Battling the pitfalls of disease and depression
By Leo Greene, Staff Writer
Article Launched: 07/22/2007 12:38:26 AM PDT


Editor's note: Daily Bulletin reporter and videographer Leo Greene was diagnosed with ALS - Lou Gehrig's disease - on Aug. 16, 2006.

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Ever hear the tale of the Louisiana Honey Island Swamp Monster?
Pull up a chair and sit a spell.

In the heart of the bayou where forsakenness lives, where the trees eat the light and the water runs black, this humanlike beast skulks for prey. Silent as a corpse, he rises from the bog and enfolds his victims and drags them into his lair.

Trust me, I know. I recently escaped from his clutches.

Not to be flippant, but for me this swamp-monster analogy works.

I'm talking about depression.

It's hard to say when I first slipped into that darkness - three, four months ago, maybe longer. I didn't see it coming. I couldn't find my way out.

According to one estimate, 80 percent of those diagnosed with terminal illnesses experience episodes of serious depression.

"Depression is something that we often don't want to talk about as ALS patients,"

said Chuck Hummer of Pinellas Park, Fla.

It's time we talk.

Chuck is one of the more active participants in ALS Internet forums, selflessly reaching out to others struggling with this disease.

His battles with depression began in 1994 after the death of his only son. The ALS diagnosis in 2004 compounded the problem, and the bouts came more often.

"The depression periods seem to be triggered by stress or specific events, and I can go from a productive, positive, active person, to a person who feels absolutely worthless, a burden to my caregiver, and I have alarming thoughts of suicide," he said.

These chemical changes in the brain cloud Chuck's mind, drain his energy and he withdraws to his bedroom and the refuge of sleep. An episode can last for several days.

"Then for no obvious reason, I will awaken without any of the disturbing mind clutter, feel energized, positive and back in the fight to make my remaining life valuable," he said.

Antidepressants might have reduced the frequency and the depth of the episodes, but they haven't stopped them altogether.

Malvena Hill of Auburn, N.H., learned she had ALS in May.

"I guess I took the news better than most people, but I wasn't very happy and did cry," she said. "I looked up about the disease and got more unhappy."

Malvena had been taking the antidepressant Cymbalta for two years prior to the diagnosis. Shortly afterwards, her therapist decided to take her off the drug.

"It wasn't a week before I became depressed, cried about everything, stayed in bed, had terrible thoughts about ALS."

Her doctor put her back on the Cymbalta.

Back in January, Cookie Peckham of Maumelle, Ark., was ushered into the world of the terminally ill ALS patient.

"I'll never forget that day," she said.

Her physician prescribed Lexapro, which helped.

However, "I find I get depressed when I think about what this disease will eventually do to my body," Cookie said.

Me too.

I had been taking the antidepressant Remeron since a few months after my diagnosis last year. At first, the drug gave me energy and improved my appetite.

However, I would eventually require more ammunition.

As the disease progressed and the relentless aches of dying muscle turned to pain, I turned inward, steeling myself against the onslaught.

A psychiatrist prescribed Cymbalta.

In two to three weeks as the drug took effect, I began finding my way out of the swamp. Mixing with family and friends also helped lift my soul.

For this column, I sought the advice of a good friend, Mark, who is not only a retired counselor, but also a cancer survivor and veteran of the depression wars.

"The very best thing one can do is admit they have depression, see the psychiatrist and get started on the meds that will help lift and hold your mood," said Mark.

Any antidepressant takes time to kick in, he said. Also, picking the right antidepressant can amount to a trial-and-error process.

"You have to tell them what is working," he said.

In addition to chemical aids, counseling can prove valuable. I paid several visits to a psychologist. Chuck said he's planning to line up some sessions.

And people in our situation are advised to work at nurturing a healthy outlook.

"My secret of trying to cope with depression is to keep my mind off my disease and remember what I can still do, not what is changing in my body," said Cookie.

Chuck's therapy includes reaching out to others, providing a helping hand and serving as an advocate for the ALS community. "It validates my self-worth and keeps me from living inside my own little crappy world, and being a part of helping others and looking at ways to solve their problems."

So, as I slog through this muggy bog, I've now learned from experience to keep a wary eye. "Here be dragons."

These oily waters might take me, but it won't be today.

And I don't plan to be bait for any ol' swamp dragon.

Leo Greene can be reached via e-mail at l_greene@dailybulletin.com or by phone at (909) 483-9337
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