Having a chronic and progressive illness doesn’t necessarily entail that the person with the condition is – or will – necessarily be at a level of clinical depression. Speaking more personally, I am an optimistic person – and I am usually able to stay in good spirits by generally taking note of my internal “gratitude list”. I am able to remain both calm and optimistic, more often than not – that being said though, I do struggle with periods of feeling down.
Some would attribute these down periods to one or a combination of several variables: my knowledge of my condition (and its’ progressive nature), the neurobiological chemical changes that occur in my brain as part of my condition, the challenges of dealing with life with my condition, and/or the medications that I take for my condition. In my case, I don’t think the latter (the medications are a huge factor, as I felt worse both physically and mentally prior to initiating medications because I was struggling to function before being medicated).
I can readily identify triggers that can quickly take my cheerfulness into a valley that I don’t enjoy going down in. Some of these triggers are as follows
1. A poor night of sleep (or lack thereof): On mornings following a rough night, when I have to awaken to help get kids ready, get showered myself, and then get ready to go to work – typically following a night of having cramps, aches, insomnia, or for whatever reason that prevented me from obtaining adequate sleep – I find my mood heading south rapidly.
2. An unexpected slap of stress: Whether it be from my children and the challenges they have in life, to my own financial stress, to things breaking or needing repair, to job related issues; the more stressful the situation – the less my medications seem to work and the more likely I am to find depression to creep in.
3. Changes in my performance ability from past to present: I think it is tough for anyone to handle a realization that he or she is physically (or mentally) unable to do an activity that was easily able to be accomplished in the past. My emotions can range from frustration to outright depression when I become aware of an activity or a challenge that I could work through in the past – or something that wasn’t a challenge in the past, but is now a new challenge. For example, I recently noticed that I have difficulty lately in getting out of a car that is lower to the ground than mine, and quite truthfully; I even have a problem getting out of my own car sometimes, especially if it is on an incline. Discussing daily challenges is a topic that I could potentially ramble on about (but will not right now), as I find myself getting frustrated, upset, or sad on a daily basis when I struggle to accomplish something that is easy for most. I am especially saddened by a difficulty in performing activities that I used to love (i.e. my Judo hobby has especially suffered due to balance and rigidity problems). I also try to avoid spending too much time thinking of the future and some of the unfortunately real possibilities that can or might occur, but when my mind takes me there, that can get depressing too (see my previous post on Parkinson’s bullying you with scary thoughts and images of the future).
4. Meeting the expectations of others: As I mentioned in a previous post about “on and off times” – I fluctuate in going from being functional, to periods where I really struggle with some tasks. Both at work and at home, when those around me witness my ability to often energetically accomplish things, there comes some expectations and duties that are placed upon me – which often suffer when I am not at my best. I don’t like it when people are disappointed in me. I also don’t like to put my responsibilities on the shoulders of others and add to their stress – which contributes to myself questioning whether it is a lack of sufficient effort on my part or problems created by and legitimately due to my condition. Shame combined with a reluctance to ask for help contributes to a low mood. I think that I often give too much attention to what others think (an example of this is that I have been reluctant to ask for a handicapped parking tag, even though there are times when walking is difficult for me – yet I find myself considering all those who are more progressed in their health conditions than myself – some of whom can’t even walk at all- and then I discover myself feeling unworthy of getting any special treatment or consideration).
5. Feeling ill: When I am feeling ill or having fatigue, I get depressed. I don’t like not being able to accomplish things (see number 3 and 4 above). I have my own self-imposed expectations. I don’t like being sick, which in turn contributes to my getting really sad and irritable on those occasions when I am slowed down.
6. Apathy: Probably a result of my condition, I have periods where, for lack of a better way of putting it, I just don’t “give a sh**”. It may start out with something like being slow to get dressed – to progressing to a thought of “If I am late for the meeting and get in trouble – I don’t care”. It may come up as a moment during the course of a day where I don’t feel like doing anything at all. It can be an unexplained feeling, which is not the real “me”, where I momentarily don’t care about things that are important to me. I don’t always associate apathy with depression, but the periods of apathy can cause depression in retrospect.
So there you have it, even your friendly neighborhood Pdude can sometimes find himself getting in a low mood. Thank goodness I have support from people like you – my readers, supporters, and fellow Parkinson’s brothers and sisters to get me through! Keep on!