Depression: The Roller-Coaster Of Life   Frank Barnhill M.D.
 

I mentioned to daddy that he was referring to the roller coaster of life and he responded that sometimes he would like to get off of that ride because the downs were getting deeper and it was going faster.  At that point, I remembered his roller coaster ride did have a lot of very deep downs and they had all occurred in a very short period.  He had suffered two heart attacks; undergone bypass surgery twice, had emergency gallbladder surgery, and was just recovering from removal of a tumor from his left kidney.  All of these downs had occurred in less than ten years.  He had fought off depression many times and was just making a practical statement. 

Later back at the hotel, I thought more about our conversation and how the roller coaster scenario really did apply to life.  Most of us probably never think about our lives as a roller coaster ride.  We have so many really good days, that we’re able to cope with the bad days.  But then, I thought about daddy’s comment about wanting to get off the ride for a while.  I had heard similar comments from depressed and distressed patients over the years.  Sometimes they said, “I just want time to stop so I can catch up” or “I’d like the world to stop and let me get off”.  It was really the same thing, only stated differently due to the difference in people’s feelings and emotions about their situation. 

Then it struck me how it was probably only depressed and distressed patients that really realized that life was a roller coaster.  Those with a lot more ups than downs probably never think about the downs.  People on the flat stretch of the ride between the valleys probably fall into the same group.  So, something is most likely wrong in a person’s life when they finally realize the roller coaster ride is getting bumpy.  With these thoughts in mind, let’s review the signs and symptoms of depression.  One of the earliest feelings in depression seems to be indecisiveness.  Stress has apparently gotten to the point that you can’t make decisions easily.  Maybe you doubt yourself or you think others question your abilities.  Regardless of the cause, this inability to make decisions causes concentration problems at home, work and in social situations.  If you’re struggling to make decisions, then you don’t have a lot of time for everything else. 

Then follows irritability and short temperedness.  Hey, you’d get irritable too, if every one expected you to make all those decisions and you just couldn’t.  Even the slightest little thing can set you off.  Remarks made by others get under your skin.  You may realize that you normally would not get upset over these little things, but by this point your roller coaster ride is on the incline and you haven’t had that first big drop.  So, you’re probably in denial.  Boy, when that drop happens things will really get going faster and your emotions will follow. 

Oops, the big drop occurs and everything seems to crash all at once.  You can’t sleep at night and are so tired and sleepy the next day, that you can’t do your job properly.  When others take note and comment, you deny the problem and become irritated at their remarks.  You lose your appetite or try to compensate for “low blood sugar” by eating more.  So, you either lose weight or gain unwanted pounds.  You worry about your job, because you notice your co- workers are becoming a little distant.  Are you losing control?  No, you think, I’m still the master of this body. 

You probably realize something needs to be done at this point, so you buy an over the counter sleep aid and get a pretty good nights sleep.  In the back of your mind, you have that fleeting thought, gee I still feel tired even though I’m sleeping better.  So, you buy a bunch of vitamins to build up your low blood.  But hey, you’re on the up now and your coaster is slowing as it takes the next hill.  Wow you think; “I just need to work harder!”.  That’s sure to help.  After all, it’ll keep your mind off your problems.  This is called bandaid brain surgery. 

Things go better for a while; you feel like you’re getting a little control back, then, something happens.  It could be anything, maybe the car breaks down or your cat dies.  It just doesn’t matter what happens, if it’s bad, it happens to you.  Oh yeah, you knew it couldn’t last forever, didn’t you?  Then the ride starts down again.  Except this time, you’ve already got the irritability, indecisiveness, fatigue, appetite, and sleep problems.  They never really went away, you just covered them up.  Remember that bandaid you used? 

So, as your coaster goes down again, guess what?  All of these little problems get bigger and grow faster.  You’re picking up speed and on the way a few more problems pop up. 

Being tired all the time usually causes lack of interest in doing things that you enjoy.  Maybe you really don’t feel like going to the ball game with the guys this weekend.  Hey, you didn’t exactly promise them did you?  Besides, you have that heartburn and indigestion that just won’t go away.  You start using physical ailments like headaches to get out of family and social events.  If you’re not careful at this point in the ride, you’ll lose the desire for most things that make you feel good.  Loss of sex desire and inability to perform is a common complaint by now.  Even worse, you start avoiding your family, because you don’t feel like doing those fun things they want to do.  You might find yourself hiding at work.  They just seem to keep piling more and more on you.  Your concentration is so bad that you turn down all opportunities for entertainment and social outings.  This lets you concentrate more on work.  After all, you’re not getting invited to as many parties now. 

Maybe what you need is a vacation.  But, can you afford it?  Well no, so you’ll take a couple of days off and do some of your office work at home.  That’ll help you get caught up and make things better, won’t it?  Well, it worked.  You go back to work feeling better.  You’re on the flat part of the ride for a few days, as everything seems to be improving.  You’re not as irritable and your co-workers, family and friends sense this.  They’re starting to spend more time with you and talk more.  Things rock along just fine for a week or two.  Then bam!

You failed to learn how to organize your work and time and you’re back in the same rat race again.  Within a couple of weeks, you’re behind on everything.  It’s just this time you feel different.  You start thinking “I’m never going to get out of this rut!” This recurring thought makes you feel sad and despondent as your coaster starts down again.  You feel blue most of the time.  You may cry for no reason.  You feel that you have absolutely no control over your life.  And as your coaster car speeds faster and faster toward the bottom of this really big drop, you wonder if you have a brain tumor or possibly if life is worth living.  You may start to withdraw to cope with constant feelings of being out of control.  Some will experiment with illegal drugs hoping to feel better or get in touch with themselves.  A few feel so worthless; they are just plain ready to die. 

I’ve had several patients tell me of their thoughts about just “driving into a bridge at 90 miles per hour”, “taking every pill in the medicine cabinet” or “standing in the middle of a highway, hoping to be run over”.  Years ago one of my associates had a depressed patient lay his head on a railroad track and go to sleep.  The EMS found a suicide note with his body.  When you reach this very last deep drop in your roller coaster, it takes a lot of energy and momentum to get back up to the next peak.  It’s far better to avoid going past the first drop in the track. 

I’ve included most of the symptoms and signs of depression in the content of the story.  You can view the symptoms of depression without the story at this link. 

The roller coaster of depression differs from person to person.  Some persons will have very minor dips and peaks and others may experience inside and outside loops in their ride.  The important thing is for you or a trusted loved one to recognize the symptoms and signs as early as possible and get help.  Everybody rides the roller coaster of life.  It’s just that some of us control those peaks and valleys and can therefore enjoy the ride.  We’ll look at treatment options for depression in our next discussion. 

Dr. Frank

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