I know depression. It destroyed my life in my thirties and almost killed me in my early fifties. Back then, had anyone dared to tell me what I am about to say to you, I would have gotten very upset. I could not imagine that there was anything good about depression. Can you? What you are about to learn could change your mind. By using a new approach to working with depression, I had prepared myself for probably the most extreme crisis our family has ever faced.
When I was first diagnosed with bipolar disorder, I wholeheartedly bought into the idea that depression is a dark hole from which the only hope is to escape. It was certainly impossible to function well during deep depression. To function while deeply depressed meant to stay alive and minimize the harm it was clearly causing in my life and in the lives of those around me. High-functioning as related to depression meant that I needed to find ways to get out of it and back to a state where functioning in any productive way was possible.
Finding agreement for such beliefs is easy. Finding someone who challenges those beliefs is difficult. Even more difficult is letting go of society’s belief that it is impossible to function while in manic or depressed states. But once you become open to the possibility that you can learn to function during manic or depressive states, your life will change in ways that you cannot imagine. You will come to understand something that few people do. You may well consider it the most important lesson of your life.
I learned that lesson several years ago and continue to learn more as time goes by. I now teach people how to do this. I want to give you a sense of what life could be like once you accept the possibility and do the work to change. I want to share with you a very personal example of how functioning highly while depressed enriches my life and that of my family.
What Deep Depression Feels Like
I fell into one of the deepest depressions of my life the first of April 2015. Within two months, it had developed into what most would call an extreme state, even though I remained high-functioning. I have interviewed thousands of people about their states and am pretty sure you will agree that I am describing a deep depression and not just a run-of-the-mill bad day. I will describe briefly what that feels like.
Depression for me is a combination of physical, mental, emotional, spiritual, social, and career/financial aspects. The one I am in now (and during the whole story here) is one of those juicy ones that hits me on all levels. While any single element can be overwhelming, the combination of all the elements creates a synergy that adds up to more than the sum of its parts. I will detail each below.
Physically, I feel like I was run over by a truck. My body aches everywhere and I am completely drained of energy. It takes a tremendous act of will just to get out of bed. My head aches, my perceptions are dulled, and I feel like a zombie just going through the motions.
My mental state has many of the classic signs of depression. My thinking is slowed. I have tremendous focus — mostly on negative thoughts. I find myself repeating the same thoughts over and over. I am obsessed with death. I am paranoid about everything. Like many others, I hallucinate in this state and see myself and others dying in a horrible tragedy.
My emotional state is hard to explain. There are no words that properly convey the level of intensity or the variety of emotional pain I am feeling. Distraught is not a strong enough word, but neither is a list of feelings like anger, sadness, hopelessness and despair.
Socially, I find myself afraid to talk with others and want to be alone while feeling the loneliest I have ever been. I am extremely uncomfortable interacting with people and feel as though I am an alien that does not belong on this world. Every person I see brings up feelings of paranoia; that they too might perceive or notice that I do not belong here.
My career and financial thoughts are of total failure. I am afraid to spend any money because I cannot afford to. Trying to move my career forward seems both hopeless and too difficult to do. My thoughts tend toward homelessness and how there is no way to avoid it.
I completely understand how such a description equates to an inability to function at all, but nothing could be further from reality. I have continued to teach my classes and do all of the work I need to do. My understanding of depression and how to function during it has grown more this time around than in any previous episodes.
And I am not even talking about high-functioning depression during an extreme external crisis yet. The story that follows will show you the challenge I met and how depression helped me during it.
High-Functioning Depression During A Family Crisis
In the midst of this deep depression, I took a trip to visit my mother and my sister who have lived together for the last 15 years. My daughter Kate and I have a tradition of surprising my mom so she went with me. We were so excited to get there and see their shocked faces. And they were certainly surprised! In spite of my deep depression, we had a pretty normal visit. You might even say we had a great time together.
But something weird happened when we left. We had said our normal goodbyes and I was about to put the car in reverse. Instead, I got out of the car. I went up to Laura and hugged her again and reiterated how much I loved her. I felt compelled to do it and it left me with the strangest feeling. Kate even said it was weird as we pulled out of the driveway. My mother later told me she thought it was strange, too. As it turns out it was strangely prophetic.
Laura had been on pain medication most of her life due to a chronic illness. She had announced during our stay that she was going to a clinic in the New Orleans area to try to get off the meds. I had committed to flying back to stay with my mother while Laura was in the clinic. We got home May 18, with plans for me to fly back alone in a few weeks. I did just that.
