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How Much is Physical? Wednesday September 13, 2017

[To listen to an audio version of this blog, please follow this link:]

I once read a story where everything changed and nothing stayed the same. What I mean is, that every day, when the protagonist awoke, things would be different from the day before. Some days he would have a wife, but never the same one. Some days he would have children, but they were never the same children. His house was different; the route to his work was different. Nothing was ever the same. Then one day, that all changed; everything did stay the same and he found he couldn't cope.

It used to be a bit like that for me, but in reverse. The world stayed the same, but I was different every day. Whether in a manic phase or in deepest depression, the days were never the same. I was never the same.

With this new medication, I wake up every morning feeling – about the same: fairly cheerful; moderately energetic and enthusiastic; reasonably alert. Not exactly the same – hey – human here, but – pretty much. After six months, I am just about getting used to it.

So, a little while ago, when, at a friend's house just before lunch, I was suddenly and for no reason, overwhelmed with a desire to weep, to crawl away into a dark place and hide; I was horrified. Was this the depression coming back?

The world retreated behind a thick plate-glass window and sound became dim. My thoughts started that cockroach skittering, that rat scrabbling, in the corners of my mind. The tide of foul darkness engulfed like floodwater, icily cold.


Please, no!


Then a lance of bright pain pierced behind my left eye and I remembered. Ah yes – migraine.

Some people get visual "auras" with migraine. Things blur, or zig-zig; one side of their sight might disappear. I get what's called a "neurological aura"; it affects my emotions. Oddly enough, the moment the pain hits, the aura disappears. It's almost a relief. I know that I must take painkillers and lie down for a couple of hours (sometimes more) and it will be over – all bar that floaty, head stuffed with cotton wool feeling, that is.

I hadn't had a migraine for years; I thought they had disappeared for good once I left my highly stressful job, but now they have reappeared as a side effect of the medication. I'll happily take that swap.

But it made me think. How many of the symptoms of our depression are the depression itself? How many may be attributed to physiological reasons?

If we are exhausted, if we have not eaten or drunk enough, if we are in pain; the mind will reflect this.

We know that some of the symptoms of depression are the overwhelming desire to sleep and a craving for carbohydrates. This is the brain decoding the symptoms of depression and effecting the "cure" it knows has worked for similar symptoms before.

But it's always worth thinking about the physical causes of depression.

Before you panic.

A Moodscope member.

Thoughts on the above? Please feel free to post a comment below.

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Molly Wed, Sep 13th 2017 @ 3:24am

Great blog, especially listening to the audio version and the music afterwards. Very clever. Thank you Mary xx

Mary Wednesday Wed, Sep 13th 2017 @ 12:51pm

Thank you Molly! That song just leapt into my mind! ;)

Cogitator Wed, Sep 13th 2017 @ 6:49am

Had this question this morning about my sudden anger. She explained that I would have been angry anyway about this issue but to be very careful how i deal it now, as i am in the middle of an episode. I may be more angry than usual as i am sensitive and dont have the social graces to deal properly with the issue right now. So in summary it all overlaps and heightens our rrspone. But i think a migraine is something different!

Mary Wednesday Wed, Sep 13th 2017 @ 12:52pm

Neither is pleasant! :)

Lucas Wed, Sep 13th 2017 @ 1:15pm

There migraine aura I get most often is anger/irritability. Every little thing bothers me, and I have nearly destroyed my phone on several occasions. This is before the pain starts, too. If I can't find a reason that I'm angered by little frustrations, then a migraine is probably on its way.

