Sunday, October 29, 2006

Blackout Part II

Tomorrow I am going into hospital.

I had written a great involved screed about this (the part I), but am unable to post it for a number of reasons.

I am very sorry about this.

Will post ASAP.


Saturday, October 21, 2006

Break in Transmission

If I could draw, I would draw a little skull and crossbones at the top of this post, like they used to have on pirate flags and poison warnings, but the skull would have closed eyes, and a little warning underneath would say "Contains Extremely Boring Material".

Because that's what you're going to get. Narcolepts, look away now. The brain is not doing what I want it to - the motor's cold, the plugs are dirty, there's sugar in the tank.

Metaphorically speaking, of course. It's not quetiapine time yet.

Things being how they are I have taken a few days off work. Because of the bipolar I almost never take holidays, reasoning that it's better to have a vast amount of leave stored up than to be caught short. The downside of this is that the time other people spend trekking the Himalayas or perousing and carousing in the wineries of the Dunwich valley, I spend lying around the house, hiding from my friends, gorging myself and moaning about how I'm bored, flabby, lonely, fat and when is someone going to do anything about it?

Anyway. I have noticed a difficulty making decisions, a few episodes of poor concentration, nurses having to repeat bits of the patient history to me that I normally would have picked up the first time, a bit of primitive, concrete thinking - so I have taken a few days off. With a bit of luck I should be back tomorrow, which is one day, and a relatively slack one, and then the weekend. And maybe back seriously on Monday.

And maybe not. Things are not exactly good.

Anyway. When I started this blog I had this vague idea that one of the things, one of the purposes was to give anyone who was interested an idea of the whole bipolar thing. In that I suspect I have failed, but it is possible that I have failed because the task was actually impossible. The idea, the actual experience of an episode of inappropriately disturbed mood, let alone a full-blown mood disorder is something that I have been unable to put across to those (admittedly few) people who have experienced it.

My ex-wife, for example, knows that I have bipolar. She knows because we have two children together, and because she saw, from the outside, some of the worst of it. But as far as I can work out, she has never felt anything like it.

I am not saying she has never felt sadness, or loss, or rage, or anything - living with me would have given her every opportunity. And I am in no way suggesting that her emotional life is poorer than mine, that my feelings are somehow deeper and realer and more important because of this stupid thing I have. And I am not saying that Ruth lacks any atom of sympathy or empathy or any other kind of -pathy*.

But it's the whole "feeling sad when there's nothing to feel sad about" thing that she doesn't get. That's the thing that is entirely alien to her, out of her experience, something she does her best to believe in without understanding. She has not had, and I hope she never will have, the experience of a continuously bouyant mood in the face of ongoing catastrophe, or the endless, grinding "seasons in the abyss" that a small, slim, middle aged man told me about five years ago in Shipton's psych ward. Long periods of dark and cold, when outside everything is bright and sunlit.

That always struck me as a particularly horrible mental image, an idea of months under a black sun and a silent sky, stunted vegetation, sour soil and things that creep.


I spoke to someone once, someone who had taken a lot of methamphetamines over about three years, in a heroic, if misguided attempt to deal with not wanting to be a lawyer any more. He had always swallowed the stuff, rather than injected, and had been "clean" otherwise, and it was usually only a weekend thing, didn't effect his work, and his wife didn't know about it. And one morning he had woken up early and lay in bed in his large, spacious bedroom in Double Bay, read the Sydney Morning Herald, drinking his coffee and wondering about getting tickets to the Ashes. And as the late morning sun came in the windows his wife stretched and yawned, and rolled over in bed to talk to him, and instead of her face she had a writhing mass of grey tentacles.

Things were different now. The breakdown had been painful, but perhaps necessary, even beneficial. The divorce was through, the allegations of violence withdrawn, and he had a decent little house in Dunwich, and the thing about a law degree was it was fairly versatile, you could do different kind of work, start again, start something new. Less money, smaller city, more restrained, but new.

