“This boat that we built is just fine

And don’t try to tell us it’s not

The sides and the back are divine

It’s just the bottom we forgot.” from “Where the Sidewalk Ends” by Shel Silverstein

In the “Art of Happiness in a Troubled World” the Dalai Llama states that the way to happiness when confronted with the big problems in the world like war and hate and crime and starvation is to first take a realistic look. Interestingly enough, the first step in most trauma and addiction recovery programs is honesty. In medicine, the first thing we assess are the problems/symptoms to get a diagnosis. In fact when we take our cars in to be worked on, our pets to the vet, our computer to the geek, or bring the plumber to the house the first question is “what’s wrong?”

I can write whole essays about what’s wrong with the world. When it is my car, my dog, my computer, or any item (or friend) that I care about or am responsible for, it is no problem to identify and admit what is wrong. Why then is it so hard to say something isn’t working or is wrong in my own life? I can only fix what I admit is wrong.

I am talking about this, because I just started a prescription medication for depression that also happens to have the off label benefit of addressing neuropathic pain.  I am in need of both benefits. A combination of chronic pain which leads to sleep deprivation, and multiple personal losses have left me physiologically incapable of feeling good, and the medications that worked with the magic of faith and hope to keep me alive have left me with chronic neuropathic pain in my lower extremities; but it is hard for me to admit to either depression or pain.

However, I have learned that there is a time and a place for everything including medicine. I rode my bike this morning, and very well might again tomorrow partly because I finally surrendered control and started a serotonin and nor-epinephrine re-uptake inhibitor. Downsides to everything (the Asian yin yang) means I am coping with some nausea and occasional dizziness which should subside, upsides is my pain is below 3 all the time and I actually have energy this morning. When I rode the bike this morning, I was nervous but not fighting the crippling panic that accompanies my status as a multiple trauma survivor or the neuropathic pain of being a breast cancer survivor; I was just struggling with the reality of weak muscles and balancing the bike.  I am amazed at the difference.

Sometimes we don’t know how bad the problem is until we address it. By the way, I don’t see medicine as the best answer or the only answer. Last year I was able to afford regular visits to Backfit Chiropractic Care (which also interestingly did generate nausea the first couple weeks) for massage and adjustments and it was the best. My pain was zero if I saw them twice a week, and my emotions balanced out, and I completed my the triathlon training for my first sprint.

I don’t have the financial resources this year for Backfit. What I do have is VA benefits, so instead of mourning what isn’t, I am using what is; which is doctors, pills and counseling.

But first, before I could use what I had available, I had to admit something was wrong.  I had to admit that I was not functional for my goals, and ask for help.  How I have been living since my sisters suicide has really not been functional.  In my survivors soul, she was one more person I couldn’t save. Which triggers my own trauma. No life story needed, but let’s just say that my first clear memory of my own mother was her threatening to “just kill herself” and me trying to comfort her and helping her by rocking said baby sister. ( My mother never did commit suicide, however much she threw that around like some moms throw around threats of groundings, she died of cancer at age 38.)

When I am depressed, I keep up appearances, but my life becomes smaller and smaller. I firmly believe that what we give power to gets bigger, so when life overwhelms me, I focus on hope and beauty and all that rainbow and unicorn stuff (not the Wil Wheaton versions), and I try to move beyond myself and focus on compassion. Usually this works.

Sometimes it doesn’t. Fear gets bigger and bigger. I get lazy or tired depending on how I am looking at it that day. I spend more time just “chatting” on social sites than doing any real writing, my house gets dirty, I don’t exercise, I eat my emotions, I start canceling social events, I stop doing the things I do that feed my mind, soul and spirit and spend more time watching TV. Oh, and I cry randomly.

First I had to be willing to assess myself and admit something was wrong. That was hard for me. I prefer anything to a prescription or the admission that I am depressed or in pain. As a nurse I may understand the physiology of both, but my All-American Bootstrap mentality sees all health problems that faith can’t fix as weakness. So even though my life was taking on water faster than I could bail, I just kept bailing and rowing, bailing and rowing, bailing and rowing.

I got to acceptance this time, by a serendipitous route that reminds me, in my world at least, there is something bigger and better looking out for me and pushing me in the right direction.  The final kicker, to get me accept the help I need, was a random statement about grief from a man I am interviewing, who had no idea what was going on in my life but has found a spiritual source within himself and was giving me examples of guidance he had received as part of the interview.

I am a survivor. Of trauma. Of cancer(mine and others I love.) Of  suicides.   Surviving is not enough, thriving is more my style.

I don’t see medication as the easy answer, pills ease the symptoms while I address the actual problems by exercising, therapy, journaling, and meditation. I have never seen anyone recover from depression who wasn’t willing to do the work and address their anger, sadness, etc but only wanted a quick pharmacological fix.  Dealing with depression has some parallels to managing Type II diabetes, insulin (medication) is often necessary but behavior changes (diet, exercise, education, and emotional support) are what bring the lasting benefits, and some move to a place where diet is enough, some balance behaviors and medication for the  rest of their lives; same with depression.

I will purge some of the pain, replace a few coping mechanisms, examine some beliefs and rebuild my physiological resources as well as my emotional and spiritual reserves. I have been here before I am afraid. My life has been full of traumatic opportunities, some related to poor choices, some through no fault but my stars. The place looks a little different this time, like returning to your hometown twenty years later, a lot of the details have changed but the major landmarks are still there for navigation. Last time I was here, my main travel guides were a massage therapist, a support group and a strong spiritual community; this time its medication and a counselor but I will travel through this challenge the way I do everything else, one step at a time.

I will keep bailing and rowing hard, but I will also fix the boat. A successful life journey  requires goals and destinations, but also a clear knowledge of where you really are and the condition of your vessel. Without an honest location on life’s map, no directions given will help; and also if your boat is sinking, you need more than maps and a compass, you need professional repair.

My problems are small compared to the biggies like war and racism, but the Dalai Lamas advice works on all levels of dis-ease. I took a realistic look at how fast my boat was sinking, and I am getting professional help with the structure, while attending to my compass readings.  I am posting this most personal blog because if even one person, whose boat is also sinking from whatever the cause, reads this and realizes its OK to admit when something is wrong with them, and then asks for and accepts the help, I will have made fertilizer from manure which of course means beautiful flowers.

And really that is what all the shit in my life is about in the end, next years flowers.