Things Run in Threes

Three quick stories, the types of things that roll around in this therapist's head during the course of a day.

Jesse Jackson Jr.

The Legend, the Dad, Jesse Jackson Sr.

 (1) Jesse Jackson Jr's Mood Disorder  


Our biggest local news is that Illinois Congressman Jesse Jackson, Jr., son of the legendary political figure and civil rights leader, Jesse Jackson, Sr., is in Arizona receiving intensive medical treatment in a residential facility.  Rumors are flying that the congressman is there for alcohol or drug addiction, but the official word is much less exciting.  He's suffering from a mood disorder.

It was really annoying yesterday, if you listened to the news on radio.  Every third sentence had to be about this story.  Forget privacy, forget respect.  He's suffering from depression, and he can't work and why can't it be left at that? This shouldn't be the most catastrophic or interesting story of the day!  Hasn't some terrorist been stopped mid-air in China?

Then today it comes up in therapy not once, but twice, patient's versions of:  I knew, he had it!  I could just tell.  One week gaunt, the next week perky.  Then listless, then . . .nothing about Jesse in the news for months!  And now, THIS! 

And I realized that it is a good thing.   It is a good thing that psychiatric illness is normalized on the news, that we can talk about it, that people recognize depression, especially, as a fairly common illness, not something that can be helped if only we (a) just worked out! (b) ate right, (c) married into the right family, etc., etc.  It happens to everyone, depression, which is what these broadcasts recognize.  Or more importantly, to me, a cutting edge population, the clinical population, feels less alone.  They are the people in the know, and they are telling us, what's what.  Delicious.

(2)  Adult Asperger's and Depression

This one explains so much!

Years ago I had a patient with Adult Asperger's, and have seen many since then.  Once you know what to look for, it isn't hard to pick it up.  Not that this is a common diagnosis, but 1 in 250 isn't exactly one in a million. Ever since Baron-Cohen came out with a better test for Adult Asperger's, more and more people with this compelling disorder are coming to therapy.

Tony Atwood

I found a list of affirmations in Tony Atwood's book, The Complete Guide to Asperger's Syndrome,  and brought it to work with me one day.  The patient read through it and told me that it didn't matter. The depression people like him have (depression is often associated with Asperger's) is born of deficiencies that might improve, but will never be overcome (we shall overcome): misunderstanding social norms, not knowing the intentions of others, cluelessness about people's expectations, a sense of isolation ingrained over a lifetime.  No amount of affirmation, I deserve respect for being different! can change this.

And yet, like other AAA patients, his sense of humor has me on the floor.

He shows me a link to a tee shirt he found online that says,  I'm not rude. . .I have Asperger's, and he tells me he could never wear it.  Too embarrassing.  We talk at length about his sense of despair, his inability to hit the mark, socially. his inability to put words on feelings his whole life. He hasn't got feelings so much as rationale.  His rationale, and only his, since empathy he tells me, for someone like him, is like Greek to a Jew.

(3) The Runaway Train of Depression

We talk a lot about how depression can feel like a runaway train.  Women in particular can't stop the crying, especially if they are suffering before menses, PMS.  It's like, sure, we're depressed.  But our bodies have to cope with our hormones, too?  Or is it all, hormonal.  Feels like that, sometimes.

It doesn't matter, really.  What matters is the feeling that this is unstoppable, that the tears will never dry, a feeling of loss of control, a feeling of serious crazy.  Insanity. What is crazy if not lack of control?  Nothing.  A person feels as close to insane with these feelings.  It is not unlike the insanity people with Asperger's feel, like they are aliens, can't speak this unintelligible language, the language of social cues.

Segue to Asperger's just a moment, because it can be so depressing (my last referral had no idea he had the diagnosis, came in with suicidal ideation).  Why do they want to be together in groups! What's with these get-togethers?  Ridiculous.  This is how it feels to have Asperger's, and this is how it feels under depression.)

Even imitating the natives, it is hard to be one of them-- both conditions.  But merely having Asperger's, being unable to read what is expected, not knowing what anyone wants from you if it is not spelled out, a person does feel out of control, a mistake will happen at any moment in a social situation.

And it does.  Insanity, not unlike the insanity we feel when we can't "manage" our emotions, especially sadness.  We're supposed to be able to do that, right?  Manage them!  And guess what?  Sometimes, that's impossible.

So what is the cure for this craziness?  For both crazinesses.  For the runaway train, those tears that don't stop?  People who are in a relationship can, and often do, ask a partner to hold them.  Holding therapy is nothing new.  We use it for kids all the time.  Kid has a tantrum?  Hold him.  Kid is sad?  Hold him.  And let the child determine when it is time to let go.

Same for a woman, or a man, weeping, thinking depression is insanity, off the charts, unstoppable.  If she can get someone to hold her, if he can get someone to hold him, it helps.

