Depression Is Like “Thought Cancer”

Slowly — too slowly — our culture is beginning to understand that depression isn’t just one person feeling blue because their life sucks. It’s a health issue with causes and effects that can be treated and ameliorated. The human brain is, by far, the most complex, complicated organ in our bodies. It’s also the organ we understand the least. Inside our skulls, 100 billion nerve cells (neurons) [are] interconnected by trillions of connections, called synapses. On average, each connection transmits about one signal per second. Some specialized connections send up to 1,000 signals per second. Our synapses work like digital circuits; they’re either open or closed. If they’re open, electrical currents can travel across them — and information moves right along with the current. “Somehow… that’s producing thought,” says Charles Jennings, director of neurotechnology at the MIT McGovern Institute for Brain Research. As ethereal as our thoughts feel, they probably have a physical form — some kind of encoding sequence “burned into” storage areas of our brains. These storage areas — dispersed across our grey matter — link up as we think associatively — connecting immediate stimuli to memories of similar stimuli.

In a happy world where only happy thoughts filtered into our brains, our brains would (one hopes) process only happiness and happiness is all we’d feel and “know”. Alas, Life doesn’t work that way. Even getting through a morning can produce the full gamut of thought possibilities. Some Life experiences leave behind more than just their physical imprint on our neural networks They leave behind darkness. Depression.

If happy thoughts produce lightness in our heads, depression produces its opposite. And, mind you, just like with cancer, there’s more than one kind of depression. Not all darkness is created equal. What Shakespeare called “the slings and arrows of outrageous fortune” can leave scars on our bodies and in our minds. I was sexually assaulted twice when I was fourteen by the religious director at the synagogue where my family belonged outside of Baltimore. The second instance was especially harmful because (having kept the secret that first time), I believed I was therefore responsible for there being a second time. Somehow, this information imprinted deeply into my brain — not just that it happened but that it happened for a complicated reason for which I was responsible. That’s a lot of abstraction spread across various parts of my brain. But, that abstraction became my darkness — and that darkness haunted me even though I denied its existence.

When does a terrible incident transition into depression inside our brains? What causes that depression to “metastasize” from “sad thoughts” into increasingly self-destructive behavior? I treated this memory of being sexually assaulted like a secret only I (and my attacker) would or could know. That’s why there was a second time, remember? Despite being sexually assaulted once, I said nothing, told no one. That must have been the case — from my attacker’s point of view — since he still had a job and wasn’t in jail. As I walked in the door that second time, he knew he was safe — and knew he could do it again. So, he did.

This particular memory — this collection of information plus perspective plus all other associations connected to it — behaved exactly like a slow-moving cancer. Plenty of other bad memories become “cancerous” in that they interfere with your life in potentially fatal ways. Just like our immune system regularly deals with low level cancers all the time, our brains find ways of, if not healing the cancerous thoughts, at least containing them and the damage done. Talk therapy went a long way toward mitigating a lot of the depression caused by my sexual assault. Unfortunately, until I dealt with that cancer directly, I was never going to put my cancer into remission.

In my case, this “thought cancer” destroyed my ability to relate to other people with confidence. It’s not that I didn’t or couldn’t trust them, it’s that I had a secret that they could never know — and if they didn’t know that secret about me, they couldn’t possibly know “me”. This put me on an emotional island I didn’t even know I was on. I had friends but never close friends; that is, they felt closeness to me that I couldn’t feel toward them because, down deep, I couldn’t understand why they’d want to BE my friend when, the dark, dirty truth was, I was undeserving of anyone’s friendship. Because of what I did.

Three days before Christmas 2016 — my cancer suddenly metastasizing at an even more alarming rate — I came within literal inches of killing myself. My darkness, my thought cancer, had blocked out all perspective. I had become convinced that my family and friends — my community — would go on same as it was just fine without me. That would not have been the case at all, certainly not with my wife and kids. But, that’s the insidious thing about “thought cancer”. Like a tumor does, depression becomes part of the architecture. The body starts feeding it blood — like it belonged there. The tumor’s essence flows into you and, like a virus, sets about turning you into it.

In my case, I convinced myself that because I’d been sexually assaulted, I deserved every other rotten thing that happened. Including death. Talk about bullshit.