Orangeblossom Wed, Sep 13th 2017 @ 7:18am

Hi Mary, thanks for the thought-provoking blog from which I learnt a great deal. I also enjoyed reading it. Hope that you have a good week ahead. Hugs

Rupert Wed, Sep 13th 2017 @ 8:19am

That story sounds an interesting one Mary. I was only thinking on the way in to work how monotonous everything is and how badly I am coping with it at the moment. And yet there is no desire to change! I need to start addressing this. Rupert

Mary Wednesday Wed, Sep 13th 2017 @ 12:55pm

I wish i could remember who wrote it. It might be Ray Bradbury or Cifford Simak (although it is not gentle and earm like his stories). Almost certainly one from the clasdic time of SF. I might put it to the hive mind of a certain Facebook group to which I belong. I'll let you know. And - just change a little at a Time, Rupert!

Eva Wed, Sep 13th 2017 @ 8:22am

Hi Mary, this is really important but sometimes difficult to unravel, after a year of bereavement (a year and a few months for the other two previous bereavements...) I went to see a counsellor, one of the things she suggested initially was to see an acupuncturist, who also practices Chinese medicine, as she felt that I was also extremely physically depleted. And so began the big unravel, whilst this was going on I was also diagnosed with a chronic disease, this should resolve with menopause, ha ha! Unravelling it all helped me so much, I was able to focus on different aspects, work on the grief, address the disease, and attend to the massive fatigue that I now had. And I've made so much progress, I think I would have become possibly chronically fatigued if I hadn't managed to address the physiology.

I'm sorry that you have a reoccurrence of the migraine, but happy that you aren't dipping into a low again, perspective is a wonderful thing.

Mary Wednesday Wed, Sep 13th 2017 @ 12:56pm

It is indeed Eva. So pleased for your progress. Go well

Valerie Wed, Sep 13th 2017 @ 8:53am

This is a very important message Mary.All sorts of physiological factors can produce symptoms of mental illness.A nurse friend told me that serious urinary infections can bring on temporary dementia-type behaviour in older people,as can constipation following surgery.

I started having classic migraine at age 8.By my 50's I thought they had gone,but they take on a different form when you are older.In my case,a rush of energy followed by exhaustion and tearful depression.Feeling giddy,irritable and a bit paranoid.There is a tight feeling in the head,more like sinusitis than classic migraine.An awful sense of impending doom.

Anyone with delicate mental health needs to take basic good care of diet,hydration,rest and exercise,check vitamin and mineral intake is adequate.

Lack of restful sleep can reduce me to a terrible state within days,something I am currently struggling with.That duvet looks so inviting! xx

Mary Wednesday Wed, Sep 13th 2017 @ 1:01pm

Under the duvet myself atm, Valerie, as another one has arrived. Hence short replies.

Jul Wed, Sep 13th 2017 @ 8:59am

A really interesting thought provoking blog Mary. I think what you say is so true. If we have one particular health niggle or obsession like insomnia for instance, one can so easily attribute every symptom to lack of sleep. This happens to me on a daily basis. It's not depression I attribute symptoms to but lack of sleep. So there may be all sorts of physical thinsg going on in my body which I largely ignore as I believe they can all be righted by a good night's sleep. In one way it's a positive as I'm not always rushing to the Dr with my symptoms. Maybe I should be!! Jul xx

Leah Wed, Sep 13th 2017 @ 11:03am

Jul I too blame my lack of sleep. If only I had more sleep I could do this and that. I wonder if I ever had a good night sleep and I still felt tired what would I blame then.

Mary Wednesday Wed, Sep 13th 2017 @ 9:31pm

"Sleep, that knits up the ravell'd sleave of care, the death of each day's life, balm of hurt minds, great nature's second course, chief nourisher in life's feast." Shakespeare nearly always seems to have put it perfectly first! :)

Oli Wed, Sep 13th 2017 @ 9:31am

I like the question Mary. I work with people experiencing physical pain and always consider, “How much of this physical pain has non-physical drivers?” so yes, it makes sense to consider if primarily mental phenomena have a physical component.

I also like the “same/difference” issue too. Very interested in this right now. Especially with the notion that the strongly perceived sense of self and continuity of identity are related to, possibly even a product of, the static lives we lead. I.e. there’s strong evidence that “personality traits” — who we are — are a (convincing) illusion. Live the same, be the same; live different, be different. Most of us do not live different hence the illusion of continuity of identity.

