Cliffs of Fall

I am feeling trapped in, this last few days. The return to standard time brings the dank November dark an hour earlier, pushing me into the warmth of the house with its foggy fingers. The air is cold with the damp and, as I write, the first snow is falling in wet fat flakes and clinging to everything. It will melt, but it is a harbinger of things to come, nasty things like icy slippery roads and icy slippery steps that challenge my driving skills and my arthritic joints. As well, it is hunting season and the woods and fields are dotted with figures in 'hunter's red' ( a nasty shade of glowing orange) shooting at and spooking the deer. We all have to drive with extreme caution because you never know when one of the wretched beasts will materialize on the road in front of you. It makes me think twice about leaping into the car and zooming off in any direction, especially after (the very early) dark.

I am also feeling overwhelmed by the sheer number of meetings I have scheduled this month. Meetings I cannot miss, having taken on the job of chair of the board. Meetings that I have to drive on the dangerous roads in the dark to attend. I can do it. I do do it. But more and more as I grow older, the effort is greater. I can see the time coming when my own fears may become disabling, a prison that I will build myself.

Confined in the Tower of London, Richard Lovelace wrote the famous lines:

Stone walls do not a prison make,

Nor iron bars a cage;

Minds innocent and quiet take

That for an hermitage.

A fine philosophy, that. But recite those lines to a young mother, tending toddlers in a home far from any public transport, short of money, and you will provoke her, at best, to derisive laughter. The expectations of our community can confine us in the adamant constraints of others' ideas of how we should live and what we should be. Poverty builds walls of cold iron around us, walls with very few, very narrow exits. However, for many of us it is more our minds than our circumstances that trap us into prisons more grim than a stone walled cell. Our expectations of ourselves can become the most stringent prison of all. Depression, illness, fear and grief are the cold, weeping stones that form these prisons and sometimes there is no door, no window, not even an oubliette, to bring us hope and news of the world.

There's a debate going on in Canada just now, in the intervals of the latest chatter about H1N1 anyway, about euthanasia. A bill allowing some types of assisted suicide is being debated in the House of Commons. It's not a simple question. The medical association in Quebec wants some guidelines to help them deal with uncontrollable pain in terminal patients. The various associations of disabled people want the value of their lives acknowledged and protected. The non-religious majority (52% of Canadians, the last poll I saw) want freedom to choose a dignified end. Courageous souls with debilitating diseases are requesting legal suicide options. I am certainly not alone in worrying about the effect an open-ended legalizing of suicide would have on the many people whose minds, not innocent or quiet, cause them constant pain.

It's not a simple question. The young man, paralysed from an accident, can fight his way through the pain and become a contributing member of society. The depressed new mother who throws herself in front of a train could have been helped, cured perhaps. Even Tracy Latimer might have been helped although I understand, I think, why her father killed her. There are no lines to divide physical and emotional pain and not all pain can be 'managed'.

Here's my personal dilemma. I smoke. I do so knowing that, although I have not so far cost the state any money from smoking-related illness, sooner or later I may develop lung cancer or have a debilitating stroke that will reduce me to a vegetable to be a burden on my family and a huge cost to the taxpayer in medical care. Would it not be both fair and simple to issue me a lethal dose of something when the disease in my lungs is drowning me or to use on my mindless, stubbornly breathing hulk? Would not that be more dignified, less costly in both emotional and monetary terms? A release from the prison my stubbornness has built for me?

Or, I could just go and drive down the county road too fast, hoping that the deer I hit would be big enough to kill both of us.

A Sad Little Story

I went to get my hair cut at one of those walk-in places last week and ran into a situation that just made my heart ache.

There was a family group ahead of me composed of a woman in her late forties, at a guess, her married daughter, the daughter's husband and toddler and a second daughter, at least eight, whom the mother referred to as 'my youngest'. When I got there the toddler's father was having his hair cut and the young mother was trying to persuade the little guy to have his done also. Toddler was having none of it, screaming 'No, NOOO!' and trying to pry the door open to escape. The little girl was next, before me, and she was acting so much like the toddler that it was hard to tell the difference. Her mother was trying to persuade her that she should have her hair layered and trimmed but she had selected a very extreme cut from a magazine and wanted nothing but that.

As her mother tried to persuade her, she hauled open the door and stormed out. Her mother shrugged and asked the hairdresser to hold her place while she tried to persuade her. So, we waited.