But the thing I got from listening to him was the horror he felt. He knew at the time that what he was seeing was a hallucination, but he was too scared and too desperate to escape to do anything about it, too scared to think straight. The monster with the tentacles looked real, and the internal voice that was telling him it was not real was small and thin, and the terror was deep and unmanningly primal. Five billion years of assuming that normally, when you see something, it's because light is bouncing off it, neurons firing, the whole mechanistic explanation - there's something there.

Same thing with the mood disorders. You can oppose the feelings, tell yourself things are not as they feel, they are as your "sensible" mind tells you they are. You can reason with yourself, say that it is unlikely that everyone loathes you, that you harm everything you touch, that this ground truly is corrupted with your steps**... but the mood tells you different. You see tentacles, the cause of the image (the tentacles) must be there. You feel hatred and contempt and loneliness, so the causes of those feelings must be there. You must be hateful and contemptible and deserving of dying alone.

Voices, obviously, must still when you walk into the room. Those side-long glances - what can they be but contempt? And why not, when so much deserved?

Anyhow. I remember wondering about the evolutionary advantage of depression (and I know there doesn't have to be one - spandrels and side effects and so on). But I wondered how come something apparently so damaging was so widespread.

Was it a side effect of the development of our big smarty-thinky-type brain, the thing the Neanderthals did without so well for so long***?

Is it a modern thing, a consequence of tribal, pre-stone-age brains in an electronic high-population density environment, a kind of high blood sugar of the emotions, a consequence of us living in a way for which we are not suited?

Is it something that's always there, but we only notice it when all our other needs are silenced, our psyche's background radiation?

There are about thirty things wrong with each of those ideas. But one thought I had recently is that depression, at least in its milder form, is still with us because in some situations it gives us a better view of the real world.

Try this idea. Inside my head sits an audience, watching a film (again, I am speaking metaphorically), something projected onto the back of your frontal bone, or maybe where my eyes should be looking out. The film is a dramatic, engaging, emotionally gripping - it's a propaganda film. The film is all about me, and it's jolly gripping stuff. In the film, my prospects are good. My actions have significance, my promises are largely kept, I - the hero - am a decent and trustworthy man. Gratifyingly, people love me, I make a difference to their lives, and it is good and important that I go on doing what I am doing.

And like all propaganda, it leads to redoubled efforts, increased troop morale, that kind of thing.

But in depression - at least in the mild to moderate form - maybe the projector breaks down. Maybe the "audience" peers out unfiltered though the eye sockets and sees what's really going on. The hero, they see, is an emotional cripple, his achievements un-noticable, his life a single endless season of insignificance. He loathes himself and is justly loathed by others.

There are certain cognitive tasks the depressed do better at, tasks where they have to estimate how much of an influence they have, how much what they do matters. Confronted with a task where you make no difference at all, the non-depressed still believe they matter. As one person said, they walk around with a rose-coloured bucket on their head. We, the depressed, know when to cut and run.

Maybe that's why we're still here.

Anyway. Even I can tell I've written enough today. And I am aware of the inadequacies in this argument for severe depression, psychotic depression, the alternate searing days and moonless nights of bipolar. I am not saying this is what I reckon is going on, this is just thoughts, and the thoughts of someone who is probably should be giving his brain a rest, letting another organ steer for a while.

Right everyone, pull over, change seats. Brain, have a nap, let's see where the pancreas leads us.

Anyway. More later. Hopefully much later.

Thanks for listening,

*Except Binswangers encephalopathy, one of the causes of a common form of dementia. Definitely doesn't have that. And I have seen little evidence of cowpathy, "a little-known form of medical practice which uses medicines prepared from the "five products" (milk, curd, ghee, urine and dung) of cows".

**The weird thing is, you read this and you read Shakespeare at the time, and there is no way you would say that Shakespeare was going to end up as the better author. Marlowe at the time, seemed to show so much more promise. But he was stabbed just over the eye in a drunken duel, didn't see thirty, all that light went out of him, and the other guy, the less promising one, went on to change the English language.