Mary Wednesday Wed, Sep 13th 2017 @ 9:34pm

Fascinating theory Oli. My brain is not up to dancing with it just now (the cotton-wool stage) but I would love to return to this. I may talk to you tomorrow... if you're okay carrying on....

Leah Wed, Sep 13th 2017 @ 11:01am

thanks for reminding us about there maybe a physical reason for ones depression. for me it is being morning as I dont do mornings.

Lucas Wed, Sep 13th 2017 @ 1:33pm

I'm similar. There sleep I get from midnight to 8 or 9am is better than the sleep I get from 10pm to 6am, even though it's the same number of hours. I've had people tell me that doesn't make sense, it that it's so in my head, but my brain is in my head, and that's real, so "all in my head" doesn't discount things immediately for me. Leaving a job where I had to get up at 6am has helped me, I think in part just because of not having to be up so early. Some of our internal clocks are tuned to different times.

Mary Wednesday Wed, Sep 13th 2017 @ 9:38pm

Hi Lucas. Did you read my blog on lions and bears, wolves and dolphins? We do all have very different body-clocks. Leah doesn't do mornings; I prefer not to do afternoons! Siesta have always seemed an excellent idea to me.

Lucas Wed, Sep 13th 2017 @ 1:28pm

It's been so long since I commented, it's funny what makes me think "no, not later, right now so I don't forget."

I also suffer from migraines. Sometimes no aura, if I do get something visual it's after the pain starts, but as far as a warning sign, mine are emotional as well. I've heard that it's possible, but this is the first time I've encountered anyone who who experiences similar. Occasionally I'll feel deeply sad it depressed, but that happens afterward more often. Most commonly I get extremely irritable and quick to anger, which is out of character for me. It too me a while to realize there was a pattern between these times of being angry over little things for no reason, and the following migraines, but I realized there were no effects making me irritable. Without fail, when that mood strikes, I have a migraine hit within 2-24 hours (usually on the shorter side).

I've gotten better at understanding how other things will affect my mood too. Fatigue and pain (which in turn will also make need tired) bring on depressed feelings. Just knowing that's what's causing them in some cases lets be be more patient with myself, and gives me "permission" to feel bad, which in turn lightens this up a little, at least sometimes.

Mary Wednesday Wed, Sep 13th 2017 @ 9:43pm

Thank you so much for commenting Lucas: I feel most privileged. I agree that it's good to give ourselves permission to feel bad. The Moodscope score can give a similar permission. I have not met anyone else with a neurological aura, apart from the GP who told me about it many years ago. He was an expert in migraines (being a sufferer himself) and had researched extensively. We are not alone!

Nicco Wed, Sep 13th 2017 @ 2:19pm

Thank you for your interesting blog, Mary. I generally have a burning sensation in my brain (which I'm told isn't possible) just before I have a depressive episode. I'm also diabetic so need to eat regularly or I get migraines. I tend to go through a bout or crop of them - usually in the afternoons - sometimes for weeks at a time, then they disappear. And yes, I do get v.irritable & snappy with them too. I have M.E. & fibromyalgia both which make me feel v.tired, as well as Scheuerman's disease in my spine, so I'm never really sure where the headaches are coming from - sometimes it's just due to bad posture if I've not noticed I've been slouching for a while - that can bring on a headache. But I'd trade anything for the depression & panic. I tend to go mad buying things when I'm depressed, although I know some people with bp do this in their manic stage. I'm just trying to get over a bout of depression now so am looking an a depleted account! I do hope you start to feel better soon & are able to emerge from the cosy cocoon of your duvet much refreshed & revitalised. x Nicco x

Mary Wednesday Wed, Sep 13th 2017 @ 9:46pm

Thank you Nicco. It will be better tomorrow. It's been a bit of an all day one, although I did somehow manage to get out and do a talk I was scheduled to perform. It seemed to go well, although I was conscious that they only got a quiet and faded version of me!