After a bit, little miss came storming back in with mother, still arguing. She refused to get in the chair. By this time other customers had come in. The poor, beleaguered hairdresser signalled for me to sit down and started cutting my hair. Little miss demanded to have hers cut; her mother said that her bad behaviour had caused her to miss her turn and that she would have to wait. While my hair was cut, the argument continued, with little miss now thumbing through the sample books looking for another style and mother insisting that she was to have 'layers and a trim'. Another hairdresser finished a client; little miss refused to have her do the cutting.

Little miss was also consuming a steady stream of the suckers that children get after their hair is cut, taking them out of the box on the counter herself, in spite of her mother's orders that she stop.

Mother did not enforce her orders. She did not try to stem the behaviour. She seemed to be uninvolved emotionally. In fact, she chatted with her other daughter and with us while this was going on, but without referring to the girl's actions, other than to say that she, herself, was a hairdresser but preferred not to cut the girl's hair herself as it was 'too much trouble.'

When I got out of the chair, mother directed little miss to climb in. Little miss refused and continued to look at the books and magazines. Mother then said that since the girl was not ready, they would leave. Little miss screamed, stamped and banged the books around. Her mother stood with the door open, saying that they were leaving, and went out. The girl stood in the doorway and screamed at the top of her lungs. Just a series of shrieks.

Perhaps the little girl was behaviourally challenged in some way; certainly her actions were far more characteristic of a two year old than of an average girl of her age. Her language level and ability to read would indicate, however, that she was of normal intelligence. That would not preclude ADD or autism spectrum disorders. Whatever, her mother was certainly not helping; she was confrontational, uncompromising and seeming uninvolved in and unembarrassed by her daughter's over the top display. If the girl was simply an uncontrolled average kid, her mother was totally at fault, in my estimation. In either case, I think she should have been taken out of the salon when she started to create and, certainly, have never been brought back for a second try.

I felt very sorry for both of them, but my heart really bled for little miss. Judging by the twenty minutes or so during which I watched the action, the girl did not know the boundaries of appropriate behaviour nor have any method of getting what she wanted other than disobedience and screaming. If she was a child with a disability she should not have been handled that way; if she was a normal child she had, very obviously, never been given rules or boundaries. And it seemed to me that her mother did not care.

Kids, I believe, need rules. Boundaries to their behaviours inside which they can feel safe. Techniques (good manners with strange adults, for one) that they can trust to work and to make them likeable. How to bargain for what they want badly. Structure. Support. This poor little kid did not seem to have any of these things. She was angry and, I think, frightened of her own anger. She was frustrated and had no way to express the frustration other than to scream.

There are a lot of children with behavioural problems who need skilled help. She may be one of them. In our province many of these children are presently waiting to be diagnosed at the request of teachers whose access to services is ludicrously small. Even when the children are diagnosed, ever growing numbers of them are on waiting lists because the service providers have no funds to hire staff to deal with them. There are caps in this year of economic downturn on a lot of the programs funded by the Ontario government through the Ministry of Health and Social Services; no money is available even for the programs that are up and running.

There are also a lot of average children whose behaviour is out of control because no one in their life has consistently tried to teach them how to act in a way that will bring them success. No one has helped them learn to govern their tempers, to share, to have patience, to get along with other people. No one has, if you will excuse the plain speaking, civilized them.

Both of these lacks are sickening, because it is the children who suffer in the long term, not the adults who fail to provide the help and support. I ended up wishing that someone would pour a pail of cold water over the head of little miss screamer. And that's horrible. Because I think every adult in the hair cutters' establishment was thinking much the same. While, in fact, she was suffering a lot more than we were, poor thing.

About the Gorilla in the Living Room

I read a post yesterday in which the writer speaks of depression as a 250 hundred pound gorilla sitting in her living room. This gorilla has been an intermittent visitor of mine for a long time. Probably not coincidently, I also found myself committing yesterday to a fairly intensive level of involvement in a Mental Health Support Project, an involvement that will be more useful if I am identified as a CS - 'Consumer Survivor' as the Ontario Ministry of Health identifies people with diagnosed mental problems under treatment. Doesn't that just sing? Anyway, the Program Director asked me if I minded being 'outed' about this. It took me a minute to understand what she was asking as I have never considered myself to be 'in-ed'. Or do I need to say 'closeted'? Whichever, I agreed to be identified. It's nice not to be worried about people knowing; fifty years ago this was not the case.

