Brain: FAIL. Alzheimer’s & Depression

I’m reading an absolutely breathtaking book written from the first person perspective of a 65 year old medical doctor struggling with early on-set dementia. It’s called “Turn of Mind” by Alice LaPlante, and we are immersed in the mysteries of her own brain’s failings, her self-understanding moving in and out like the tide, and the death of her best friend.  We only know what she knows at any given moment.

turn of mind

This is what hits hard:  Her reality is so convincingly utterly absolutely true to her in that moment, even as we know, it’s dementia ruling the day.  But what she does, what she says, what she thinks, it all makes absolute sense to her.  Sometimes, she can be brought back to the more objective reality of those caring for her.

She insists one night it is an emergency, she absolutely must get to the drugstore THIS INSTANT, she is out of tampons.  Her caregiver reminds her she is 65.  “O,” she says, “Right.”  The strange working of the mind, that one minute she knows without a doubt it’s a crisis.  The next second, her medical mind remembers no 65 year old woman should be having an emergency tampon crisis.  And she can trust her caregiver who tells her, she is 65.  Crisis averted.  But she doesn’t always trust what others tell her.

Here’s the thing:  This is what depression feels like.  You forget you have depression, and your emotional responses make absolute sense to you, and you do NOT understand why no one else sees the crisis, or the sadness, or the pointlessness of this moment.

 A mundane anecdote from when I was struggling:  My daughter got up early and ran out the door without telling us where she was going.  I suspected she just went out for a run, but I was mad that she hadn’t told us.  I start to dial her cell phone, but my husband rightly said calmly, “Let me talk to her.”  Because in that moment, he knew better than I that this was not a crisis, and did not need me treating it like the emergency it was to me.  I sort of got it.  At least I trusted him enough that I handed him the phone.

LIke when tears would spring up for no reason, and I wondered what the HELL is wrong with me? Or I couldn’t find the energy or will to put on my running clothes, or if I did manage, it took everything out of me, and I had to lie down.  And again, like someone struggling to remember they have dementia, that’s why depression is so challenging to face.  Because it’s your own brain turning against you.  Since our brains are relentless meaning-making machines, the narrative runs:  “You are just lazy.  You are weak.  If you just tried harder.  Just get up off the couch!  How hard can it be?”  Resisting the obvious explanation:  You are depressed.

 And then, if you are extremely fortunate, and blessed, someone you trust will point out that maybe it’s depression coming back.  And even though you KNOW they are lying, they are just trying to be kind, they don’t know that really, you are just a lazy slovenly couch potato, some part of you is willing to believe, like the main character:  O, 65 year olds don’t need tampons.  And you trust them enough to agree maybe you should just check in with your doc.  Because maybe something isn’t right.  And maybe those stories in your head aren’t telling the whole truth about you as a person.  But it’s hard, because those stories seem so, so real.  

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