14 days

Mind altering introspection

“When do you think you'll be able to get to the laboratory for the blood workup, Paul?” Erik Fermann scrutinised his friend and patient through bottle-bottom thick eyeglasses which, from the opposite standpoint, made his clear, blue eyes as large as those of a Japanese animation.

Paul sat fidgeting on the uncomfortable, straight-backed chair in the doctor's tiny examination room that doubled as an office. It was probably a good thing that Dr. Fermann didn't attempt more than the simplest of exams in the overcrowded space because, everywhere one turned, were stacks of patient files likely to collapse at any moment into a cascade of confused histories. Paul's shirt was untucked and his severely dark, suit jacket hung open. He considered his work schedule for the upcoming week and then answered.

“I should be able to do it for next Saturday morning, Erik, if nothing blows up in my face this week at work.” Paul gestured with his hands to indicate an explosion followed by bewildering aftermath. His fingers were trembling. Dr. Fermann nodded, accepting the information.

“That should be perfect, Paul. It will give time, before the results come back, for me to give you a bit of homework.”

“I think I'm a bit old for homework, Erik,” said Paul. The sides of his mouth creased into the slightest of smiles and then relaxed into an impassive expression.

“Not where it comes to your health, Paul, you aren't,” instructed the doctor, sternly.

He swiveled with a loud squeak of metal that caused Paul to involuntarily jump and pawed quickly through some teetering stacks of folders. Finding what he was looking for, with a satisfied grunt he extracted a sheet, studied it and turned back without the annoying sound. He held the sheet in front of his alert eyes and then placed it on the desk with his fingers folded over it. His gaze settled on Paul.

“How long have you been depressed, Paul?”

“What? I'm not ...”

“Paul.” The interjection silenced the other man's knee-jerk reaction. “I want you to think about your response and answer me, first, as your friend and then as your doctor. Will you do that?”

Paul nodded, silenced.

He had, he knew, attempted for a long time to keep it to himself. Certainly, his problem with depression had grown worse over the past ten years but, reflecting soberly over his life as far back as he could remember, the phases seemed always to have been there.

To say that it worried him was not only minimising but, honestly, a severe understatement. As a younger man, he had been aware of the drastic nature of the lows. However, being less mature and, perhaps, less self-aware, he had never  thought to put a name to it and, being more imbibed by youthful vigour, he had simply trudged through those months of mental darkness until, eventually, he emerged again into the light side of life.

The change had come only a few years previous – an admission to self that, yes, a problem did actually exist. With awareness came, in his own perception, a recognition of the extent to which it affected his life, subtly colouring his actions and reactions in certain situations and robbing him of the dynamicity which, he knew, was a vital characteristic of his personality.

With awareness also came the worry regarding stigma – did he truly want to be labeled as someone with 'depression', or worse – 'mental illness'? He thought of being shunned by friends or being subjected to the uncomfortable and stilted question, 'How are you feeling?' It was almost enough to get depressed over.

“All my life.” His answer was brief and truthful.

Dr. Fermann nodded. His eyebrows creased inward with concern, forming deep furrows above his long nose.

“Have a look at this, would you please, Paul?” Erik passed the photocopied page from the top of his desk to Paul's outstretched hand. Paul scanned the short questionnaire.

Over the last 2 weeks, how often have you been bothered by any of the following problems?
1. Little interest or pleasure in doing things.
2. Feeling down, depressed or hopeless.
3. Trouble falling/staying asleep or sleeping too much.

The list continued and Paul read it to the end, nodding as each 'problem' found a reflection in his own memory.

9. Thoughts that you would be better off dead or of hurting yourself in some way.

“You only need one 'yes' box,” joked Paul but with little humour.

In a fit of the absurd, he wondered, with suitable, post-modern uncertainty, whether reading the questions and contemplating upon them should not be a factor of study, in and of itself. He shook his head to dispel the notion.

Erik Fermann smiled at his friend. He removed his glasses and his eyes immediately returned to normal size. He toyed with the frames between his thick fingers, considering his words, and then spoke.

“Let me explain something to you, my friend. Depression is a disease. It is precipitated by under-active receptors and/or over-active inhibitors. That's it. Like almost any disease, it can be controlled by addressing it symptomatically and then, through study of your particular circumstances, finding the root cause.

“It is also, you may know, epidemic in our society. The causes may be various – from lifestyle issues to real physiological problems such as vitamin deficiency, hypothyroidism or a host of others. Of course, the two can also be related.

“The important thing to remember is this: You do not have to live like that.

“Being depressed does not mean that you are less of a man because of it or that you are whining about your life. It is a condition and we will address it.

Paul nodded, wondering what it would be like to revel in the bright sunlight again, smile at the sound of children's laughter while playing or, in himself, recognise that he was no longer stumbling, directionless through life but, instead, finding again that energy that seemed, somewhere along the road, to have dissipated.

“OK, Erik.” Paul internalised his friend's words. “Where do we start?”

“We start with the page between your fingers. In two weeks, once your blood results are in, we will have a better handle on your physiology and you will come back with that page completed. You will also already be feeling better because you are going to take action against this thing that has been ruling you instead of you ruling it.”

Paul smiled and, standing, shook his friend's hand.

“You know what, Erik?” he said as their palms pressed briefly together. “I think I already do.”

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