Monday, October 29, 2007

Mood Watch - 41

Since my last post I’ve been through three periods of depression, each of about four to five days’ duration. They’ve followed the same pattern as most of my depressions. That is to say, my energy level will drop, usually for some plausible reason, so at first I just seem tired and in need of rest. I take some time to recharge my batteries, but they don’t recharge. Instead — and quite quickly — my mood drops into such a trough that I can hardly stand to do anything but sleep, and I sleep as much as I possibly can. At such times, not only do I have no interest in my regular work (or anything else), I feel a sense of foreboding about it. It makes me anxious even to check my email. When I go down to campus to teach a class or attend a meeting, I feel no sense of emotional connection. I can’t “read the room” to understand its tone — whether, for instance, I’m making any sense to my students beyond the mere fact that I can speak complete sentences. If I have to type something, I can hardly figure out how to organize my thoughts, and I notice I make a lot of typographical errors (I’m generally a pretty accurate typist).

All in all, the effects are about as debilitating as a bad case of the flu, except that the hallmark is a pervasive sense of misery and shame, as well as the fear that I will never return to normal. Cognitively I know that this is distorted thinking, but at a gut level this is simply hard to believe — it’s striking the extent to which one’s biochemistry informs our impressions of what really makes sense and what doesn’t.

Lastly, although I remember feeling OK, I literally cannot remember what that actually felt like. It seems amazing that I ever enjoyed life or could ever enjoy it again.

In formal diagnostic terms, one would have to exhibit these symptoms for fourteen days to qualify for a major depressive episode. Mine generally last three or four days; occasionally five, but that’s unusual. When I bounce back, it’s abrupt, just a matter of a few hours.

It’s always tempting and sometimes useful to look for correlations with external events which may act as catalysts or triggers. Over the past year a very strong correlation has emerged between business travel and depression. I return from a trip; a depression ensues. My therapist and I have theorized about the possible connection. A couple of explanations have seemed plausible and it’s possible it’s not an either/or question. But at the moment, the front runner is that these trips, in the nature of travel, are tiring and disruptive of my normal routine, and also usually involve giving a public presentation — often two or three in quick succession — so that I have to “gear up” to be animated, energetic, etc. Taken together, it’s no surprise that this would have an effect on my biochemistry.

Since I can’t avoid business travel — it’s pretty much a bedrock component of my professional activity — the issue now becomes whether to just accept the fact that depression will be the likely sequel or, more imaginatively, to find a way to manage the problem. One possible solution would be to make sure I get periods of regular rest during these trips and as far as possible adhere to a normal schedule.

I should have a fair degree of control over my time when attending, say, academic conferences. Invited lectures are a different matter. Having gone to the trouble of flying me in, putting me up in a hotel, and paying me an honorarium, my hosts generally try to get as much mileage out of me as they can. My most recent trip, for instance, involved:

a. dinner with students

b. a 90-minute workshop

c. breakfast with more students the next day

d. a meeting with yet more students at mid-morning

e. lunch with faculty and students

f. another meeting

g. a 90-minute public lecture, including Q&A

h. dinner with faculty

… to which I myself added item g(1): a few afternoon beers with some grad students.

It’s not a question here of being exploited. I liked everyone I met and had a very enjoyable time. Indeed, one could almost posit a connection based on the abrupt transition from a warm, validating atmosphere to, well, the regular workaday world. But if there is something to the thesis of these depressions emerging from my having to remain “on” for extended periods, notwithstanding the wear and tear of travel — then in the future I’m going to have to request what might be called “reasonable accommodation” for the disorder; i.e., a lighter schedule.

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