The Gardener Wed, Sep 13th 2017 @ 6:01pm

Can I 'high-jack' to apologise to Leah for my high-handedness yesterday - I was seeing 'clear' remedies for something which was not clear. On the business of being popular - I thought about it a lot - in particular to people who, over the years, I saw as 'popular' full diaries, always off in nice clothes, in fact, envious. Then almost ALL of them were only living that life because of the MAN's position, which demanded attendance often in high places, full evening dress, all the trimmings. As people they may not have been 'popular' but their very ubiquity made them seem so. Now I see much popularity as notoriety - viz Hello magasine and such like. Thanks Mary

Mary Wednesday Wed, Sep 13th 2017 @ 9:47pm

You ate very welcome indeed! Hijack away with impunity.

The Gardener Wed, Sep 13th 2017 @ 6:16pm

The 'blaming' lack of sleep (above) is interesting in cause and effect. One thing is unarguable, without enough sleep, and that of good quality, however short, you cannot function properly. I don't get migraine, thank heavens, but lack of air and over-heated buildings will give me awful headaches. Dreading Mr G's return from respite and demand for central heating at full blast . All my visitors or phone calls today have brought trouble - so many people ill. It's rained all day - housing market awful - my b-in-law seems to be near death, and I am trying to help his poor daughter whom he treats as a near servant - she dreads going up to stay with him, in a soul-less house, on a soul-less (if elegant) housing estate. Now, it is I who am advising HER not to be pushed about, and, in particular, not feel guilty for not doing enough - he is a past master at that, make sure and get help for dealing with his affairs, he may not be able to - she is no fool, she was a teacher, but no business experience at all - only major thing in her life buying her house after a divorce. Valerie, your advice on basic good care is 'spot on' at any age

Mary Wednesday Wed, Sep 13th 2017 @ 9:48pm

I would echo your words. About to have an early night myself!

Lexi Wed, Sep 13th 2017 @ 9:07pm

Hi Mary, I hope that you are feeling better soon. When I was younger my depression was brought on by my bad wiring and broken spirit. Sometimes a word heard, or hearing about another’s life, or just feeling like I was in the wrong place with the wrong person, anything along those story lines would send me into the well. Now that I am older I can manage my story lines better so I don’t fall so far anymore. But my depression can be brought on by my chronic back pain. I have suffered for as long as I can remember with back pain, brought on probably by years of being throw from jumpers and dressage as well as just bad alignment. I am not happy with my weight right now or my lack of mobility in my arms and back, so I can tie my depression to that. Meditation and yoga and eating a healthy diet ( not the one of a 20 year old college boy, like I do when I feel bad) will bring me back out of the well. My back pain is also starting to become a “friend” - at the first twinge I think “Ok. What am I doing too much/not enough of” and I know I need to get back to the basics. xo Lexi

Mary Wednesday Wed, Sep 13th 2017 @ 9:50pm

So interesting that your back pain is becoming a "friend". It is a messenger from your body carrying warnings. It is indeed a friend. I am sure my migraines are a friend too - I just need to interpret the message

Ach UK Thu, Sep 14th 2017 @ 7:49am

Good morning Moodscope, sorry to interrupt the Wednesday blog but it's now Thursday morning 7:45 ish a.m. has something happened to Thursday's blog? It hasn't appeared. Hope this is just a glitch I hope everyone at moodscope is well. Hope to hear from Thursday soon thank you.

Ach UK Thu, Sep 14th 2017 @ 8:04am

Thank you moodscope we're back sorry to have agitated but this blog is so useful I was worried thank you all moodscope team

Caroline Ashcroft Thu, Sep 14th 2017 @ 10:49am

Thanks Ach, technical glitch I'm afraid! We're all fine, sorry it was late this morning. Carolinex

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