Introducing the Letter ‘C’

Depression runs in my family but I don’t know if that’s true. I’ve been in therapy sporadically since I was a teenager. I have been depressed since I was a child. I don’t know if that’s true. I have been told many times that depression is in my brain and that I need to take drugs to “manage” it. My father was depressed. My mother was depressed. Ergo, I was depressed. I am depressed. I will always be depressed. No, I’m not. No, I won’t be. Oh, yes, I am.

It has been suggested and accepted by many people, that mental illnesses may be caused by chemical imbalances in the brain. I used to believe this about my family and myself. Both of my parents were depressed. Some of my siblings were depressed. One of them committed suicide. It was therefore logical to think that my chronic mental distress was depression. I had all the symptoms from a young age. But I also had questions.

During high school, I had a friend who was manic-depressive (as we called bipolar disorder at the time). We had a lot of fun together but he was often challenging to be around. He had drastic mood swings. He was often depressed (angry) and just as often he was manic (fun). From my time with him, I learned that the human mind is unfathomably complex.

My first therapist, when I was 15, told me I should get a job. This was after I told him the trees were calling to me. I had to find out why. I told him I was consumed with sadness, that I felt no joy or hope in my life. All I wanted to do was get high and sleep. He said my depression was because I had no sense of purpose. He did not inquire about my family life or my relationship with my parents. I took his advice even though he believed in aliens. Working did not bring me joy or hope but it enabled me to buy drugs and alcohol so partial success.

My next therapist was one of my high school teachers. Her name was Marilyn and I was in love with her. The class she taught was called Values Clarification. My high school had some progressive ideas and programs and the existence of this class was one result. It was the only class that I attended regularly during 10th grade. I don’t remember the curriculum but I remember being interested and feeling engaged. The classes weren’t lectures, there were no quizzes or tests, and the textbooks were paperback self-help manuals. “I’m OK, You’re OK,” was one of them.

I became so enamored with Marilyn that I would seek her out while skipping my other classes. She allowed me to hang out in her cubicle as often as I wanted with no questions asked. At first, she was a mentor to me but our relationship evolved into a therapeutic one when we both found ourselves volunteering at the town’s crisis intervention and drop-in center. We had weekly sessions where I poured my heart out about the things teenagers obsess with and she taught me the value of self-inquiry and sharing my feelings. I guess we can say she’s largely responsible for turning me into a process whore. No self-deprecation or offense intended. I yam what I yam, as these words testify.

At age 20, I was told that I had mood swings by a woman I was in a relationship with. (Hi Cathy.) She thought I might be manic-depressive. Before her observation, I didn’t realize I had mood swings. But she was right. I was mostly either up or down and rarely in between. My downs were always more intense than my ups and they lasted longer so I began to think of myself as suffering from chronic depression.

In my 30s, my wife and I began couples therapy. After a couple of years of that, with good results, we discovered that I had some long-neglected underlying issues that I needed to explore. I continued seeing our therapist by myself and after a few more years we determined that I needed to see a specialist. Specifically, I needed to see a therapist whose focus was childhood sexual abuse. All in all, it took about twelve years for me to discover, to remember, to admit that something like that had happened to me. It’s difficult for a lot of people to grasp what the previous sentence means. It suggests a concept that some consider controversial: the idea of “recovered memories” of childhood abuse.

Something that took me more than a decade to come to terms with isn’t something that can be explained in a paragraph. So here’s the short version: I didn’t forget that I was assaulted. The memory was always there. I just couldn’t see it. I was hiding it from myself. The brain is a mysterious and complex organ which means its processes aren’t easy to comprehend or describe.

Many times in my life, memories of my assault would start to surface, but before I could understand what was happening my brain would stop me from allowing that to happen. The mechanisms are many, ranging from simply thinking about something else, to total dissociation. Dissociation is a common and normal function of the brain. Children often do it while playing. Pretending to have magical powers, or to be an animal, requires a certain amount of suppression of one’s true self. Dissociation can also be automatic and unconscious, usually as a means of self-defense.

In my case, I existed in various levels of dissociation from a very young age to… yesterday. I mean, today. No, I’m not sure when it stopped. Or if it stopped. What was I saying? (That’s an approximation of how it feels from the inside.)

The point is that I was hiding this memory from myself for more than thirty years so, yeah, it took a long time to admit it was there. Which was just a first step. Even after admitting that I was sexually assaulted as a child, I still couldn’t talk about it. The specifics of the assault continued to elude me because whenever I tried to go there I was overwhelmed by existential fear. It literally felt like I would die if I allowed myself to fully remember.

