Monday, 5 December 2011

Down, Down, Down

Now at home, sitting in the study, it’s all very different. The Polymyalgia, the PMR, might be in retreat but in its stead hang the dark clouds of prednisolone. I’d been warned. Like the market things can go up and they can also go down. Past achievement is no indicator of future performance. Depression. Have I been here before?

For those who’ve never sat under such dismal skies the word depression no doubt suggests feelings of mild discomfort, of vague unhappiness, of dissatisfaction with the way things currently are. You’ll be okay. Just shake yourself. Get up and face the world. Get out and have a breath of fresh air. Come on. You can do it.

The reality is different. You can’t. As anxiety gives way to caves of dark the head, that part of it that carries conscious thought, seems to switch itself off. The fog arrives. The mind slows beneath its blanket of desperation. The author Horatio Clare quotes Gerard Manley Hopkins as describing just how this is: “I wake and feel the fell of dark not day.” That too is how it is for me.

The blanket wont lift. Dark fallen on it. It lies.

Your friends, your loved-ones, and those around you all say they understand. But they don’t. They really can’t. Unless they are there with you, in the midst of the somnambulant and unmoving smog, where sparks don’t light and nothing sounds.

Back at the doctor’s the GP suggests that my own basic underlying anxiety about Polymyalgia and what I’m going through may be contributing as much as the Prednisolone chemicals themselves. She might be right. It matters little. The fog is still real and the blankets don’t change.

I return home and write some of the most dismal poems I’ve ever managed. Will I put any of these in my next collection? Will there be a next collection? Doubt on both counts.

But there is a part of me, somewhere above the dreary layers, that’s taking note. And that’s a good sign. I work out that the depressions rarely arrive arbitrarily during the day. They are either there when I wake or they are not. And often by the time we’ve moved on to the day following they’ve gone It’s also possible to get the blanket to lift, just a little, by going out there into the bright world and walking vigorously about. I take to cycling the three miles to the top of Roath Park Lake and back, to walking at speed round Waterloo Gardens, and, once, to putting my running shoes on and jogging slowly along the lane. Not a brilliant success, that. Too early in the process. But other and milder forms of exercise seem to work. Just a bit.

Listen to your body is the standard advice. I’ve listened to mine and right now it’s not saying much.

But as the Prednisolone dose tapers the incidence of depression should reduce. That’s the hope.

1 comment:

  1. The mental side-effects of pred are probably the biggest reason for patients (or their doctors)rejecting them having tried them. Some people become manic - and the ladies do all the cleaning they haven't been able to do and then wonder why they are sore afterwards - whilst others tend in the other direction. In almost all cases the effect reduces along with the dose - and that is the primary reason for starting treatment with a lower dose (15mg or so for PMR) and trying to reduce it even further for the longer term. High doses here are kept for giant cell arteritis where being a bit manic or depressed is acceptable compared with the risk to your sight.

    Even for the people who don't get obviously depressed though - getting out in the fresh air and, hopefully, some sun has a dramatic effect on mood.