Aging and Depression

Aging and Depression

October 2, 2003

Yeah, yeah, I know. Like I said earlier, Ugh.

The reason I've put off this "chapter" so long is because I haven't wanted to fess up. For all my blabbermouth exhibitionism on other subjects, this is going to be the first time I talk about this part of my life in public.

I should probably title it: In Which Our Heroine Turns Invisible From Lack of Sleep

My son was only a few months older than Baby Jessica when she fell down that well in Midland, Texas. Although things had been going south for me emotionally for a while at that point (stay-at-home motherhood was dissolving me into a endoplasmic puddle), I began to realize that something was seriously wrong when I lay awake half the night worrying obsessively about somebody else's kid.

At about the same time I was beginning to experience the "cloak of invisibility" that I described in part at an earlier point in the blog, that period of a woman's life when she is no longer noticed as readily, not just by men but by other women and even herself. One afternoon when I drove by a plain, unsmiling woman pushing a stroller down the sidewalk, I realized with a dull internal thud of horror, "That's me!" To the world -- to myself -- I, erstwhile Cutie Pie Hotshot of the Western World, had somehow become Generic Suburban Housewife, an extra straight out of Central Casting. People's eyes skimmed over me like I was a rock or a pine tree. I was the impressionistic rear drop, the John Williams elevator music, the out-of-focus swirl of background activity that made the foreground stars look like they were in a real place doing real things. There I was, the once perky, pretty, powerful Julia Grey, suddenly playing Nobody (female) in a babushka...with children.

With insomnia, too. I wasn't sleeping worth a damn. Sometimes I'd fall asleep without trouble but wake up in the wee hours and pummel my pillow and turn over so many times it was like I was spinning in a grave. Other nights I'd lie open-eyed and exhausted in the twisted sheets from the beginning. During one of my fitful intervals of R.E.M. a couple of nights after I recognized "myself" on the street I had a nightmare in which I went around to friends, relatives and -- oddly -- random jetsetty strangers in glamorous travel destinations, pleading for them to listen to me because I had something dangerously important to convey (what it was I don't know). But they couldn't see me or hear me, and meanwhile I was gradually fading away to myself, so that by the time I got to the beach at Negril I could see the breakers through my midriff. Bizarre. Like most nightmares it was terrifying in a way that went far beyond what the "facts" of the scenario would justify.

Looking back I can see that these incidents were the first overt signs that I was falling into a clinical depression.

That was hard to say. If I was telling you this story out loud I might have stumbled over that word: "depression." I'm sure my real life friends and maybe some of my internet pals have strongly suspected as much for some years now, but I haven't come out and admitted it. It's not supposed to be a big deal these days. Nothing to be ashamed of, just a chemical imbalance, an illness, not a character flaw, and all that, but you know what? It's still embarrassing. To me. It still feels like an admission of weakness, and I have always hated to be thought of as weak in any way, shape or form.

Back then the terror of admitting weakness, especially emotional weakness, was even worse. I was SUPERWOMAN! I'd had some bad moments after my first baby, but I was past that! I was strong and resolute and smart as a whip! I could solve any problem with brainpower and pure, bull-headed bravery, yessiree!

So why was I crying and why couldn't I SLEEEEEEEP?

COMMENTS ON THIS POST

Surely, Julia, there is more in store on this subject. My wife has mild depression, and takes Prozac. Just run "prozac and libido" through google, and find bunches of references to what I call "the libido killer." I'm hoping you'll talk about this, about prozac alternatives (Wellbutrin, perhaps) and more. I love your stuff. Please keep it coming.
Harry [apple] 10/2/03; 11:30:37 AM

Surely, Julia, there is more in store on this subject.
OH yes. I just had to take a really big deep breath to write this stuff this morning and I ran out of air. Heh.
Lots more to come.
Julia Grey [apple] 10/2/03; 11:46:25 AM

