Sunday, May 19, 2013

A Real Life Faust

The world was my oyster she said. I started from the inner city slums and reached and touched the stars..

In her early 80s she was still a stunning woman with gorgeous blew eyes and a smile more brilliant than the huge stone on her finger.

I am dying she said. One moment I am traveling the world the next I am diagnosed with a rare and fatal illness. I am not ready to die especially not on this illness terms. I always got what I wanted but still there is an emptiness inside that power and money never filled. I want to feel whole before I die.

Her words carefully articulated and perfectly syntaxed painted a picture in my mind of a beautiful and powerful goddess issuing proclamations and receiving adulation from her throne set high up on a pedestal. I shared this image with her along with my feeling of how lonely and scary this throne can be at times. Her blew eyes pierced into mine searching for criticism or condemnation. What she saw instead brought a mist in her eyes which she quickly blinked away. There is no room for vulnerability in my world, she protested.

But vulnerability was exactly what this doctor had in mind for her healing. She had to come down from her icy throne and talk about her fear, ask for help from the people in her life, especially her loving husband whom she had always kept at an arm's length, most of all she had to find her own feelings of affection and get the courage to express them.

Reluctantly she started opening up, first to me about her fears of loosing her independence, of becoming a cripple, of putting her pride away and asking for help and finally of her dying. Then she started opening up to her husband and to her astonishment she felt closer to him than ever before and he became more loving. 

Months into the treatment she started for the first time in her life listening to the people in her family and friends and truly connecting with their problems and pains. The tears of joy in her niece's eyes when she paid her college tuition reawakened a feeling in her heart so intense that shook her very foundation. And just like that she discovered Faust's redemption : That her joy, her purpose, her wholeness, her very redemption was inextricably connected with that of those around her. Her tears were melting her icy pedestal and for the first time in a very long time she was feeling free and light, like a kid.

I don't know how long I have, she said to me one day, and there is plenty of work left for me before I die. You have opened my eyes to a world I had not believed existed for me and for that I am immensely grateful . There is one more thing you can do for me: Tell my story. There are other ice queens out there waiting to be saved, maybe my story will help.

 Yes, I believe it would and I am grateful and deeply touched for entrusting it to me.

Sunday, May 12, 2013

The organs weep the tears that the eyes refuse to shed

Psychologist have for years now accepted the connection between depression and susceptibility to infections and gastrointestinal inflammation. Two recent studies at the University of Michigan found that depression and the use of certain antidepressants are both associated with increased risk for Clostridium difficile infection, C. diff, which causes diarrhea and in some cases death.

More specific the researchers found that the risk of C. diff infection among people with a history of depression or depressive symptoms was 36 to 47 percent greater than among people without depression.  Very interesting was also the finding that bereavement and living alone was also found to lower the ability to fight infections in older adults.  

A second study, involving patients, average age 58, found a similar relationship between infection and depression. The same study found an association of specific antidepressants — Remeron, Prozac and trazodone — with C. diff infection. There was no association with other antidepressants.
Although the connection between these antidepressants and the infection was not clear and more research is needed, it seems that at the very least patients on these meds that come down with serious infections should be talking to their doctors about the possibility of switching to different antidepressants.  
The ancient proverb comes to mind: "The organs weep the tears that the eyes refuse to shed"
Whether ongoing depression or the pain of bereavement sadness needs to be experienced and processed appropriately before the body suffers too.   


Sunday, May 5, 2013

The best Antidepressant/Anxiolitic

I have often told my anxious and depressed patients that one of the most effective medication is exercise.  Their response is often " but I don't have the desire to do it, it will not work".
It turns out that  a new U.S. study finds that exercise can help reduce anxiety and depression, even when you don't feel like working out.

Researchers at the University of Colorado Boulder found that being forced to exercise -- for instance by a doctor or gym instructor -- helps reduce stress, anxiety and depression just as well as exercising voluntarily does.

Ok then, here is what I suggest for all of you skeptics who struggle with anxiety and/or depression:  come on in, we will go for a nice bike ride on our newly reconstructed boardwalk!