My path out of the darkness and back up into reality began with talk therapy. Acknowledging the need for help was essential to both getting help and being helped. But, I was still keeping that secret from myself — literally denying that such a thing had ever happened to me. I needed even more help — that was my suicide attempt. I had feared mood stabilizers because of the reasons above: we have a “guestimate” understanding of how our brains work but an even bigger gap in understanding how exactly these drugs work in our individual brains. I grew up in a medical family; my dad was a surgeon. I know the culture. I know that my GP doesn’t have a background in these meds — not their fault. Most likely, they’d prescribe whatever the last Big Pharma rep left behind last time she visited and handed out samples. I wanted to deal with my depression while leaving my hypomania alone mostly (that’s where my creativity resides — I’m bi-polar too) and had found lamotrigine (lamictil). The anecdotal information available while I was Googling back in 2014 and 2015 was scant compared to now. At higher doses (I’ve since researched), lamotrigine can impact one’s hypomania. But, I got lucky.

Boy, did I get lucky. Immediately after my attempt — knowing I needed more help than just talk therapy — I drove straight to my GP and told them everything. I told them what happened — but not why because I didn’t know that yet. I told them I’d researched lamotrigine. My GP (and the head doctor — I got a lot of attention) whipped out their smart phones to look it up for themselves. By that point, they’d asked me three times if perhaps I should be hospitalized. I assured them that if trying medication didn’t help then, yes — I’d agree to be hospitalized. They wrote the script.

I went hope, told my family what I was planning — they signed off on it (they were even more desperate than I was that I get help) and I took my first 25 milligram dose. That’s when luck really kicked in. Within 36 hours at that minimal dose, I levelled. I literally felt the darkness lose its power to control me.

My rage was explosive back then. Though usually self-directed, my rage could just as easily be pointed at something stupid I heard on the radio or LA traffic. I don’t remember what set it off that time but the rage erupted in my gut and began to funnel upward with increasing velocity. I was quite prepared for it to hit my throat and — per usual — explode out of me in waves of angry, vituperative spew. But, this time, just as the rage went to explode, instead, it dissipated like a soap bubble popping. I knew I had felt this incredible anger but, just when I expected to really FEEL it? Nada. It was gone except for the (already) fading memory of it.

This was liberating! After the exact same thing happened again several hours later, I understood exactly how the mood stabilizer was stabilizing my moods.

With my depression no longer in charge — no longer able to derail me and my emotions, I could begin the real process of healing. In my case, I could begin to address the eight thousand kiloton gorilla sitting on my chest: my secret.

Long story short: I did confront my secret and confronting it hurt like a mofo. But, confronting that secret — talking about it finally — took away literally all its power over me. Writing about it was even more healing.

I haven’t removed my darkness, I’ve disempowered it. It still lurks within and it knows the power it has over me. If this was “cancer” cancer, I’d change my diet to keep it at bay or alter my lifestyle as necessary. Thought cancer requires the same pro-active measures.

I don’t think for two seconds that I’ve “beaten” this thought cancer. I’ve just figured out how to live with it — and find happiness while living with it. That’s the good news on the subject: there is hope. Lots and lots of it.

What Being Deeply Depressed Taught Me About Life — And Being Happy

Three days before Christmas 2016, I came within literal inches of harming myself, perhaps fatally. It was pure impulse — a flash of self-directed anger that I’d been building toward for a decade. Oh, the irony… even as I plotted to off myself, I didn’t know (or admit to myself) WHY I felt this terrible compulsion.

In my case, I’d been keeping a secret from myself: I was sexually molested — twice — when I was 14 by the religious director at the northwest Baltimore synagogue where my family belonged while I was growing up. For 45 years, I kept that bit of personal history boxed up deep in my psyche. I always knew this “thing” was there. I simply refused to acknowledge it.

More irony — it wasn’t until after I tried to kill myself — and sought treatment — that I had the emotional strength to face the fact of what happened to me. The night I came clean with myself — to myself — was the longest, loneliest night of my life. I understood myself in a way I never had before. I understood my inability to bond with other people the way everyone else seemed to bond with each other.

I understood why I felt so much emotional distance from the world. Why I felt like I lived, by myself, on an island from which I could never escape: if you didn’t know this terrible secret about me, you couldn’t possibly “know” me. Only two people knew the secret: me and Yehuda Dickstein, the man who molested me. Perversely, I kept our secret — kinda like Yehuda knew I would. He molested me twice — so, he knew for a fact that I never told anyone about the first time.

That’s the hook on which I hung myself for 45 years — the fact that I never told anyone — and then it happened again.

Like lots of victims, I blamed myself. I couldn’t rationalize the first time. That made absolutely no sense to me. It was too surreal. But the second time — I helped manufacture it by not saying anything — convincing myself even that it couldn’t possibly have happened. Then I walked in the door to the place where Yehuda awaited me — and I instantly knew: yes, it HAD happened and it was about to happen again.