This comment may seem a little off topic, but I was reading some of Julia's earlier posts on the blog, and I wanted to respond to the comments that a lot of men were writing.
I've recently celebrated my 5th wedding anniversary. We have two children, and since the birth of the second, my wife and I have started the battle over sexual desire.
I would like to comment that is seems that most of the men responding to your column are being incredibly closed minded. Do they not want to improve their marriage? Do they just not care?
I have worked desperately to try to communicate with my wife and find out how she felt; to discover what changed in our relationship, and over and over I hear her say things that I THINK are petty and sound like excuses. However, the things that she says fall right in line with what Ms. Julia Grey has been saying. She feels bad about gaining weight, doesn't feel sexy, she's tired or frustrated from the day with the kids, she can't get her mind off the housework, she gets turned off when I talk bluntly about sex.
The point that she has tried to make is simply, these things don't usually matter to MEN, but they most definitely DO matter to WOMEN. Women seem to have a need for perfection when it comes to sex. (not talking about performance) The story book romance, castle in the sky, things. A dirty house, screaming kids, and an increasing dress size does not fit in that fairy tale. She doesn't want to have sex because she doesn't feel SEX-Y. And this happens for a lot of reasons. I promise she feels bad about it already, and you making a big issue about it every night makes it worse.
I get caught up in the moment, the passion, and the magic. She gets caught up in the situation, the setting, and the environment. I say, " I want to express my love in the most intimate way I can." She says, "then why don't you help me clean the house."
That makes me mad, but It is probably closer to the truth than I realize. She wants to feel "intimate" with me. So she needs me to help her get rid of the things that keep her from FOCUSING on me. Her intimacy happens in the mind. Mine happens in the body.

Or so it seems.

Guys give it a chance..... Listen to you Spouse and see what she is saying.
Matt [apple] 10/2/03; 12:07:31 PM

There are few of us not embarassed by the "D" emblazoned on our chests. The people who try to make it sound like everybody's just fine with it these days... they're doing all of us a disservice.

laura [apple] 10/6/03; 7:25:37 PM

October 21, 2003

The reason I made so much of not being able to sleep when I was talking about depression last time is because I have this Theory. (I can see you rolling your eyes, but bear with me.) It may not be strictly scientific, but it makes sense to me, and as soon as I get more than ten minutes to rub together I'm going to get with my doctor friends and researcher buddies and books and stuff and see if I can make a real live case for it. In the meantime, here's the draft.

I think that not being able to sleep properly is not just a symptom of depression, but an actual CAUSE of it. It may be a chicken and egg thing, but I'm becoming more and more convinced that if we slept better in the first place, we wouldn't get into sleep deprivation spirals that derange our brains in ways that alter our chemistries which causes us to lose sleep that further alters our electrical ecology which interrupts our sleep which makes our brains even more crispy....you see what I mean?

One of the things that the earlier medications for depression, like amitriptyline (Elavil) accomplished to perfection was to act as non-habit forming sleep aids (and it's what they're increasingly being used for today, for people who are not overtly depressed). So today, before I even get into more about the sometimes VERY subtle symptoms of oncoming depression, I'd like to talk about sleep and how to get more of it.

First, the alcohol connection. Booze can help put you to sleep, of course. But the problem is that the sleep you're getting on booze is not what the experts call "restorative." It jangles your REMs and bubbles your stew and just makes a mess of the whole business. Especially as you grow older, alcohol adds to the looseness of the tissues in your mouth, nose and throat which can increase snoring and induce sleep apnea, which is an actual stoppage of your breath as you sleep. If you inevitably wake up in the middle of the night after a boozedown, you're probably waking yourself with your snores or because you're not getting enough oxygen. But the biggest problem with alcohol as a sleep aid is that once you've gotten into the habit of putting your lights out with it, it's damn hard to get your body to work the old-fashioned way.

Alcohol can interfere with sleep even when it's taken in moderation. A consistent daily pattern of 4 or 5 beers doesn't make you a drunk, but it can still screw up your brain. The best advice I've heard is that you should confine your consumption to a maximum of 2 glasses of wine, but only with dinner, and that you shouldn't drink any alcohol at all within 2 hours of going to bed.

COMMENTS ON THIS POST

Makes sense to me -- for quite a percentage of depression cases. I tend to think depression is a system or matrix of factors, not just one factor, and that drug therapies alone are insufficient because they focus on only one point in a system/matrix of causal factors.
For instance, a person who's experienced loss may become depressed. Which came first, chemical imbalance or a lack of interest in regular physical activities? At what point do either of these things, chemical imbalance or lack of normal physical activities, interfere with sleep patterns? Or did sleep pattern disruption come first before chemical imbalance and a reduction in normal physical activities?
Sex drive is just one more symptom/causal factor in this complex matrix. Addressing several of the factors at the same time rather than any one in particular may increase the rate of "recovery" from depression.
Rayne [apple] 10/21/03; 8:27:47 AM