*** They had a bigger brain, but they used it different. This is a fascinating area to read about. They buried their children surrounded by flowers. I think we ate them - the Neanderthals, that is.

Aleesher and the Last First Time.


Rather than write about my own feelings (because believe me, everyone who wants to know has heard about it), I am going write about someone else's. Because otherwise I might as well just lie around the house wearing a teeshirt that says "I wish someone would do something about how whiny and boring I am". Anyway, rather than point out the individual excellent and often stop-and-stare beautifully written posts of Foilwoman, Cupcakegrrrl and g_pi I will just refer people again to these blogs, and continue to lobby for them to be included in the late secondary school English Literature syllabus. And read everyone else's stuff too.

Moving right along - and strong language alert for what follows - I saw Aleesher today. Aleesher is probably one of the Ten, one of the five percent of my clients who cause me ninety five percent of my work. And she's not violent, and her drug problem isn't that bad anymore, and she doesn't have any overt, classifiable mental illness.

But she's one of the ones I worry about. Twenty one years old. Married now, mother of one. Slim, blonde, pneumatic lipped, relatively fashionably attired. She looks - I don't know.

This will sound odd, and uncharitable, but her face - there is something wrong about it. Nothing obvious, but her ears are close and high. She has large brown eyes with an upward slant, at rest her face has a slightly odd expression, there is something that suggests to me some damage, some genetic lesion. A Barbie-doll deformity, something that makes you wonder about a touch of fetal alcohol syndrome.

And the thing is, there is something wrong, something cognitive. It's always hard to tell in someone you see for only half an hour every month or so, but there is stuff she doesn't get. A few years ago, when things were worse, she had to check into one of the homeless shelters. A crisis care centre, inadequately staffed, with about two hundred people, one hundred and eighty men (most straight out of prison) and twenty women. It is one of the worse homeless shelters in Mordor, everyone injects, rapes and assaults and the like are common.

It was a hot day and Aleesher turned up in a tiny yellow bikini. This was what she wore around the house, and she'd come there via the shops. The social worker (now working for us) describes how she shoved a size twenty two fisherman's jumper and a pair of gargantuan track-suit pants on her and bundled her off to the Salvation Army to get some acceptable clothers - all the while trying, and failing, to explain to Aleesher why a yellow bikini and sandals was not going to work to her advantage.

"But you said" said Aleesher, "that a woman should be able to dress how she liked and not get hassled."

"Yes I did" said Michelle, "and I stand by it. But there's only one of me saying that, and there's one hundred and eighty men there who reckon different, and youre not staying at my place tonight."

And there's other things. Her husband takes her up north every weekend to visit relatives, she doesn't know exactly where, even though they've been going every few weeks for a year. That kind of stuff.

Anyway, things have got better for Aleesher, due more to my wife's care than to mine. Of course, being a young blonde with puffy lips and some mild cognitive impairment, she has been snapped up in the marriage market and has a husband whom she describes as "very strong but not really supportive", and child number two would normally not be far away. She got cancer a few months ago - cervical, she thinks, she's not sure, she just had surgery, more treatment Monday - and she's always tired and the baby boy takes after his dad, big and strong, a real handful. And Brad works all the time and she can't give him sex and that's another strain.

This is why I try to make sure the patients before her finish early and the ones after her are okay with waiting a bit. Aleesher takes time.

And today she was talking about heroin. She'd used again. She was angry, she'd had a big fight with her sister, walked out and there'd been a friend from the old days, and she'd scored, just fifty dollars worth. And her chest'd been tightened up with rage and frustration, that black churning in your stomach and tears in her eyes, and she'd used. Stuck the needle in, and that'd fuck her sister and fuck her mum and fuck everyone she was angry at. Fuck herself.

And of course, afterwards the guilt. Because we've got her on twice weekly random urines and the next one was tomorrow, and it came up. I called her in.

"The thing is," she said "I hate it."

I nodded.

"Why do I keep doing it when I hate it?"