We all have varying degrees of darkness inside of us. Comes with being a sentient being with intrinsic knowledge of our vulnerabilities. When healthy, we see the world with a high degree of perspective. We understand when we’re at fault and when we’re not. But depression allows our darkness to take the wheel. The more control our darkness has, the more perspective we lose until, finally, we see everything though a vary narrow, very dark lens.

Though I had lived a very good, successful life, something inside was holding me back. My inability to bond — like a time bomb — ticked away steadily. Worse, my secret was the silent foundation for feelings of incredibly low self esteem. I believed my work was good — but I had no belief in myself whatsoever. And when things started to turn — because life has its ups and downs — I took those reversals of fortune as my due.

My secret had convinced me that I absolutely deserved everything bad that happened to me. In fact, I deserved worse. My darkness’s naked cynicism became a kind of mantra.

I knew I was in trouble. I was in therapy — and that was working up to a point.

But there was great white shark swimming just below the surface. I was afraid of medication, having read and heard more horror stories than success stories. Having grown up in the medical culture (my dad was a surgeon), I understood that the most my GP probably knew about the mood stabilizers I was asking about was whatever the last pharmaceutical rep told her as he slipped a package of samples from her briefcase.

And even if the mood stabilizer might work for me, it would be six to eight weeks before we’d have an inkling of whether it would or not — and there was the distinct possibility that this mood stabilizer would make my depression worse. Add to the mix — I wanted the medication to deal with the darkness while leaving my hypomania alone (I’m bi-polar, you see). My creativity resides in my hypomania — and the thought of losing my mojo — that sounded like a shortcut right back to suicide.

I had done research and identified a drug — lamotrigine (lamictil) that could work for me. After my near run-in with mortality, I drove straight to my doctor’s office and told them what happened. Great life hack? If you want really quick medical service, tell your health care professionals you just tried to hurt yourself.

I got not only my GP (a terrific doctor) but one of the two HEAD doctors. They got from the look in my eyes that I was deadly serious. They asked me three times if perhaps to consider hospitalization. In said no — I was there to try and help myself; but, first, they needed to write me this prescription. My two GP’s whipped out their smart phones and looked up the drug. They agreed to write the script.

Then I got really lucky — even luckier than I realized in fact.

Whereas one normally has to wait six to eight weeks to see if a mood stabilizer works or not, I leveled within 36 hours. I felt the lamotrigine’s impact: I triggered.

I can’t remember why anymore but something caused the rage that had been living rent free in my gut to ignite. I felt it rising like a lava plume rushing upward toward my head and my mouth — and just as it got there — just as I would normally speed up, lose my cool and become utterly irrational — the rage vanished — poof! — like a soap bubble popping. I knew I had felt all that rage and yet… now I felt nothing. The rage was gone before it could take flight and overwhelm me.

I’ve never taken more than the 25 milligram minimum dose since. And my depression has been kept completely at arm’s length. Here’s where the extra bit of luck kicked in. My research? It wasn’t complete. Yes, there was anecdotal data that lamotrigine wouldn’t impact my hypomania. There’s way more anecdotal data (no one’s ever tested lamotrigine as a mood stabilizer; it’s used mostly as an anti-seizure medication) that says it absolutely would impact my hypomania — at higher doses.

That bit of luck aside, the first lesson my depression taught me was that until you finally stand up to your darkness, it will own you. And it knows it.

Look — standing up to your darkness is hard. There are no easy answers here. Terrible things put you where you are emotionally. The thing about standing up to your darkness though is it requires help. To beat your darkness you must reach outside yourself. Seeking therapy is essential of course. But it’s important that you actively engage with your therapy — that you see therapy (the act of seeking help) as you being pro-active. It’s not just a good thing, it’s a great thing. But the real work of getting healthy remains ahead of you.

There’s no certainty in this. We’re not talking about concrete, we’re talking about the human mind — and we don’t really understand how we even “have” thoughts. And everyone’s darkness is a little bit different — because we are all a little bit different.

The goal always is happiness. The absence of suffering and emotional pain. The goal is to be the master of your darkness and not the other way around.

I’m a “devout atheist” to my core but I know exactly what born again Christians are talking about. Being able to see my darkness in its proper perspective — understanding WHY there was that darkness to begin with and WHY it had held so much power over me — liberated me. It can’t make the memory of that event go away. It can’t undo the broken relationships and poor choices. It can’t bring back all the time I lost to being depressed and having zero faith in myself.