My good fortune was that my therapist not only had experience working with men like me, but he was also a founder of an organization, called MenHealing, that held weekend healing retreats for male survivors. Called Weekends of Recovery, these workshops are designed specifically to enable men like me to get past that final fear and learn how to talk about what was done to them. To tell their story.

Unlike my memories of my assault, I remember my first WOR vividly. Without exaggeration, I can say it was the most important weekend of my life. I was terrified. In a way, it felt like I was about to meet myself for the first time. I was nervous with equal parts excitement and dread.

Growing up, I never felt like I belonged. Not to my family, not to my schools, and apart from a few close friends, not to society at large. I have always felt like an outsider. For much of my adult life, I assumed this to be the result of not having been raised within the boundaries of any culture. The illusion of a cohesive American culture had been vaporized by beatniks, the civil rights movement, hippies, and the Viet Nam war protests* but I was born too late (1959) to identify with any of those movements. My mother was English, my father Irish, but apart from a few drunken singing uncles, that signified nothing to me. As a kid who got in trouble at school for refusing to recite the pledge of allegiance, I was a prime candidate for the punk scene but there wasn’t anything like that in the cow town I grew up in, nor on Cape Cod, where I spent my teen years.

I arrived at the WOR. on a Thursday evening and met some of my fellow survivors at dinner. Aside from some brief small talk, I barely interacted with any of them. Having never been socially adept, I had no skills with which to break the ice with them. I was also afraid. Of them. None of them looked like me. By that I mean, except for one unusually dressed man, most of them looked like ‘citizens.‘ You know what I mean. They were uniformly unremarkable. Some in sports coats, some in sportswear, a few knitted sweaters, a rare one or two in casual suits. Don’t get me wrong, we were all white and seemingly middle class, so very much alike in that sense. But I still felt like an outsider. I saw no visible tattoos, piercings, not even a goatee.

When it hit me was upon entering the first group session the following morning. As is typical for me, I waited until the last minute to enter the large conference room. Inside was a large circle of chairs with about 30 people already seated. I was one of the final stragglers to enter. What hit me was recognition. As I surveyed the circle, and as many of them looked back at me, I thought, ‘this is them. This is my tribe. I am not alone.’

The weekend was transformative, to say the least. I left feeling exhilarated. I returned home a changed man. I got back just in time for a Thanksgiving gathering with friends. Everybody remarked on my demeanor, disposition, mood, attitude, whatever it was. They all saw that something in me had shifted. It was a wonderful time for me, and those around me.

Of course, it didn’t last, too good to be true, etc. By the same time next year, I was back in my depression. My symptoms, unfortunately, expanded to include intense anxiety, insomnia, and a rekindled paranoia. The simple fact of being back in my darkness made it even worse. Because now I had something to contrast it with. For most of my life, my mental distress was so familiar I took it for normal. I now knew, had experienced, that things could be different, better. So why wasn’t it?

I continued my therapy but I also reverted to thinking that my condition was genetic. I had been using antidepressants for several years but I turned to psychiatry. Maybe there really was something wrong with my chemistry? I spent the next few years exploring this idea. If antidepressants alone weren’t enough, maybe some other medications might help. During this time I was diagnosed as having, in addition to generalized depressive disorder, generalized anxiety disorder, cyclothymia, and bipolar type ii. All of these diagnoses came with prescriptions and I tried all of them. I kept getting worse.

At some point during this time, I also remembered that my younger brother was once diagnosed as having PTSD. From his childhood. We weren’t close so I only know the gist of it. His childhood was traumatic enough that he had PTSD symptoms as an adult. Could that be what was wrong with me? Could that be what was wrong with my parents? Were we all struggling as a result of trauma?

Post Traumatic Stress Disorder. It happens to combat soldiers. Victims of violent crimes or accidents. Torture and rape survivors. Hostages. And children.

Mental Disorder. Generalized Depression Disorder. Generalized Anxiety Disorder. Bipolar Disorder.

dis·or·der | ˌdisˈôrdər |

noun

  1. a state of confusion (check)
  2. the disruption of peaceful and law-abiding behavior (check)
  3. an illness or condition that disrupts normal physical or mental functions (check)

Which came first? The mood swings or the chemical imbalance? The trauma or the disorder?

Thinking about my condition as PTSD was helpful but this framing alone wasn’t enough. It wasn’t complete. I continued my therapy, while also continuing to explore different medications under the advice of a psychiatrist. My insomnia, as well as the constant stopping and starting of new medications, make the years 2016 and 2017 difficult to remember in detail. I was functioning but I was also a wreck. I kept up appearances but I was in a downward spiral. After an absence of many years, an old friend came back to visit me. His name? Suicidal Ideation.