I paused. Aleesher wasn't the kind of person to deal with the neurochemicals explanation.

"A lot of people say what you're saying," I said. "Using it and hating it. It's hard to stop when you want to. That's why you sometimes need help."

She nodded. "I saw a tv programme on it the other week. About the first time. Did you see it?"

I shook my head.

"It said that the first time you use heroin it's like nothing else. It's the best. And it is. And so I keep saying 'one more time like the first time and then I'll quit'. And every time I stick the needle in I'm hoping it'll be like the first time, and it never is." Her hands - slim, tanned, cheap engagement ring, scarred from tens of missed veins - were clenched in tight white fists on her lap.

"It never fucking is. And instead it keeps getting worse, more and more shit, so you end up chasing something that gets further and further away. And no matter what you do you never get that that first time again... do you?"

"I don't think you do. From what I've read, you don't."

She stared at me. "Does it ever come back?"

I tried to think of what people had told me, what I'd read, what I should tell her. Limits of knowledge versus things I should say, that kind of thing.

"No," I said. "No it doesn't. It's gone forever. You've had your first shot and you can't ever have it again. It never ever ever comes back."

And I don't know if it's true, and it's probably not true in the way that "the atomic weight of sodium is 22.990 grams" is true, but it's what I've heard and what I suspect to be the case, and the first shock of pure heroin to young neurons - there's probably nothing like it.

Certainly, with her on fifteen mg of buprenorphine and surrounded by what continues to be fairly shit heroin and an on again off again habit low-grade that she can't really afford ... nothing like it.

What I am told is the problem with heroin, the pathology of it, is not so much the early days, when it is all about pleasure, it's later, when it becomes a form of pain relief. You start out and it's usually that things are things in your normal life are okay, certainly livable, but with heroin they are great.

Then you fast forward to a few years later and things are different. Life without heroin is unbearable, shivering and shaking and too painful to endure... and sometimes (and not for everyone, this is only what I have been told) all the heroin does is makes you feel normal again. Pain relief that causes you more pain.

When things get like this people come to the Drug and Alcohol Service, and take our toxic addictive medications and endure our preaching and our humiliating limitations on where they can go and what they can do and how long they must stand in front of the chemist before opening their mouth to prove they have done what they are supposed to.

Don't get on smack. I'm warning you.

Anyway, Aleesher and I spoke about this. About how this whole thing of chasing what she couldn't get, and what she could do instead. And we put her dose up (the one that wrecks her sleep, and screws up her teeth, and gives her those headaches, and will one day make her fat) and I spoke to her about the sleeping tablets she'd been given by her GP, using one a night now, had to be careful with them, said I wanted her to see Isobel, our hypomanic social worker, twice a week for the next month. Just because of the cancer and the stress and the using and all that. And someone else can just be found to look after Brad Junior. And we'll do the blood tests to find out why you're tired, various viruses and anaemias and so on, but I don't reckon it's anything we don't already know.

Anyway. There is an analogy that can be drawn here, not in terms of the shivering and shaking, but in terms of other first times that we always remember and that hit us hard. I don't mean sex, I mean love, and I know the analogy is a fairly fragile one. There is no buprenorphine for love, there are no dealers on the streets and no-one cuts love with other emotions. And first love is intense, changes the structure of your mind, gives you that whole can't breathe, heart pounding stuff - but later love is different, stronger and something you can live with. Love doesnt get worse and worse each time, chasing after something you can't have.

Well, there it is. I don't think it's an analogy that can really be used to anyone's advantage, but there it is. For people like (most of) us, who haven't used, it's the closest thing we can imagine to someone like Aleesher's first time.

Thanks for listening,

Sunday, October 15, 2006

Timor mortis conturbat me

The preceding, as the devout amongst us will readily recognise, is a line from the Office of the Dead. It is part of the Liturgy of the Hours, and is normally read on All Soul's Day. It means, literally, "the fear of death confounds me", or more commonly, "I am scared to death of dying".