But I can see that period of my life for what it was. And I can see my present for what it is and, more importantly, my future for what it could be — if only I pursue it. That’s the nature of hope — of believing in a future where happiness can blossom in its fullness.

That’s the biggest lesson my depression taught me. Happiness is absolutely possible.

Notes From A Former Drinker — Drinking Culture Is Really, Really, REALLY Stupid

Perspective is the damnedest thing. For the overwhelming majority of my adult life, I was a drinker. I never thought of myself as an alcoholic though I drank at least 2 glasses of wine every day. Religiously.

I prided myself on making not merely a good martini but a great one (I still do as my wife can attest). I savored the creative output that some craftsperson spent years probably putting into whatever bottle I had just cracked. I actually pitied anyone who didn’t drink.

Oy.

Meanwhile, alcohol fed my depression. Theirs was a sick, co-dependent relationship with me caught in the middle. Toward the end, it’s not like I was drinking great stuff anyway — I couldn’t afford great stuff anymore (though I still had some pretty great stuff in my dwindling “wine cellar” including some Chateau Lafitte Rothschild and some Opus One). Even after I came within inches of killing myself, it still didn’t occur to me to look at my 2+ glasses of red wine every night as a possible co-conspirator.

I owe a small debt to lamotrigine, the mood stabilizer I now take every day to keep my darkness in check. I owe an even bigger debt to a great therapist and a smaller but not insignificant debt to cannabis — the other part of my mental health regime. There are no specific warnings about taking lamotrigine and drinking alcohol. And, at first, when I started my regimen, I continued right on pounding down my two plus glasses of red.

But then a strange thing happened. I noticed it about a week in to taking the lamotrigine (I got very, VERY lucky by the way; I leveled within 36 hours at the minimal dose, 25 milligrams). All alcohol suddenly had an aftertaste. All of it. Beer, wine, cocktails… A lovely glass of Zinfandel or Petit Sirah (I loved em big & inky) would start perfectly from the nose to the first blast of fruit on the palate then start to settle in for the aftertaste when — kapow! A flavor like grapefruit rind took over everything. And it didn’t go away quickly.

As I was already deep into cannabis, I figured “what the hell” — that would be my “cocktail” of choice from now on. Funny thing? I have not missed alcohol for two seconds. Not even one.

Now, I do take my marijuana with me. I’ve got a little traveling pouch with an unbreakable silicone pipe and three or four pre-ground flower strains (sativas and hybrids) in 10 dram glass containers. I may not go drink for drink when I go out socializing, but I’m not relying solely on my fizzy water, ginger beer or overpriced mocktail for a thrill.

For the record, I do not get high. Ever. I’m not interested in being high. To me, cannabis is for sleeping, working or relaxing. When relaxing (think strains like Cherry Pie, GSC or Bruce Banner), I want to be mellowed a bit but social. I want the warm, friendly euphoria to keep my hypomania at bay. So — even when I go to a party at someone’s house, in no way am I “keeping up” with everyone else around me who’s drinking.

Watching other people drink from a place of alcohol sobriety is almost always eye-opening. I’ve watched friends slowly get silly over the course of an evening. I’ve watched the quality of the conversations descend from heights of great repartee to meandering repetitiveness — all within an hour or two. People getting soused by the way have no idea that they’re not being witty any more.

Also remarkable — the amount of planning that has to go into drinking. I can make a few grams of my favorite strains last for a month. A bottle once cracked will probably disappear within an hour if shared. While most restaurants have liquor licenses, I have been part of dining decisions made where we overlooked a place’s inferior food because the cocktails were special. When the cocktail is the point, nothing else matters.

A group of people drinking and a group of people smoking marijuana have very little in common — even though our perception might be that they’re all self-medicating. Because of the way marijuana was demonized and falsely mythologized, we have it in our heads that marijuana and alcohol do the same things to us. That’s absolutely not the case.

I do some work occasionally for a marijuana tour company here in Los Angeles. The tours start out at a dispensary where (after lots of good, quality information about legal pot), the tour goers buy lots of marijuana. The next stop — a house (owned by the company) where the tour goers can smoke the pot they just bought. That part of the tour lasts about 45 minutes.

Then we take this dozen or so people of varying ages (all over 21 of course) to a glass blowing factory where they can see how bongs are made (it’s very cool actually). Then the tour takes them to a glass warehouse. Now — here’s where the difference between drinkers & pot smokers is most pronounced. This group of people who’ve just spent 45 minutes smoking pot walk into a glass warehouse… and nothing breaks.

Think about it — would you dare take a dozen people who’d been drinking beer for an hour into a glass warehouse? Does that sound like a good idea? Of course not — because people who’ve been drinking lose motor control whereas people who’ve been smoking marijuana GAIN motor control. Fine motor control even.