Depends on whether one is depressed or is suffering from clinical depression. Everyone gets depressed.
My observation is that some people, like me, sleep well and others don't. The don'ts need to learn how to sleep, which involves creating a ritual, etc. I have a few bad nights a year, and those are usually tied to stress or caffeine.
I think I sleep well for a variety of reasons. First, I love my dreams. My wife has told me she's jealous of my dream life because it's so real to me. I dream in beautiful color and can often step past the silly storyline to watch the images go by. My dreams are occasionally beautiful beyond belief and they can be so hilarious my wife has woken me up because she thought I was crying - I was laughing.
Second, my way of thinking is highly associative. My brain clearly draws connections while I'm asleep and I appreciate the interplay between those sides of me. I wonder if more linear thinkers have the same need.
Third, I've learned that if I see my dreams, I'm happier and that I see my dreams regularly if I get more sleep. Positive reinforcement.
Fourth, I'm not overweight and don't have any health reasons why sleeping would be hard.
My wife has bad sleep habits - sleeping on the couch and then waking up to go to bed; reading in bed, so she stays up too late. These are avoidance mechanisms. She's somehow afraid of sleep, perhaps because it brings out bad dreams (that she doesn't remember consciously). Being emotionally abused will do that.
My daughter told me when we were moving - she was 2 or 3 - that she was afraid to move because she was afraid the "dark would be different" when she went to bed. I explained to her that the dark in her new room would feel very different for a while but that she would get used to it and it would be her comfortable friend.
People who don't sleep well don't have a friend in the dark. If the dark is your friend, you welcome sleep. If it isn't, you drink, medicate, delay and otherwise avoid it.
jonathank [apple] 10/21/03; 1:59:10 PM

My best advice was already mentioned by Jonathan - ritual. My ritual is the same pretty much every single night - same time every night, evening hygiene, climb into bed with my book, snuggle with my sweetie, and go to sleep. As a result, pretty much as soon as I climb into bed, I can generally only read for about 10 minutes before I can hardly hold open my eyes anymore. Even if I was pretty much awake a short time before. That's why sex is never an afterthought. ;-)
Then there are the more tangible things, like getting rid of the crappy waterbed and the too-small-for-two comforter in favor of a high-end pillowtop waveless waterbed mattress and separate blankets.
catnmus [apple] 10/22/03; 7:23:44 PM

October 22, 2003

I only have a few minutes this morning, but want to continue the sleep discussion. I know this might be boring and apparently off-topic for many of you, but these "little things," like a lack of sleep and the gradually descending irritability or depression it causes, can add to other problems that accumulate over time and gradually, almost imperceptibly nudge a marriage off the track. This is the sort of thing people are talking about when they say that relationships take "work." The work is this deliberate thinking about these dull, stupid, dinky little details of everyday life and experience.

So. Sleep. Rayne and Jonathan's comments go into some of the things I was going to mention today. Rayne brings up the very important role that physical exercise plays in the smooth functioning of the human machine. You don't have to be doing some big sweaty workout every day in order to sleep at night, but I think everyone has noticed how much easier it is to get to sleep and stay asleep after a day out in the yard or after a softball tournament. The only caveat about exercise is that it's probably not wise to fall right into bed while your heart is still going forty miles an hour, but some people don't have any problem with that, either. (Sex is exercise of a sort, but its cardiovascular effects are usually too brief to be truly useful aerobically. wink)

Jonathan notes that routine and expectation can be aids to sleep. He's very right that a scattered, reluctant or disorganized approach to bedtime and sleeping will interfere with the process. All the sleep research I've read says to make a studied, deliberate, regular ritual out of bedtime. Decide when you'll turn the TV or the reading lamp off and do it at the same time every night. If possible, get up at the same time every morning, too. Decide on a time of day to stop drinking caffeine. Even if you don't think it is actually keeping you awake (and researchers have shown that many people are mistaken about this), the decision itself has a "preparatory" effect on your mind. Maybe you can think of other things that might give you a similar "I'm serious about this now" feeling.

One of the much touted chemical sleep-aids out there is melatonin, and it works, but there's something you should know about it. Melatonin is a hormone produced naturally by the brain in the dark. You can interfere with its natural function any time you let even dim light into your eyes during the night, even light against your CLOSED eyelids. So if you turn on the light in the bathroom when you get up to pee, you are interfering with your melatonin -- and probably your wife's, too, because even when her eyes are closed, some of the light is still reaching her retinas. Some of the worst kind of light interference is the jumping, moving light of a television, so if you can't sleep, whatever you do, don't get up and turn on the TV. You will ensure at least another hour or two of wakefulness.

