Paying Attention to the P’s of Depression.

As a therapist I often meet with individuals who are dealing with depression but I’m no stranger to it myself. Winston Churchill described his bouts with depression as a visit by the “black dog.” My experience is more of a grey fog. I’m probably more accurately diagnosed as having occasional dysthymia – a low grade depression – one that allows me to function for the most part – not super high, not super low – just ok, but usually feeling just a little blah. The fog analogy works well for me – imagine a grey thickness hovering close to the ground that sometimes reduces visibility, blocking out the sun, leaving you feeling sluggish and weighed down.

One winter a couple years ago I had a particularly bad week. It was dark and cold (as winters often are) and I experienced several frustrating encounters with a coworker, but mainly I just felt bad, weighed down and lacking energy. It felt like I was covered in a heavy x ray protective apron – but instead of protecting me from radiation, I felt as if it exposed me and all my inner turmoil for everyone to see. I knew that I was experiencing a more acute moment of depression. (And, surprise, surprise, depression can make you more sensitive to others remarks and more liable to misinterpretation.)

My experience that year brought into focus what is helpful when we find ourselves feeling depressed. Sometimes it is difficult to find the right words to say to someone when they are experiencing depression. Sometimes the grip of depression can feel and be very powerful. But there are things that can help in a very practical way.  Wherever you or a loved one might be on the depression spectrum, there are several things you can pay attention to – I call them the P’s of depression – that can be instrumental in helping you or others navigate depression with integrity and health.

SymPtoms
Depression (which is much more than sadness, something we all experience at different times) can show up with many symptoms including: loss of interest in typical activities, loss of energy and appetite, a ‘closing in’ or ‘closing down’, sleep changes (including difficulty going to sleep, staying asleep or wanting to sleep much more), a physical sensation, a weight, anger and irritability, feeling helpless and hopeless.

Depression is personal and unique. Though there are common causes and symPtoms, depression can affect each of us in different ways. Thus I believe that the treatment of depression will also be personal and unique, though there are some general ideas and solutions to pay attention to that may be helpful.

Precipitators (Common Causes)

PROBLEM – There can often be a very real and specific problem that is affecting your mood and emotion. This can be a PHYSICAL health issue or a PERSONAL relationship or PARTICULAR situation that is causing PAIN and pain is very real. Any loss can lead you in the direction of depression

PURPOSE – Depression can occur when you don’t feel like you have a PURPOSE – whether that is because of a change in your family, job or a variety of other reasons. If you feel like your PRESENCE is not valued or you don’t know your PLACE anymore this can affect your purpose in life.

PRECIPITATION – You may laugh, but once I left the gray and cloudy Pacific Northwest and moved to the East Coast, my overall countenance improved. My wife and I joked that we literally saw the light.  I was never officially diagnosed with Seasonal Affective Disorder (SAD), but having more sun helps and I don’t miss the gray!

Depression – The P’s that can help  (in no order of importance)

1. Psychologist/Psychiatrist/TheraPy – This might be the most readily encouraged solution and there’s a reason for that. Talking to someone can help. Talking to someone who is trained in the ways of the human mind and heart and knows how to be helpful is even better. And if that helpful person is also a medical doctor he or she can do a physical evaluation to assess if hormones and chemicals are in balance and prescribe medication if it is needed. (see #2)

2. Prescription – I’m not a pill pusher, but I’m also not a pill avoider. We are probably over diagnosed and overprescribed in this country, but medication can be very helpful in many situations. Don’t discount it, but do know that it might take some time and adjusting to find the right medication and dose for you.

3. Purpose – Losing your sense of purpose can quickly take you to dark places.  I find that when I start to sink, it’s because I feel like I don’t have a purpose. I can quickly spiral down wondering what I am doing with my life. Do you need to make a change as a result of a circumstance that has changed? Or do you need to pay attention to #4 and #5 – ways that you can be reminded what your purpose is.