Despite exhaustion from two months of deep depression and the rigors of travel, I got up on June 2 at 5 a.m. After traveling all day, I landed in Orlando, rented a car, and drove the remaining distance to my mother’s house. I finally arrived at 11:30 p.m. Laura had been in the clinic since the day before. I was so exhausted I had a hard time falling asleep. The last sound I remember was the two o’clock chimes on the grandfather clock, so I must have finally drifted off.
At 5 a.m. I was awoken by my mother screaming frantically at the side of my bed. “Laura is dying! Help me, Laura is dying!”
“What’s going on Mom?” I held her while she shook terribly. I had never seen her like that. She had gotten a call from Laura’s girlfriend from the hospital and was told Laura was in the emergency department.
And that is how the worst nightmare for my life began. We had no idea what to do, so the first thing I did was call Kate so she could call the hospital and find out what was going on. Kate is a doctor and speaks “the language.” We depended on her to figure out what to do next, while I tried to help my mom hold it together.
All we knew was that Laura had been rushed from the drug addiction clinic to the hospital. She had been hospitalized so many times in her life that we were unsure if this was just another normal episode. This time, the hospital was an hour north of New Orleans and it was not a simple matter of getting in the car and driving there. I realize now we should have driven the two hours to the airport right away but at the time we were just too confused to act.
It was like we entered a time warp that both drastically slowed down our experience of time and, at other times, sped it up. In this ever-changing state of the experience of time passing, the minutes seemed like hours while the day sped by without action. The next thing I knew it was 3 p.m. and we still had not decided what to do. Kate called from Phoenix and said we should get to the hospital in Hammond, Louisiana as soon as possible. Laura’s condition was dire and we were still in south Florida.
You might say my depression was getting in the way and in some ways, you would be right. But I had turned the decision over to Kate and was essentially waiting on her to determine what was going on and what to do. It was the worst nightmare of Kate’s life too, but at the time she was in the best position to figure out how to proceed.
The next five hours after Kate’s recommendation to go to the hospital were spent figuring out what to do with Laura’s dog Jack, looking for plane tickets, packing, etc. It turned out the best we could find was a flight that would not get us to the hospital until 4 p.m. the next day, so instead we left at 7:30 p.m. to drive the 12 hours it would take to get there by car.
Exhausted and now even more depressed, I drove until 1 a.m. to within an hour of Tallahassee and about half way to the hospital in Louisiana. I was down to stopping at every rest stop and exercising for a few minutes to wake myself up enough to drive some more. A security guard walked by and started a conversation, so I related my predicament. He told me I should stop in an hour when I get to Tallahassee because after that I would not find a place to stop for several hours.
We didn’t get to bed until after 3 a.m. Neither of us slept, but I did get some much-needed rest. We left at 7 a.m. and arrived at the hospital at around 2 in the afternoon.
Laura was on life support. It was clear that things were critical. She had suffered two heart arrests and was unconscious. The imminent fear was that the heart stoppages had caused some brain damage from lack of oxygen and she might not be the same when she woke up.
Understandably, my mom was freaking out. I was extremely upset myself, but this is where depression really became an advantage for me; I was so used to feeling distraught that I could function during it and help my mother through the nightmare.
At first, I tried to protect my mom from everything just like when I was first diagnosed and everyone tried to protect me from my triggers. My thought, and the thought of those who say we need to be protected from such difficulties, was that she “could not handle” the intensity and needed to be kept from hearing more bad news.
This protectiveness escalated to my scolding Laura’s friend Jen when she said something that set my mom off. Jen walked out and I felt so bad that it startled me into recognizing my error. I apologized to Jen. But more importantly, I realized I would serve my mom better by helping her experience the pain instead of trying to protect her from it. I realized at that moment that depression made me uniquely qualified to help mom through the trauma and the pain.
Everything changed for me after that. I allowed my mom and I to feel the full pain of the experience while using my familiarity with pain to hold us both together. We cried openly and often, while holding out hope that Laura would be okay.
As the days went on, I started to get a sense that things were not going to turn around. Tests were not confirming the worst but they were not indicating any improvement either. The hospital was frustrating all of us, but especially Kate because she understood it all, yet was having a very hard time getting the hospital to share data she needed to determine what we all should do. It was a horrible experience for all of us. All I could do was to help my mom and Kate through it.
Remember this nightmare started on June 2. We spent all day pleading with Laura to come back. I cried so much my eyes hurt. By Sunday, June 7, I had accepted that Laura was not coming back and now faced the arduous task of helping my mom accept it too.