Keep it as dark as possible in your bedroom. Some people have even accustomed themselves to sleep masks to keep stray light out of their eyes and to allow them to sleep later in the mornings during the summer months. If you work shifts and have to sleep during the day, they are an absolute MUST.

Another aid to sleep that has been overlooked until recently is calcium, a mineral that is used extensively by the body's nerves. Time is running out on me now, so I'll talk about that tomorrow. Again, I look forward to reading your comments.

COMMENTS ON THIS POST:

People also tend to develop a tolerance for melatonin pills. I've taken them, mostly to test for my wife. They hit you hard at first but then you need more and they become a crutch. I guess that's true of most everything.

A lot of people use colored night lights. My understanding is that green ones disturb sleep rhythms more than red ones - maybe that's why they use red lights at night in subs. Unfortunately, those cheap plug in night lights are often green.

May I make one suggestion: check your allergies and how congested you are. It's very difficult to sleep well if you're congested. I have pretty heavy spring allergies. One effect is that I become like a zombie and don't realize they're on me right away. When the residual functioning part of my brain kicks in, I start taking allegra (or equivalent) and then can breathe and then I sleep normally. Those nasal sprays (like flonase) work very well too.

But in the end, I think that sleep problems must be increasing because people are "increasing" - in size. One side effect of obesity is poor sleep. I'm not talking just about the morbid obese who stress their lungs when they lie down, but what's becoming the average obese American. Lose weight/sleep better.

jonathank [apple] 10/22/03; 12:58:13 PM

Given that the subject of this blog is why our wives won't have sex with us, I suppose it's natural to focus on the lack of good sleep and how it affects our wives' level of desire, but Julia, I want to chime in on behalf of any guys who might be in the same boat as me. Sometimes my sleep is disturbed by the fact that I am laying next to my wife, in our bed, in which we have not had sex for months. I ride waves of sadness, resentment, anger, horniness, and despair. Sometimes, I can't seem to turn my mind off. I see her dark shape next to me, breathing softly, and want so badly to touch her, feel her stir, and feel her respond to me, yet I know that it is more likely she will sweep my hand away.

Just wanted to let you know that sleep disturbances affect us, too, the guys whose wives won't have sex with us. We're decent guys, who committed ourselves to someone who, incidentally, we thought enjoyed sex with us. Now, we have come to the realization that something, somewhere, went horribly wrong, and we must depend on some sort of intellectual "knowing" that they love us, instead of being able to feel loved merely by feeling their caresses, hearing their sighs, tasting their dewy skin, and holding their bodies while we both slip into blessed sleep.

Harry [apple] 10/23/03; 6:36:08 AM

October 23, 2003

More Boringness (Calcium Cheerleading)

In recent years calcium has come to be more and more visible as a crucial mineral not only for aging women's bones (to prevent osteoporosis) but for everybody's overall health and mental peace of mind. Calcium helps your heart to beat properly, helps your blood clot, and keeps your nerves and muscles working. It is crucial to relaxation, brain function and pain control, all increasingly important to people as they grow older. Some studies hav recently shown that it also can be valuable to people trying to lose weight. And, as I mentioned yesterday, it helps you sleep.

It's sometimes pretty difficult to take in enough calcium through food, especially given that the optimal amount of calcium might very well be significantly higher than the minimums currently recommended and it's hard enough to gulp up that much, so supplementation is often warranted. Studies have shown that calcium citrate, rather than calcium carbonate, is the most "bio-available" form of the mineral, particularly if you take any kind of medication that reduces your stomach acids (I personally take Citri-Cal with Magnesium and Vitamin D). Bone meal and dolomite can sometimes have lead, uranium or other unhappy contaminants, so I'd stay away from them. I'd also keep the amount under 2,500 mg a day, take it in a couple of doses at different times of day, and remain well-hydrated, in order to avoid any possibility of encouraging kidney stones. That's not a huge risk in healthy people, but something to think about, especially if it runs in your family.