In fact, it is forty nine years since my beloved aunt, in the grips of depression, hanged herself, leaving her pubescent daughter to my parents' care and causing such grief and guilt as I still cannot adequately describe. From the vantage point of the 21st century, it is possible to speculate that my maternal grandmother and all her daughters had varying degrees of bipolar disorder that in my aunt's case, exacerbated by the menopause and the sudden death of her husband, sent her over the edge into clinical depression, undiagnosed and untreated in accordance with the practice of the times to tell such sufferers to 'pull themselves together'. Her death was of benefit to my mother and her next younger sister in that they did learn to recognize menopause as a time that they would be vulnerable and to take steps to get support. My aunt, thirteen years younger, was able to benefit from hormone therapy. My mother took the unprecedented decision in her life to put herself first, tried out tranquillizers and finally returned to university to do a master's degree, thus keeping herself fairly stable.

My family used to describe their depression as 'the black dog'*, a condition that caused, for example, my grandmother's withdrawal from the world into the cocoon of her bedroom for almost a year when her mother died. I clearly remember talking one of my aunts down from an alcohol fueled threat of suicide when I was in my early twenties. You see, my positioning in the family was that of 'the little ray of sunshine'. I was always seen as the happy, lucky, stable golden child whose path through life, if not strewn with roses, was at least anticipated to be free from thorns. And when post partum depression hit me like a hammer after my elder daughter was born, I followed my mother's recipe of keeping busy and exercising my mind, took a university course and, deliberately, got pregnant again as soon as possible. I clearly remember crying big salt tears onto the fuzzy head of my younger daughter while frantically thinking about how I could hide my misery. I was not supposed to be sad -- I had a mild case of 'the baby blues' and a few days would clear it up.

I navigated that choppy and iceberg dotted sea with limited help from fairly unsatisfactory counselling and medical help and managed to hold onto my 'ray of sunshine status until I was in my early forties, when a combination of stressors tipped me into depression. I spent a few months in the basement weeping, watching television and snarling at my nearest and dearest and pulled myself sort of together again, partly out of the necessity of caring for my parents, especially my mother whose physical illness and growing dementia required, it seemed to me, a show of strength. Ignoring the well meaning advice of hospital counselors who told me to step back, I did my best to help as she became critically ill and died, struggling to fulfill my role as little friend to all the world and bringer of hope and good cheer.

A few months after her death I went to a doctor for help to stop smoking through hypnosis and in our first session I lost it. 'You have a clinical depression' said this wonderful man and he quickly arranged for most effective drug therapy and counselling. I went onto the first of the SSI's and for the last nineteen years I have been on one form or another of these drugs and feel, mostly, very well. I do have 'ups and downs', as they say, and some of the drugs' side effects, such as lowered libido and fluid retention, are frustrating, but mainly I function well.

One of the ways to fight this disease is to try to know yourself, to accept what you are and celebrate what is good about it, to tolerate mistakes and move on from them, to take responsibility where you can but not to be afraid to ask for help. I cling to the old prayer in which one requests that God grant you the skill to change what you can, the courage to endure what you must and the good sense to know the difference. Another is to be disciplined about diet, exercise and way of life. I do fairly well at the first of these, I think, but I suck at the second. (Finished a box of chocolate liqueurs last night at bedtime. Blush!) Humour helps a lot! As does time and maturity. In TH White's marvelous book, The Once and Future King, he talks about the benefits of time and maturity in a wonderful metaphor, equating the angst of the growing adolescent and young adult with the fledgling bird and the self knowledge of the mature adult with a grown bird, the oil on its feathers allowing it to ride the waves with serenity.

I find that I think of my vulnerability to depression as a medical condition of the same type as bad allergies, a little less serious that Type II diabetes, a physical condition that requires me to be aware of my health and to take medication without guilt. That's a long way from my diagnosis. It's also a long way from the attitudes that caused my husband's family, in the late 1950's, to relegate one of his aunts to the upper floor of a house that several of them shared and to refrain from mentioning that she was there. There's an interesting body of work developing on the changes in attitudes to all types of mental illness but there are, unfortunately, stigma still attached to some of them. Lately I have been reading about a lawsuit brought against his employer by a sufferer from bipolar (?) disease who was let go from the fear that he could not do his job**. Fifty years ago he would not have dared to tell them. Even thirty years ago he would not have had medication that allowed him to function well.

We've come a long way but there is still an even longer journey to go. If publicizing my history of illness will help that, even a little, I am 'out' and will try to do so. And hugs to my friend for doing so too.

* a very quick Google search of this term leads me to believe it's British, probably Irish, in origin. And that Winston Churchill was the most famous user of the metaphor.

** A second quick Google does not find this. I may have the wrong disease.