Several doctors tried to describe the most recent findings (her brain was gone) but in a way that was difficult to follow or accept. Kate described what happened by comparing it to a bruise; the injury was there when you first got hit, but it took a day for the bruise to show up. Laura’s brain sustained catastrophic failure after the second heart attack but it took a week for it to show up on the tests. By Sunday, June 7, it was clear that Laura was going to die any time now. (It hurts as much writing it now as it did then.)
We called my two sisters and my wife and they all made arrangements to come Monday morning. Kate made arrangements to come too. The plan was to drive in the morning the one hour to the airport to pick them all up and hopefully get back in time to see Laura before she goes.
By now, I had become so in tune with my mother that I could hear her every breath. Neither she nor I got any sleep that night. We both knew tomorrow would be huge to say the least. Our emotions were as raw as I can imagine. I was visualizing a car crash with everyone I love in it. I was also doubting if I could make it to the airport and back without getting some sleep. I was in the deepest depression of my life and, although deep depression usually includes a lot of sleep, this bout did not.
We made it to the airport, and everyone arrived within two hours. When Kate arrived, she had already spoken with the lead doctor at the hospital. Laura had taken a turn for the worse. It looked like death was imminent. Her brain had been swelling (remember the bruise analogy) and that was putting pressure on her brain stem, the only part that was still functioning and keeping her heart pumping.
Kate suggested a drug that constricted Laura’s blood vessels in the hope that she would stay alive long enough for us to get there. The doctors agreed to administer the drug. It was an hour away and it didn’t look like we would make it. Fortunately, we did.
My mom went back and forth from accepting the inevitable and hoping against all odds that Laura would somehow miraculously come back. Kate looked at all the test data and said it was impossible, as her brain was no longer functioning. We all tried to get mom to accept the reality of the situation. It was excruciating for us all.
Even though Kate is a doctor and had seen this many times before, it was particularly difficult when it was her aunt Laura. She did phenomenally well but I helped her to get through it by talking with her, holding her, crying with her, etc. During that time I also had to facilitate conversations with doctors, help them present to my mother because they were doing a very ineffective job, support my mother and the rest of my family, and facilitate the all-important discussion of what to do next.
With the support of the whole family, it didn’t take long for us to decide that the right course of treatment was to let Laura go. Everyone but mom had accepted the inevitable and recognized that the longer it was delayed, the longer my mother would suffer the agony of holding on to hope in a hopeless situation.
No matter how many times we would convince her that Laura was dead, she would soon bounce back to the thought that perhaps she could come back. You could feel her heartbeat when holding her hand so it sure did feel like she was alive. The doctors tried to explain it in medical terms but to get the point across, I finally had to tell her the situation was “like a chicken with its head cut off.” She got it.
When my mom finally did decide it was time to let Laura go, the hospital added another tragic waiting period. They were about to do a shift change and we would have to wait a couple more hours to get started. I could not imagine my mom making it through the night, as we could not leave Laura’s side and the pain was becoming unbearable for everyone.
During the wait, my mom continued to hope that Laura was alive. It was a living hell for all of us. In spite of the doctor’s request that we go to the waiting room while they perform the procedure, all six of us decided to stay. Why? Because I was the only one high functioning enough to know where we needed to be.
The crew came in to pull the tube out and let Laura die naturally. I met with them before we started and told them of our plans to be right there during it. I talked about what an important event it was for us and how we were honored that they were part of it.
Mom and I held Laura with Kate above holding us both. I knew the procedure would be ugly so I put our heads on Laura’s stomach while they pulled the tubes and cleaned Laura up.
When I knew they were done, I said, “Let’s say goodbye to Laura and tell her how much we love her.” I held mom and we both cried with everything we had while we expressed our love and goodbyes. Mom recalled many wonderful moments in a beautiful outpouring of love and pain.
And then Laura’s eyes started to open. I was afraid mom would freak out so I said, “Look mom, she is saying goodbye one final time. Tell her how much you love her again.” Mom poured her heart out while I held them both and looked into Laura’s eyes one final time.
The moment lasted only a few seconds, but to me it seemed like hours. To Kate too because, although she thought my improvising was genius, she feared Laura could continue to hang on for minutes or even hours before her heart actually quit beating. Fortunately her heart stopped right away and Laura was gone. (I wasn’t exactly improvising because I was describing to her what yogis like myself believe happens when one dies; they look up and their soul leaves their body. I was describing what I was seeing at the time.)
This was the most painful thing I have ever done. At the same time, it was a beautiful experience that I am glad to have been a part of. It felt to me like I was witnessing a miracle and helping the others to see it, too. It was like we were actors in divine play and had delivered an incredible performance. It probably makes no sense to most people but I was in a state of ecstasy the whole time and the pain was just as much a part of it as the “high” that some describe during their own ecstatic experiences.
