhausted by every little thing any more - she's keeping up with her studies (easier now since she's only got one class that she kept through the whole semester - and I'm glad I convinced her not to drop out of school entirely) and not finding as many excuses to call in sick at work. The fact that she gets up so early for the morning shift at the preschool still means that she conks out at around 8:30 PM half the time when we're trying to watch TV, so it still means weekdays are pretty boring for her because there's little time for us to do anything interesting together between the time I get home from work and the time she turns into a limp rag doll. I've thought of changing my work schedule to accommodate this, or working from home a little more often, but her work schedule could change after the holidays anyway. We'll see.

Getting her out of the house to do something in broad daylight for a change seems to have been a pretty big turning point. A friend of ours went to Santa Barbara for the entire 4-day weekend, just as a personal retreat, but the two of us arranged to drive out there just for the day to meet up with her. The three of us went on a very scenic hike, fairly rocky and moderately steep, and usually my wife is the one dragging her feet on those things, but she was forging ahead, happy to explore and see what was around the next corner. I asked her about it and she said she was feeling a lot better emotionally. Doesn't mean that was a quick fix, but I'm hoping it's a harbinger of things to come, and I'll try to keep up the activity at a reasonable rate that doesn't wear her out.

NP: "Curiosity", John Reuben