Christmas 2015

This is the 7th year we have created a collage card to send to family and friends and to remember special moments from the year. Highlights of this year included a trip to Ireland in September, Duncan's trip to India in March and a work trip for Andrea that took her to several countries. We are grateful to know that the work we do can and is making a difference.

I am grateful for the reminder that "in those days" there was much fear and division in the world, not unlike we face today, BUT "on this day," because of this day, there can be a new way forward, a different possibility and the reminder - Do Not be Afraid! (Luke 2:1-20 Thanks Dottie Younger)

GK Chesterton writes, "Christmas is built upon a beautiful and intentional paradox; that the birth of the homeless should be celebrated in every home." So on this day that we remember a middle eastern family that was looking for a place to stay and the good news that came on this day, my hope and prayer is for peace and safety and justice for all.

Duncan and Andrea

The Emerald Isle

We left for our trip to Ireland at the end of September the day after my final day at the USAID Staff Care Center where I worked for the past three years. While I have many thoughts about moving on from this position, the subject of this post will be our ten days in the Emerald Isle.

Two reasons.

I had long wanted to spend a week or so with my dad in some beautiful part of his homeland, which I assumed would land me in the Cotswalds or the Lake District. When we knew my parents were going to be in the UK for a month we began to make plans to try and join them for a week somewhere…but where? Long story short, we decided to fly into Dublin as it is much cheaper than flying into London and then my parents were kind and flexible enough to come meet us there for our time together. 

Flying into Dublin also made it easy to take the two hour bus ride up to Belfast to see my former dorm parents from the Philippines. If you know anything about my life, you probably know the profound influence that Alan and Hetty Dorman had on me during my last two years in high school when I lived in their dorm at Faith Academy.  Amazingly it had been 20+ years since I had last seen them!  Earlier this year, Hetty had been in NYC for a few days so I caught the bus up there to spend a few hours with her in Central Park. Almost immediately we began scheming how we might get Alan over to the US or Andrea and I over to visit them in Belfast. One thing led to another and before we knew it we were being picked up by Alan at the Belfast Bus Station and warmly welcomed with their Dorman hospitality. It was so good to be together again and to talk and talk and talk some more. Chrissy and Susan and their husbands came over that first evening for dinner so the reunion was complete.

 We spent the next four days together just hanging out and talking. We saw a few attractions including The Titanic Experience – did you know the Titanic was built in Belfast?, CS Lewis’s childhood neighborhood, Alan’s office, Giant’s Causeway – where I had been before on my only other trip to Belfast when I spent Christmas with the Dormans in 1991. On that trip they took me to several castles and sites including Giant’s Causeway and I swear we were the only ones there on that cold blustery winter’s day. This time it was a beautiful autumn day, warm and sunny with no wind but lots of other tourists. What a contrast! The other contrast at Giant’s Causeway is the very nice visitor center that now exists. Tip – if you are ever going you can park at the closest village for free and then be driven to the main entrance by bus – just a five minute ride – but you’ll get a discount on the entrance fee. You can also bushwhack your way to the Giant’s Causeway the back way, bypassing the visitor center and not pay anything!)

The BEST Picture ever!

Alan and Andrea enjoy delicious Fish and Chips

CS Lewis statue in his childhood neighborhood

The Dormans heard someone likes cheese!

Chocolate and Cheese...TOGETHER - who knew!?

Giant's Causeway

India...incredible!

I have been back from India for just over a week. I’m still trying to sort out in my head everything that I experienced and I should sleep on it some more, but people keep asking what my time was like and I’m looking for a good answer. I keep thinking of two quotes that I mentioned in this post seven years ago after our first month in South Africa. I think they describe how I feel about my brief time in India.

“Traveling is a strange business. To have been in Khartoum is somehow more poignant that being in Khartoum. Being there involves dust, dirt, discomfort, noise, suspect food, dicey water and being homesick. Having been there is amazing. Memory, learning and mind weave together a cloth more fabulous than the indifferent roar of its traffic.”

“If anyone tells you African travel is easy, tell them they know nothing.
If they tell you it's not worth the effort, tell them they still know nothing.
If they've crossed the Nubian Desert pay them due regard."