When Laura had gone, I helped my mom settle down and I turned to one of the clinicians to started a philosophical discussion with her. She agreed that being a part of it was very special for her too. She was moved by how freely we expressed ourselves and how I was able to manage the experience for everyone to be fully present to it.
As we started to leave the critical care unit, Pat took my mom downstairs while we gathered our belongings and prepared to leave. On the way out, the nurse stopped us with some more forms to fill out. While looking over the forms, I heard mom screaming and looked up to see her running down the corridor towards Laura’s room. She was yelling about how we had left her and that she was not going to leave Laura.
I ran behind her to the room where she climbed into Laura’s bed and held her tightly. She was frantic and in tears while saying ”I will never leave you” to Laura. She was in a total panic attack like I had never seen in her before.
I held mom and told her I would stay by her side. I said “We can stay as long as you like and I will make sure nobody keeps you from Laura.” A minute or so later, mom got up looking completely normal and said “Okay, we can go now.” It ripped my heart out that I got distracted by the hospital and was not aware of mom’s needs for even the few minutes that caused her to go into a panic attack.
Here I was in the deepest depression of my life and performing the most painful task I can imagine, while helping everyone else more fully experience it. That is what depression gave me and why I consider it an advantage to have learned to function during depression and see the beauty in it while it is happening. That advantage helped everyone involved. To me, that is the very definition of high-functioning.
But my work was far from over. I had to stay an extra day to help Kate through it before flying home to pack and later return to Mom’s for the funeral. I gave the eulogy at the funeral and facilitated as many people as I could for them to stand up and say something about Laura. It was another painful, yet beautiful, experience where high-functioning during depression was a critical element.
As everyone left over the next few days, I was alone with Mom and then the hard work began. I moved into Laura’s room and started helping my mom though the grief. All the while I am haunted by the thought that my mom will likely die before having a chance to even come to terms with her loss.
I stayed with my mother for the next month to help facilitate her processing of this tragic event. While others focused on the all-important role of creating distractions so she wouldn’t think about it all the time, I was free to help my mother look deeply at the experience.
For example, while driving down the street one day, I discussed with her the movie analogy (mentioned above about us being actors in a divine play) and her response was, “We sure played our hearts out, didn’t we?” I had to remind her of that discussion a couple of weeks later and that time she just smiled and said, “Oh yeah” in a manner that said, “I got that.” That is a great sign of progress to me.
My own extreme depression gives me a heightened awareness of the pain other’s are experiencing and I use that to moderate the frequency and intensity of the help I give to others. I don’t always get it right, but my openness over the years has given those around me a better willingness to express themselves. For example, one night I showed mom a picture of Laura and openly cried. At first she was into it and cried with me, but in a couple of minutes, she said that it was too hard for her to face at night just before bed. I know now to only address such topics with her during the day and when she is showing signs of strength.
I also had daily conversations with Kate and spread out the times when we would deeply discuss the experience and her current progress with processing this difficult challenge.
It has been a very interesting experience for me. I feel like I processed the pain in real time and was not only comfortable performing my functions but was immediately comfortable with what was happening. I had no need for any further processing. That does not mean that I don’t regularly look at a picture of Laura or some other reminder and freely cry and experience the pain.
But when I share some of the details of the experience and someone expresses sorrow, I feel that they should be happy at the prospect of being able to have the same experience. I think when people talk about “processing the pain”, they’re really talking about prolonging the suffering that is caused by the resistance to feeling it fully. They need to “process” the experience long enough to come to that realization. Most never do, although after about eight months or so they get used to it. Everyone I have talked with says they never really get over it.
I have not had a lot of time to focus on my work, but I have been able to continue the live classes, the scheduled one-on-one conversations, and keep up with all of the requests that came in. I have spent a lot of time thinking about and writing this document, too.
If I did not understand how to function during depression or, worse yet, still clung to the notion that it is not possible, I would have been a burden to my family instead of an asset. Most people fear they will break down and become a burden on those around them or that their bipolar loved ones will break down and add to the already difficult situation.
While the whole episode is tragic and the most painful experience of my life, it is also the most important. It validates everything I have been saying for the past several years and points to what we are all capable of.
When I mention I see it as one of the most rich and beautiful experiences of my life, I know that sounds incomprehensible and impossible to do. This may frighten those who cannot yet accept the possibilities. But you can’t imagine what it can be like if you learn how to function instead of just trying to keep depression away and avoid the kind of circumstances that might trigger it.
It is my sincere hope that sharing this painful episode will help some to accept that it is possible to function highly during depression and inspire you to begin the journey to making it a reality in your own life. I am here to help when you are ready.
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