There's usually a problem with that, however, which is that sometimes the trigger for the tears is something that this partner said, or something not done.  So asking for a hug puts a vulnerable individual in a position of potential rejection.  They just argued.  Timing is bad.

This is where I say, Own the craziness.  Just like with Asperger's.  Own that you feel out of touch, insane, that you are in a crazy place and it is nobody's fault, least of all that partner's.  Even if it is, you don't say that, not if you want to neutralize the fight and start over, get the drug, the feeling of human arms around you.

That's the cure.  It really is.  One of them, at least.

therapydoc

Snapshots: Way Beyond SADS

MORE than a little wing, there.

We’re at the Midway Park and Fly for an overnight check-in and Chris, a man-of-girth parking attendant, has lifted my carry-on to the shuttle.

"Wha’cha’ flying?" he asks FD.

"AirTran."

"AirTran it is."

Yes, AirTran has wooed us away from American, at least when we fly south. And we do this so often that the Park and Fly knows our name. They reserve us a special angle parking spot against the garage, Aisle J.

I’ve blown off a Sunday full of patients and FD has a new baby in the hospital, so both of us have misgivings about the trip. But we’re Bubbie and Saba* and we have a job to do.

It’s supposedly snowing down south. We land and it’s not snowing. It’s driving snow. Someone up there is pelting us with snow. There is snow on the ground, at least two inches, and the kids in the row in front of us are saying, Yeah, we’re getting four inches, for sure. Maybe more.

This isn’t why Chicagoans fly south.

The city is up in arms, freaked out, at a standstill. They don’t own scrapers in the south. What’s a snow scraper?

They don’t know about salt. There are no in-service workshops teaching Streets and Sanitation that if you salt icy streets, magic, snow will melt.

I look out at the ground crew scratching their heads. A minivan with a miniscule plow at the bumper weakly pushes snow along the tarmac. "That’s what they use to plow runways," I crack to FD. He chuckles.

"So glad you’re in a good mood," I shoot back.

Our son picks us up from the train. The city has a nice public transportation system and you know I love trains. He looks good, our boy, as all young people look good to us, but he seems to look better than most. He tells us our granddaughter has her wish, this wish for snow, and I’m thinking . . .Marvelous, should have brought my skis. We pull into the driveway and there she is building a snowman with her aunt.

And everything changes.

The endorphins rush from the walls just seeing her. FD is out of the car in a flash, building a snowman, too, searching for a nose. Of weaker stuff, I slowly gather my things, wave to the kid, and head indoors to see her sibs and stretch out a bit. It's a long time in that sardine can they call an airplane.

These other grandchildren are edible, so I eat them, mostly visually, the camera snapping away. My beautiful daughter-in-law is laughing as I brush snow off my sleeve. She's apologizing. "We didn’t ask for the weather, honest, Mom, you have to believe me."

Sure I believe you. I continue to eat her children, three months old, six months in all. We do multiples in our family, not quite on the scale of the octuplets, but doubles aren’t that unusual. And for me, having had twins over thirty years ago, having one of these small people father very new multips--well, watching him and his lovely wife juggle the two of them, it’s déjà vu all over again.

They try to feed us, but we’re too busy with the entertainment.

None of us wants to go anywhere and there’s ICE out there, you know, and people can’t drive in this, some of it could be black ice. We're led to believe southern drivers are all homicidal maniacs; we believe what you tell us.

At some point FD thinks of the obvious way out of the cabin fever that has followed both of us from the airplane and gingerly suggests, "Let’s go to Target!" Well, this is an acceptable field trip, nearby, and there’s always room for diapers.

Before we go, my granddaughter reminds me that I'm supposed to make her warm milk and honey, some weird tradition she associates with me, so we do this. She’s sipping, searching her brain. "Remember those kids at your house. . ."

"Your cousins! Yes! We’re all going to be together again soon, for Pesach. (rhymes with grey socks and it's Hebrew for the Passover holiday coming up). And you’re going to see all your other aunts and uncles, even the one who JUST became editor in chief of law review and it’s not based on looks. . ."

"And, and, and. . .play with the kids."

"Uh, huh."

“What’s this?” she asks, tugging at the tangerine silk blouse I have under a pale orange cotton sweater. Neither is warm enough in this unexpected cold, but surely better than the silk kimono on a skinny fellow we saw rushing off the train. Did you see that? A kimono! He must be freezing!



"Do you like it? It’s my tangerine blouse. Want me to get you one, too?"

And we’re off to Target. I buy her mother a book, Look Me in the Eye: My Life with Asperger's by John Elder Robison. It comes highly recommended, although I haven’t read it myself. This is my cheap way of getting books. I buy them for Rac, she gives them back to me to read when she's finished, then I send them to the next bidder in the family who shows an interest.