I’ve watched people I know for a FACT are “high as kites” pick up beautiful, delicate glass bongs — works of art, some of them — like surgeons doing microsurgery. Smoke a lot of strong indica and, yeah, you can get “dopey”. But — because marijuana actually makes your brain “think more” (it causes more of your synapses to open so you process more information — the reason some people feel paranoid), most users can pull out of a cannabis high and think clearly; if you really want them to think clearly, feed them a little CBD; it will mitigate the THC’s effects almost instantaneously.

And, another huge difference, though pot smokers can get loud — they do laugh a lot — they never get violent (contrary to the mythology first drug czar Harry Anslinger invented to scare white people).

Imagine if sports fans smoked pot instead of drinking beer. There would never be violence at the end of a sporting event — though there might be lots of hugging (“You played great, dude!” “But you played better — ya won!”) and a few people happily sleeping or dealing with a severe case of the munchies.

Violence wouldn’t spill from the stadium onto the city streets. That’s for damned sure.

From time to time, I do miss some of the rituals around drinking. I like the process of making a martini. I loved the theater surrounding absinthe and the way a good bottle of red opens up as the tannins oxidize over the course of an hour.

But then I tap a little Durban Poison into my regular glass piece — and, as my mind focuses and the world comes into sharp relief — I could almost forget alcohol ever existed.

The Urge To “Off Yourself” Explained

Three days before Christmas 2016, I was close enough to killing myself that my two GPs wanted to hospitalize me.  But I refused.

I had gone there to take one last ‘stab’ at saving myself.  I was at such a nakedly emotional, impulsive place that I was capable at any moment of acting out in the most self-destructive ways possible.

The idea of stepping backward into traffic beckoned to me like a friend…

And I thought it was a friend.

Depression is a process of your inner darkness consuming you.  Some emotional trauma or event — or a series of related events — have caused you not only to question your self-worth but to become increasingly positive that you HAVE NO self-worth…

You’ve never had the chance to correctly deal with the cause of your emotional wound.  It is no different from sustaining a hairline fracture in your arm that you never treat, never deal with — but then causes you pain forever.  And it’s just a matter of time before you put enough pressure on the fracture to finish the job.

In your arm it feels like a knife blade.  In your psyche it feels like self-loathing.

And the self-loathing all goes back to the original fracture that never got dealt with.  One of the problems with how we treat depression at present is we treat the symptoms and rarely the CAUSE.  It’s depressing how poorly we treat and even think of  HAVING DEPRESSION.

The trauma, whatever it was, starts a whisper in your ear.  In my case, it was being sexually molested when I was 14.  The man who did that to me put me on an island — I had a secret, a terrible secret, about myself that I could never tell anyone.  No one therefore could ever really KNOW me.  I would be, forever, alone on an island.  Just me and my secret.

That takes root in your mind.  And when you BLAME YOUR YOUNG SELF for being the cause of your molestation — your feeling isolated in the face of emotional hardship becomes your fitting punishment.  It is not rational.  But it is.

Some people call this ‘Their Darkness’.  I call it ‘My Bullshit’.  I had other bullshit at the time but this became the ‘organizing  principle’ around which all other bullshit in my life would from that point forward be designed:  I had it coming to me.

You question anyone who sees value in you.  What the hell do THEY know?  YOU know better — because YOU know the TRUTH about who YOU really are.

And every bad or terrible thing that happens to you happens BECAUSE of you.

The trick is in realizing — in time — that the voice now screaming at you is the Voice of Bullshit.  It’s NOT your voice.

It’s not easy convincing someone whose BULLSHIT has convinced them that they have no value that they do.  Loving them even harder won’t work — because the love feels so terribly unwarranted.  You’re throwing it away…

The fix lies in KNOWING that there’s a deep, dirty WHY — and in letting your depressed loved one know that it’s okay to ‘HAVE’ that deep, dirty WHY — that the WHY wasn’t their fault.  That they CAN let go of their WHY — and not only survive — but thrive.

Some people already know what their ‘Core Why’ is.  It’s the mountain in whose dark shadow they’ve lived their whole Life.  Some people only ‘suspect’ what their ‘Why’ is.  It’s an ‘Undiscovered Country’ that scares the hell out of them.  Who knows, they worry, if once they cross that border whether they’ll be able to get back to safety.

But naming your Core Why – Your Bullshit – is the essential first step to helping yourself. Refusing to allow yourself your own bullshit’s warm embrace — that’s the real trick.