Why bring that up? (the actual title of a book on seasickness written between the wars, when people probably needed something to distract them)

Well, it was true for a fortnight or so. It's part of the reason I haven't written for a while. Part of the reasons is because I have been a bit low - I am still so.

I will try to explain what this is like, although I suspect I cannot.

For me it is the somatic symptoms - weird sleep, initially waking early in the morning, always tired, wanting to be in bed by nine, then eight. There's the usual voracious eating - I've gained four kilos in two weeks, I lumbered back into the gym today.

Then there's the purely cerebral stuff. I get a mind full of odd thoughts, ideas about the past and the future and how I must make recompense for my many sins. I get rumination, my mind going over and over on things, scoring furrows deeper and deeper into the earth. Like a bullock-cart or a blindworm, each time you go down that track you make it deeper, each time you think that thought you make it stronger, neurons entangle and make stronger connections.

And there's that strange, almost inarticulable feeling of fear, that focussless, formless fear, a fear intransitive. I get a feeling of almost physical pressure that gets me in open spaces, a sensation that some vast weight is going to crush me, that there is something solid and massive in the sky above me, a sensation that I am a cripple on an anvil. Something is coming, something crushing and killing, and I don't know how to run or hide from it, and perhaps it is better that I do not.

And of course, the endless mental judo where I try to convince myself of how people will be better off without me, how the ripples of even something like this fade away, how people will get over it. Deeply stupid thoughts, and ideas that cannot withstand even a moment's analysis.

If anyone is reading this, believe what I am saying because I have seen. Suicide damages the survivors, those around you. And it selectively damages only those who love you, the ones you wish to hurt the least. There is no way of preventing this, no way of insulating them. The more they love you the deeper they will be hurt.

Anyway. Things are on the up. I went out a few nights ago and had what had all the appearences of a good time. The problem with my friends, family and workmates is that they are basically ornery - they refuse to co-operate with my feelings of worthlessness, self-loathing and guilt when I am depressed, and still write, visit, chat, etc. It's difficult to lie hunched in bed, softly singing "Are you loathsome tonight?" and reflecting how I am alone in the world when people keep on talking to /texting/emailing me.

Plus, not even the most determined narcissist - and there is an aspect of some depression that is that, that is a form of dependent, needy narcissism - not even a florid monomaniac could feel his/her problems were worse than those of my patients.

To give a taste of this, one of my patients today was estranged from her family because her husband had run off with her sister (after informing her that her niece was actually fathered by him). This was before the house burnt down but after the tribal punishment.

In terms of betrayal this ranks alongside the woman who found her husband in bed with her mother, and the three (count 'em, three) women in the last six months whose male partners left them for their daughters.

At least one girl I know (sixteen, this was when I was at that Child and Youth Health place) was ejected from the family home by her mother (thirty four) because mother didn't trust her in the same house as the new boyfriend (twenty five) , because he'd already made appreciative comments.

You don't get to be poet laureate by being stupid.

Anyway. Things are on the up and are largely better. No more whining. Will blog more soon, and will now go off and read other people's stuff.


Monday, October 02, 2006

The truth of the matter

First off, thanks for the many undeservedly kind and helpful comments.

Today, I suspect, I may have alerted my co-workers to the fact that all is not well as far as moods go. We had our doctor's meeting and we were talking about drug companies giving gifts to doctors, and whether we should let them drop off pens/notepads/other bits of subliminal advertising to us.

Some said it was harmless and some said it was a bit dubious, and the boss asked me what I reckoned. I said that my considered clinical opinion was that pharmaceutical companies were, and these were the exact words I used, "the incarnate spawn of Satan, and Glaxo Smith Kline is Satan walking to and fro upon the earth."

There was a fairly sizeable pause, and someone said "Mmm", and the other guy said "well, where would we be without pharmaceuticals?" and I said I had nothing against the individual molecules themselves, it was the ideological hegemony of the bloated* pharmacrats and their capitalist construction of illnesses. Phrases I haven't used in public in near on twenty years.