It's that or the library, also a good thing, but they charged me $2.40 for an overdue book the other day, and I swear** to you, I renewed it on time.

Anyway, it’s pretty hard to find our favorite three-year old a tangerine shirt, so she opts for a dress, navy and kelly green, although she really wants a frilly, lacy, yellow Easter frock that just doesn’t work for me. We find a Size-Me chart and she stands up next to it.

"You’re a 4-Toddler," I say.

"A FOUR!!!! I’m a FOUR!!!! My mommy says I’m THREE! But I’m really FOUR!!!" As in, I knew it.

We put in a solid couple of hours shopping and eating, meeting her mother and sibs at the pizza shop, and everyone behaves incredibly well. We return home for bath time and I'm elected to do this, which only makes sense, since I bought the new rubber duckies, the yellow ones, you've seen them, with the big momma duck and her three babies. I have also donated a fourth duck, a brilliantly engineered species that is really for testing the bath water to make sure it's not too hot. There's a sensor on the duck's underbelly and the word HOT will turn white if the water might roast your kid. The idea is that you put the duck in the water before the kid.

Anyway, the kid is swimming and splashing and I’m washing her, amazed at my good fortune, and it’s a good time overall, even hair-washing goes very well. At some point I sigh and say, "Maybe we better get you out of the tub now. I have to go."

She gives me this incredulous look. “You’re going?”

“Well, Saba and I have to get back to Chicago early in the morning.”

"You’re going?"

"You’re coming to visit soon!"

"Maybe I’ll come to Chicago with you now," she reasons. "And I’ll see Blue*** I want to go with you now. On the airplane." Done.

"But you’ll miss everybody, you’ll cry within minutes, as soon as you realize your mom isn't with us. You'll miss her, and your daddy."

"No I won’t."

"You’re only three."

"I’m four."

"Come on, let’s get you out of the tub into pajamas."

"No. I’m coming with you."

"Ask your mommy."

She lights up. Idea. She wriggles out of her towel and works the idea over with her mother.

Rac gives me a look to kill, as in, how COULD you?

But our little three/four year old is in pajamas and she knows she can’t go. But it is sad, and there's no getting around it, I've failed her. She thought we had a chance.

Next morning there’s hardly any more snow on the ground. Things melt quickly in the south. FD and I are back on a plane and the pilot’s telling us what to expect weather-wise in Chicago. We have a little snow.

He also tells us we’ll be taking off in ten minutes. A half hour later FD grumbles, “Good thing the pilot’s not a surgeon.”

“Huh?”

“You know, Uh, lady, the surgery only takes ten minutes, you’ll be out of here in no time. Oh Mr. Jones, that surgery went just fine, just great, you won’t have any pain (sic)."

FD is in a hurry, hates wasting time. He wants to discharge that baby and AirTran doesn’t seem to care.

I’m marveling at my view. Usually I sit in front of the wing but somehow couldn’t get that seat, and now I’m right here, on the wing. I look down and see the wing is made of several pieces and shapes, and one of them has arrows.



“What’s the story?" I ask anyone in hearing range. "They don’t know how to put the wing together without the help of arrows?”

Something to do with airflow. I change the subject.

“I can’t wait to see my fish. I hope they’re all okay. Number #4 takes good care of them, which makes sense, since food is a priority for him. But you know, a mother worries.”

I ramble on, FD seems to be listening, maybe. “I worry a little about Blue, you know, I really do. He's my favorite fish and he’s grown so big so fast. Maybe he has heart trouble. How would we know if he has heart disease?”

“Don’t worry,” FD quips, totally deadpan. “He swims every day.”

We land with a thud and I’m pretty sick, stumble out off the plane. Chris, our driver recognizes us as we take a seat on the shuttle. “Didn’t I drive you here just a couple of days ago?”

“It was just yesterday,” FD tells him.

“How could you go for just one day?” Chris is flabbergasted.

“Gotta’ get back to work,” I offer weakly.

“And this weather,” he continues. "To go from there to here. . ."

He lets us off at our car and before we can blink Chris is sweeping the snow off the car with a huge rubber snow scraper. This is not your average snow scraper, it’s more like an industrial push broom.

“Where did you get that?” I cry enviously. “I must have one.”

He mumbles something, but I’m thinking: If it keeps up, this global warming, this climate change, call it what you will, then there’s a new niche in the south.

Think . . . . scrapers.


therapydoc

*The Wall Street Journal did a piece about a month ago on grandparents and how people in my age group hate old-fashioned names like Bubbie, Nanna, Gramma, Tatti, etc. The labels make them feel old. They want their grandchildren to call the Fred, Sally, Gert, Debbie, Jim, etc.

Who ARE these people?

**blee neder, meaning I don't really swear.

***Blue, my favorite fish, is a Niger Trigger. He's from Nigeria and builds things out of sand when he gets bored.