Monday 20 October 2014

Depression and Inflammatory Bowel Disease

Time to vent some thoughts.

I have much I want to share with you guys.  Whether its basic updates on my health, recipes I feel like I should share, lots of personal rants and opinions (as petty as they may be), things I am grateful for, lyrics that inspire me, personal goals, or lessons I have learned from this disease. It just all feels overwhelming so I'm just writing when I feel up to it.  Most of all however, I feel I owe it to others with this disease to share with the world what kind of living hell this disease truly can be.

I don't post how shitty I'm feeling or how depressed I am for sympathy.  Don't get me wrong, I've found sharing to be therapeutic, but the main reason I do it is to share with the world what crohn's, and other "hidden" chronic diseases really do to people.  I know that I will get better.  Maybe in a few weeks, maybe in a year.  I will be strong again.  I will be happy again, and I know that I will achieve great things.  That is all great, but my fear is that I will get better without the full story being told.  I feel this responsibility to share HOW I got better, and what the entire process truly entailed.  I even fear losing touch with the suffering myself.  The last thing I want is to get better and move on to this happy life, and start taking things for granted again.  I want people to know how truly awful this experience has been, and I myself don't want to lose touch with it because of the perspective it has given me.

Out of all the terrible symptoms of crohn's and colitis, mental health is one of the most important things for me to share, because nobody has any idea that this disease can mess with your brain.

I've struggled with depression of varying degrees for the last two years, and for a combination of reasons.  For anyone who doesn't know depression isnt simply being really sad.  The best way I can describe it is things like:

-A total loss of interest in anything.  This brutal combination of being bored out of your skull, having all the free time in the world, yet nothing appeals to you.  Nothing brings you joy, nothing seems worth doing.  It messes with your head.
-Feeling extremely dull.  Life is dull, everything feels grey.
- Feeling paralyzed.  Feeling stuck.  I can tell when I'm depressed, and I know what makes it better, but you lack ambition to the point where nothing seems worth it.  The tiniest, most menial tasks become so intimidating.
-Feeling like you have nothing to offer.  When I'm depressed I'm totally conscious of the fact that I'm not fun to be around, I can be rude and condescending to people I love, and I never have anything positive to say.  I'm aware of it.  I'm not proud of the fact that I'm bitter.  What ends up happening sort of goes along with "If you can't say anything nice, don't say anything at all."  So I hide alone in my apartment, not wanting to be toxic to the people I love.
-Depression isn't sadness or a sign of weakness, it is the result of staying strong but fighting a losing fight for way too long.
-Insomnia.  Always tired, can never sleep.

So that's how I would explain it in a nutshell.  It is extremely debilitating yet easy to mask.  It can happen for no reason at all, which can be the worst because you beat yourself up for being irrational. 

The first thing that contributed towards my depression was losing my identity as an athlete.  This I'm actually thankful for, because almost all high performance athletes go through this when they lose their sport, whether its because of retirement, or an injury.  Athletes have this unhealthy tendency to base their entire identity around being an athlete, thinking that is all that makes them who they are.  It sounds cliche, but they don't see that there is more to life, that there is more to them than sport.  I was one of these athletes, and the reason I'm happy I had that "particular" depression is because it was inevitable, and I got it out of the way at a young age.  It was NOT easy, but having pole vault taken away humbled the shit out of me.  I didn't have any say in the matter.  I had no other option than to find joy in other things, and to figure out what else I had to offer the world.  The beauty of it is that vaulters peak in their late 20's, so it will still be there when I'm healthy.  Difference is that this time around, it will be nothing but a gift, nothing but a bonus.  Though I miss it like crazy, I now know that I can be happy without it.  When I'm back on the runway, it will be nothing but a celebration rather than an obligation.

Then there is depression caused from isolation.  I've been stuck in my apartment for months on end, even before/aside from social anxiety, simply just from being sick as a dog!!!!  At any given moment, my torso will completely lock up, I'll become short of breath, and I'll start to feel knives twisting inside my my stomach.  This will escalate for about 20 minutes until I pass about 3 tiny, bloody bowel movements that makes me want to throw up at the same time.  This "only" happens 5-10x per day, so yeah, there are plenty of "non-sick" parts of my day where I could go for a walk or watch a baseball game, but the fact is that I cannot predict it, so I have this constant fear of leaving my own small comfort zone.  Its not the pain attacks I'm afraid of, I'm used to that.  It's being sick and vulnerable out in public that scares the hell of out me.  Other than a very small number of people, I don't want ANYONE around me during those episodes.  Do you know what it's like to be in a small class and have to make 3 separate, 10 minute bathroom trips within one hour when they don't know your situation?  Or how depressing and frustrating, and stressful it is to risk having to pull over to a gas station (again, for like 10 minutes) any time you want to drive across the city?

So I got on some tangents there, but you can start to see why people with inflammatory bowel disease just sort of disappear, and never want to leave the house.  Keep in mind we only even attempt these outings the rare time we even have the energy to do so.  Even in between pain attacks the fatigue from anemia, insomnia, and lack of nutrient absorption (if you are able to eat at all) , is enough to make you never want to get out of bed.  So you can imagine how frustrating it is to have a pain attack on those very rare times you actually feel like living life.

The result of living in isolation is becoming detached from the world.  Detached from your friends and family, from your job, from your hobbies, detached from life.  It doesn't happen overnight (which is why it is so hard to catch), but eventually you find yourself feeling dead inside, wondering what the hell happened.  By the time you realize you are depressed, getting out of that hole is extremely intimidating, even if you know how.

I also was on prednisone off and on for over a year, which chemically induces depression as a side effect on its own.  I'm still emotional as hell because of this disease (see next paragraph), but prednisone can change people into a total Jekyll and Hyde.  I won't get into it, but that stuff is evil and I'll never take it again unless its a total emergency.  

The last, but most important contribution to depression that I want to share is how this disease affects the brain just by its very own nature.  Crash course here: serotonin is the body's "feel good" hormone responsible for happiness, motivation, etc.  Without serotonin, you become depressed. Bet you didn't know that 80-95% of a person's serotonin lives in the gut!!! So you can imagine how digestive diseases can wreak havoc on people's emotions.  This explains why even with IBS many of the main symptoms are psychiatric, not just digestive.  It's not just serotonin that is made/resides in the gut, but a whole other host of hormones and neurotransmitters.  It makes sense to me, looking back I have always been an anxious kid, and I've displayed symptoms of ADD my entire life.  This is pretty new stuff, but scientists are already starting to refer to the gut as "the second brain".  I didn't even know this stuff until recently, but I always make sure to mention the mental side of things now when people ask me what crohn's is. 


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