And there was another silence and the other guy said, "Quite, quite", and we moved on to the difficulties we've been having getting good dental care for our patients.

It's not as bad as it sounds. They advertised my job (well, the equivalent one) the other week and no-one applied. There seems to be a perception that nobody in their right mind would work for Drugs and Alcohol, which dovetails nicely with my observation that no-one in their right mind does. There are only about ten of us doctors in the organisation, and once you rule out the daft, the disinterested, the disinclined to work and the detainably unwell, demand far exceeds supply. And believe me, the heroin problem in the south isn't going to go away anytime this Age, and Emergency Departments in the south are looking at three times the patients being treated by half of the emergency doctors in twenty years time.

I am essentially unsackable.

Having said that, I found out the other day how much money I could make just writing prescriptions for oral morphine tablets. The going rate for 100 mg MS Contin (oral morphine, you crush it up and inject it into your vein, or snort it if you can't do that) is apparently something like $60. Temazepam and the various "sleepers" are a lot cheaper, but still, it adds up.

There are apparently entire communities, particularly in the Northern Territory, funded by morphine tablets - the elderly who cannot survive on their savings or pension go to the doctor and say they have back pain, the doctor prescribes them oral morphine tablets, the pensioners sell it to the able-bodied youth who clean their gutters, etc.,... it all goes around.

It's weird looking out across this imagined landscape, where beaming matrons push gurgling babes in prams down well-kept streets, and think it all depends on drug money. And all voting to get tough on drugs.

I don't know this is true, by the way, but the patient who told me this looked very sincere (and tanned) and was on one hundred and fifty milligrams of methadone.

As an aside, have a look at this. It appears to be a hand-held game that kids (6 - 10) year olds play that rewards them in chocolate and candy - without the hassles of them trying to sneak into the pokies. It's made by Nestle. Nestle are the only company trying to do something about our epidemic of "kids who don't sit around and stuff themselves with junk food enough". From what I can work out they have adopted a rather sophisticated "triple pronged" approach to the problem - the Wonkazoid simultaneously prevents dangerous outdoor exercise, ensures that we don't run low on national stocks of kids with attention deficit disorders and helps our kids learn that "sugar", "fun", "popularity" and "artificial colouring" are actually synonyms.

With industry support like this, paediatric cardiology is going to be one of the hottest growth areas of medicine in about ten years time. In thirty years time, we doctors who can remember when one hundred kilogram eight year olds were unusual will be considered quaint.

Anyway, enough about other people, what about me? Not sterling. I usually manage to get five of the required nine symptoms of deppression for two weeks with little difficulty. I've got nine before, when unwell. I have a friend who regularly gets nine for weeks on end, but she's always been driven to excel. Currently I sleep like a baby (waking every two hours screaming and not knowing where I am... not really), and I am eating all the pizza in the house to avoid the temptation of there being pizza in the house for me to eat. But I am going down the gym and checking out how many days of holidays I have accrued and doing all that stuff.

Speaking seriously for a moment, there is a lot I could say here. There is a lot on my mind, stuff that goes around and around, churns and thuds repetitively like malfunctioning machinery. The usual thoughts, the usual threats, the usual things. But I don't know that there's any benefit to me saying it, or anyone hearing it. Writing things down only bores me when I am sick and embarrasses me when I am better.

Once I am worse, of course, I will "realise" that these thoughts are not the symptom of a disease, but are insights into the true nature of things, profound glimpses into what is actually wrong with me, the skull beneath the skin. And I will doubtless look to share this with anyone who will listen, write for hours and hours, filled with the need to apologise to anyone who listens, or to stand at some upper window and lash myself for the public amusement. Prove something, in some futile and deeply screwed up manner.

But before then there is the cognitive stuff, and the maximum dose of the reboxetine, and the higher dose of the valproate. And the body and the brain and libido to match.

Lucky I have accrued twenty one days off. And I'm not rostered on for holidays for a while, and we're short staffed, but believe me, nothing gets you to the head of the sick leave queue like a history of bipolar depression with psychotic features. If they mention how it's not a good time to take sick leave, I can always say "Funny, that's not what the owl people said". Go directly to your car, do not pass go, do not collect two hundred dollars.