 I had moments of great enjoyment and sheer amazement and a few moments where I had had enough. At one point I was quite ready to return to the US – something I have rarely experienced when traveling. I always want to stay longer and not return. But now that I am back, I find myself looking through my India guidebook, dreaming and scheming about what I would want to see when I return. Note that I said when I return. India’s siren call is beckoning.

Sign at the airport

And to be honest, I really didn’t see much of India at all (it’s such a large country it is often referred to as its own continent.) I didn’t see any of the sights that most tourists go to India for, but, I did see India. For a few days I was back home in Asia.  I was able to live and breathe the air, the warmth, the chaos, the sounds, the food...the incessant honking…

So here are a few highlights.

The main reason for going to India was to attend a wedding. Aroha and Peter were Andrea’s classmates at Duke and who also live here in DC. After attending Beth and Vincent’s wedding in Switzerland on our nine month wander around the world, we decided that if ever we are invited to a wedding overseas we will go. Unfortunately, this is Andrea’s busiest time of year at work and she was unable to go. So I went to represent!

Peter, Aroha and Aroha's dad at a pre wedding party

But wanting to justify flying away and leaving my wife at home, I was also able to spend a couple days working at my company’s office in Bangalore which is where I began my trip. While there I stayed with another of Andrea’s Duke classmates, Shailesh, and his wife Rohini who were so hospitable and welcoming into their home. I had not spent that much time with Shailesh while in Durham and not ever met Rohini, but I am very privileged to count this couple as dear friends now. I loved listening to them and learning from them. They put up with all my questions and helped me navigate a few places in town – as it seems like I had a string of bad luck getting taxi drivers who did not know where they were going. Anyway, highlight # 1 – Shailesh and Rohini. Rohini has just written Seasons of Trouble, a book about the Sri Lankan civil war that has received critical acclaim around the world.

Rohini and Shailesh at the wedding

 Highlight #2 – Meeting and spending time with my Workplace Options colleagues. Again, in addition to the work I needed to do, I was able to spend time just listening and learning, finding out about their situation and what life looks like for them. A special shout out to Vijeth who fed me lunch every day!

Vijeth and lunch

View of Bangalore from WPO's office

From Bangalore, I flew up to Dehradun (a smaller town of about half a million people about a five hour drive north of Delhi.) The plane landed briefly in Delhi and most people got off while the few of us continuing on to Dehradun stayed on the plane while it was cleaned and prepped for the next leg of the journey.  Aroha’s family generously put all of us out of towners up at a nice hotel for the festivities.

Highlight # 3 was meeting Peter and Aroha's family and friends who had come from all around the world to celebrate the occasion. Peter’s family and friends all went out for dinner the night we arrived in Dehradun and I just remember feeling so happy to be a part of a special group of friends and family. Those of you who know me, know that I am not a big dinner party kind of guy – but this group of friends and family, just clicked. I’ve been to enough dinners and get-togethers where there is a lot of silence and awkward moments – this was not one of them.

Peter and family and friends

Always time for a little cricket...

...until you need to set up for the wedding!

Peter and his family that came from the US

Highlight # 4 – The Main Event. The wedding itself. While there was a party and reception the night before the wedding as well as other pre-wedding ceremonies for both Peter and Aroha, the main event began Saturday evening when those of us representing Peter were driven a few blocks away from the hotel to where a white horse, a brass band, and an incredibly loud PA system was waiting for us. Our task was to be the parade and dance down the street announcing Peter’s arrival to the guests waiting at the hotel. To be surrounded by the band, loud music, and drums - oh and fireworks -was deafening and totally cured me of any residual PTSD that I carry with me. How the horse does it, I don’t know. I think it went deaf a long long time ago. And so we danced and moved ever so slowly to the hotel where the entrance to the lavishly decorated grounds was packed full of guests waiting for the groom's arrival. We pushed (or were pushed) through the crowd, being welcomed and blessed by one of Aroha’s family members and made our way down to the wedding site. And there we joined with hundreds of other guests, young and old, beautifully dressed in colorful saris of every shade, surrounded by pulsating music, lights, flowers and we waited for the bride's entrance. Eventually the music changed and Aroha walked in under a canopy of roses and went and met Peter up on a raised platform. I have never been a part of something so…I don’t even know the words to use.  Needless to say it was amazing. Incredible. Spectacular.  Truly.