I have always contemplated suicide but I have never attempted it. Thinking is what I do, what all of us do, so thinking about suicide is not only common but healthy. How can we choose not to do something if we haven’t fully considered it as a possibility? But no matter how much I may have thought about it I never came as close to attempting it as I did in the fall of 2017. I began rehearsing it in my head.

Pam and I had been together 30 years at the time. She knew me well enough that, no matter how much I tried to shield it from her, she knew. She called a suicide hotline. I love how life is full of coincidences. I used to volunteer at a crisis intervention center and was trained as a suicide counselor at the age of 16 and, whaddya know, 42 years later I’m the subject of an intervention. Pam was instructed to take me to a hospital emergency room, which is how I ended up spending 7 days in a psychiatric hospital.

I’m happy to report that The New Yorker saved me. Not from suicide, that was Pam, by convincing me to check-in. The food was horrible. The company was… interesting. The fact that I was there at all pushed me deeper into my depression. They gave me Ambien to help with insomnia but then they woke me up every hour to make sure I hadn’t been playing with the bedsheets. The group therapy was like being in a Eugene Ionesco play. While it wasn’t quite as bad as a Cuckoo’s Nest, it was unsurprisingly miserable and demoralizing. The New Yorker saved me from trying to kill myself with ennui. I read every word of about 30 issues, including the antidepressant advertisements. Have you seen how tiny and dense the type is on those? Every word.

I was actually at a very good hospital, one that was connected to Emory University and Hospital. They offered state-of-the-art therapies including shock treatment and ketamine injections. Of course, I asked if I could try the ketamine. No such luck, but they didn’t zap me, either, so there’s that. I met daily with a panel of doctors, professors, nurses, medical students, and a few unidentified men in black suits with dark shades (I think they were from the cafeteria). Oddly, they barely spoke to me, apart from asking a few routine questions about my childhood abuse. They encouraged me to talk freely and I took them up on it.

Have you heard the expression, ‘diarrhea of the mouth?‘’ Yeah, that was me. I was only allowed 20 minutes per session so I talked fast. I spewed my words at them non-stop for 19 minutes and 58 seconds, ending each time with, ‘can I go home now?‘ I was astounded when, on day six, they said, ‘Yes, you may go home tomorrow.’

I was relieved but dumbfounded. What happened? I asked for an explanation and they gave me one by adding a single letter to one of my diagnoses. It was the letter, ‘c.’

“We don’t believe you are bipolar. There’s strong evidence that you have mild forms of general depressive and anxiety disorders but we think the root of your problem is C-PTSD.”

Complex-PTSD. Here are some brief descriptions from a few different sources:

“…a psychological disorder that can develop in response to exposure to an extremely traumatic event or series of events in a context in which the individual perceives little or no chance of escape, and particularly where the exposure is prolonged or repetitive.”

“Complex PTSD comes in response to chronic traumatization over the course of months or, more often, years… because the [child’s] brain is still developing and they’re just beginning to learn who they are as an individual… severe trauma interrupts the entire course of their psychologic and neurologic development.“

“The psychological implications are enormous leaving the child with a complex mess of their core beliefs about who they are what they are. This tangled mess becomes even more complicated by flashbacks, nightmares, and other symptoms that are worse in adulthood.”

Remember this from a few paragraphs ago:

“In a way, it felt like I was about to meet myself for the first time.”

Self, meet self. Big Eric, meet little Eric. I thought I was hiding from my painful memories but I was hiding from myself. For more than 30 years, I was operating on the assumption that there was something wrong with me. That I was genetically flawed. That I had inherited my mental illness. That there would never be a cure but only mitigation. All it took for me to finally find my path away from a life of mental distress and dysfunction was a single letter, the letter ‘C’.

I’m not saying that I didn’t inherit some of this from my parents. There may well be genetic traits that are contributing factors in my story. Just as there are legacy factors. During my healing journey, I discovered that both of my parents had been sexually abused as children. The conditions and factors to come together to cause mental illness are legion.

Nor am I suggesting that medication didn’t help. In addition to receiving a final diagnosis of C-PTSD, I left the hospital with a new prescription, a combination of medications that I have now been taking for three years. During that time, I have consistently felt closer to ‘normal’ than I ever thought was possible. I will never be someone who wasn’t sexually assaulted as a child. But I no longer live in fear of those memories. I can talk about them. I can write about them. I continue to have mood swings but the difference is in the range, the intensity, and the effect they have on me. They no longer control me. I live a full, rich, and stable life. Most important, I have reconnected with that scared little boy, who has finally realized it’s safe to come out and play again.

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