Anyway. Thanks for everything, and any and all remedies will be employed (while I still think I am sick - that's a joke, and not a particularly funny one), and apologise in advance.

Thanks for listening,

*I didn't say bloated, but it was definitely implied. Aside from that it was word for word. The wide eyed medical student is starting to look like a manga frog.

Sunday, October 01, 2006

Yippee ki yay.

Well, what's going on?

Not a lot. Sarah is over on the coast, at a cat show spectacular, my niece is out mushing or moshing or something, and I am at home, alone, not visiting my friends.

Why is this?

Well, it's because I feel ever so slightly low. To be honest, more than a tad low. A sizeable tad. Sleeping stupid hours, thinking stupid thoughts, eating rubbish, that kind of thing.

Now, there are protocols which I have developed for these circumstances, ways I have for dealing with the moods. There are a variety of things I can do, and if I do them I can head things off at the pass, neurochemically speaking.

- remarkable mental image, isn't it. The serotonin rustlers riding hell for leather towards the amygdala, driving the lowing neurochemicals before them, while the sheriff's men gallop madly along the prefrontal gyrus of the brain -

Mmm. Anyway. Every time I get a bit low, especially if it coincides with Sarah's "as if she has her own life to live" absences, I go off and visit my friends. If you ever move down here, know now that these are occasions to be avoided at all costs. Not that you'll be able to - I usually phone to invite myself as I pull into the victim's driveway. I emerge with a bottle of cheap wine in hand (which I will drink myself, along with whatever anyone else has got). I hunch in a chair, emitting misery like black body radiation, and gorge myself on whatever food my victims had prepared for themselves. People around me try to lighten the atmosphere with chatter and cheering conversation, I quash it. Then after what must seem like hours I mutter a few gnomic pleasantries and I depart, leaving screaming children, sobbing wives and all manner of domestic discord in my wake, then on to the next house.

So much for my "whine and dine" therapy. It does work, possibly if only via that whole "trouble shared" thing. But to be honest, I'm not feeling up to that at the moment.

Instead I have been practicing the social withdrawal method. Withdrawal is as effective a treatment for depression as it is a method of contraception. One day, if I ever find "the answer" for depression, I'm going to write it on the bedroom ceiling. That way, when I lie in bed staring at the ceiling, I will see it.

That's not a bad idea. If I got a sizeable font, I could fit "How about you get off your arse" and "think about someone else and grow a backbone" on each side of the light fitting. A mantra for troubled times.

Anyhow. Rather than that I am going to do the whole thing - the gym on Tuesday, writing as soon as possible, maybe some study. All that cognitive stuff I rave about to everyone else. Working, seeing people, that kind of thing.

Anyway - they say it helps in these cases to have a definite goal, a deadline. Therefore I aim, with the help of modern psychopharmacology and a pair of boxing gloves to get happy, by this time next week. In fact, since I have a science background, I'm going to be more precise and aim to be at least three point eight percent happier each day until next Sunday. I'll just attach myself to the gloomatron....

Anyhow, thanks for listening. This is not, by the by, a plea for condolences. Without wishing to sound ungrateful, wjhat I'd rather get if anyone wants to comment is people saying five things - the movie, the book, the piece of music, the friend and the food that they find has the most potent anti-depressant effect.

Hopefully without the weight gain and sexual side effects of many of the SSRIs.

Thanks for listening. Normal neurotransmission will resume shortly.


PS - a friend of mine has started a blog. He is the best writer I know, he's one of the better writers I've read. When We were in a writer's group together I took home some "bit of crap" he wrote and framed it and put it one my desk as an example of what writing could be. He will be mortified when he reads this, he demonstrates an almost anaphylactic reaction to traces of praise, but fortunately I am able to hide behind the anonymity of the internet, so he won't suspect a thing.

Anyway - go thou and read it.

Thanks again,