Bracelets at the cocktail party

Bracelets and Henna

Pre wedding ceremony

The groom is dressed and ready to go...

...get on his white horse for the procession

Christmas 2014

 Merry Christmas and Happy New Year!

From literal to figurative deserts, this has been a year of waiting, endurance, and seeking answers. We are grateful for those who have walked with us, prayed for us, and provided encouragement. We are grateful for moments of beauty and reminders in the midst that we are not alone. And we’re grateful for new beginnings as Andrea begins a new position in her office in January.

Many of you will know that over the past few years we have developed a pattern of finding a poem or phrase that becomes our word or mantra for the year. My former boss at the Staff Care Center introduced me to the following poem and it has carried us through the past months. Perhaps it will do the same for you. 

This is the time to be slow / Lie low to the wall / Until the bitter weather passes. / Try as best you can, not to let / The wire brush of doubt / Scrape from your heart / All sense of yourself / And your hesitant light. / If you remain generous / Time will come good; / And you will find your feet / Again on fresh pastures of promise / Where the air will be kind and blushed with beginning / 

(John O’Donohue to bless the space between us: a book of blessings)

Duncan and Andrea

Namibia

In November I spent two weeks in Namibia for work. While I won't show any photos or talk about the actual work, I will say that the people we were privileged to spend our time with were so great - welcoming, resilient in spite of many challenges, fun, talented and inspiring  in so many ways. 

Namibia has been on Andrea's list of countries to visit for a long time. When Andrea and I were in South African in 2008 we strongly considered going to Namibia also but we didn't have enough time - so you know she was quite envious of my going on this trip. Which just means we'll have to go together some time in the future! So a few highlights and observations from this trip...

Highlight #1 before even arriving in Namibia was experiencing Delta's direct flight from Atlanta to Johannesburg, which is currently the worlds second longest direct flight - 14 1/2 hours going, 15 1/2 coming back! After a night in Joburg our entire team met up for our short flight to Windhoek.  And as we came in to land, this is what we saw...nothing - just stark beautiful landscape! As we came into land at the airport (which you can see in the photo below) we couldn't see anything - buildings, roads, people. It was amazing.

Namibia is a large country by size but small in population (only 2 million). Below the view from my room at our hotel with the hills that surround Windhoek.

Another view from the hotel with the Supreme Court buildings in the front and the famous Christ Church behind. 

Above - the team (Dawn, Walter and Molly) from the US in planning mode on the roof of the hotel prior to our work. We spent a lot of time together and worked really well as a team. Each brought different strengths that made it a joy to work together. And we had some good meals...(see below)

On the weekend Molly and I hit the road with Chameleon Backbackers to see the desert and especially the dunes...

Oryx

Above - our campsite, and the small wall surrounding it below - on which the cutest jackal jumped up and looked at us that evening while we were eating!

Getting up at 4:30 in the morning allowed us to experience sunrise at Dune 45 - which was spectacular

More Oryx...and dust and sand...

On our way to the dunes, we stopped in at the tiny 'town' (encampment?) of Solitaire - one of my new favorite places in the world...

After our work days were over on the second week, the rest of the team returned to the US. I stayed a few days longer to go to the beach - specifically, Swakopmund.  The landscape became more and more arid and stark until it looked like nothing would survive...and then wedged in between this desert terrain and the ocean is the holiday town of Swakop.

Huge wide roads

Surprised by flamingos on the beach

Breakfast to send me on my way...

Beautiful, stark and striking - so much to love and more stories to tell, but I know some have been asking when I would post on the blog - so this is a start and I'll circle back around and add some more.

Duncan