Never take your calcium supplements with your iron supplements, but always take your iron supplements with vitamin C (ideally with your orange juice in the morning, since you'll want to take your calcium at night). Finally, never take any kind of vitamin supplement on an empty stomach. That gives most people instant nausea. So you should have a tiny snack before bedtime (also a good idea even if you don't take any pills), ideally, a bit of cheese or some nuts (which contain another sleep-inducing chemical, tryptophan), with a whole wheat cracker, which will stay with you for a couple of hours and at least keep your stomach from waking you up.

I thank everyone for the very interesting and challenging comments from yesterday. I'll try to get back and answer (and read my email!) this afternoon, but I'm also trying to get caught up on my paid work and things are wall-to-wall nuts and berries around here again. I have a link somewhere about sleep that contains much of what I was going to say about it (although with not nearly the entertaining marvelousness with which I would have expressed it, heh), and I will try to dig that up and post it sometime today or tomorrow.

This very limited amount of posting time is likely to continue for a good while, but I will do my best to write a little something every day. Thanks for your patience.

COMMENTS ON THIS POST:

I want to explain my problem if I may. First let me just say this website is amazing. I feel so much more positive just reading it. Well, I'm 23 years old and my wife is 27. We will have been married 2 years in November. I can honestly say we haven't had sex in over 9 months. We have Sever financial problems! My average house income peaks at about 10k a year and I have school debts of over 40k combined between us. Neither one of us ever finished college however and as of right now I really don't have any money to go back. Neither one of us have jobs. I'm not lazy I'm trying, I swear. We all but have to totaly rely on her parents for money. Her parents are VERY emotionally abusive, controlling and refuse to resprect her marriage and "let her go." As you can see I care nothing for them but they just kinda add to the main problem in this case. She has no idea what she wants to do career wise, and I believe her parents are to blame for this as they gave her no choice of what school to go to or major. She has a sever self image problem and again, I believe I stems from her mother constantly mouthing things like "you really need makeup," or " I don't like your hair today." She is extremely stressed out at this point and so am I. I know it seems obvious at what the problem is but should I be worried? I've honestly grown to deal with the lack of sex but will this cause permanent damage to our relationship? I mean we been sleeping on a damned air mattress all but the whole time we've been married. I can't expect much thats, why I don't say much. I guess the biggest fear of mine is that she doesn't seem concerned about our lack of sex and she even talks about the subject like there's no issue. Honestly, marriage is work and I had no idea what it involved. I have no friends that are married and not many period. We live in Louisiana and hate it here so that means we are not having a chance to meet people who we find interesting and stimulating. It just seems like we have so many problems, should I focus on the sex at all? It does bother me. Sometimes I just don't feel like it bothers her. I mean we just got married didn't we? I wish I could paint a better picture. Please ask any questions and I know there are people here that have valuable advice and much needed reassurance.

marco [apple] 10/23/03; 10:44:16 AM

severe, sorry.

marco [apple] 10/23/03; 10:46:36 AM

Hey Marco. I'm sorry to hear about the problems you and your wife face. It sounds like you have a heavy load. Obviously, if things are as bad as you say, I believe your wife loves you or else she wouldn't stay around. If her parents cause so much trouble-get away from them as fast as possible. If you need them now, make sure you do everything to help your wife recover from their abuse WITHOUT being critical of them. Have you ever discussed your sexual issues with your wife? Personally, I have a problem with my own sex life. My husband can't be affectionate with me without it progressing into something too heavy for me. He gets this "look in his eye" and I know he wants sex. That's a lot of pressure for me, and we have to work on being intimate without being sexual until I'm comfortable. I don't want to hurt him, but everytime he caresses my arm or something, if I reciprocate his affection, it immediately shifts into hyper-drive and if I ask him to slow down or stop he gets visably angry whether he says so or not. He's disappointed that he had to slow down and he feels like that means no sex will follow. When this happens, it makes me feel like he wasn't touching me because he wanted to touch me, but that he was touching me because he wanted sex. When he thinks he's not getting the sex, he stops touching me and he pouts. That hurts me deeper than I can say, and I feel like any old plastic doll would serve his purposes. I don't care to be his plastic doll. I don't know what your situation is, but do you show affection to your wife because you want to, or do you do it in order to progress to sex. I think men should learn to slow down sometimes, as I have heard many of my girlfriends complain about the same thing. Feel free to email me cajungirlashley@hotmail.com I'm no expert, but I have sexual issues with my marriage, and I'll be glad to offer you as much insight as I can. Good Luck.

ashley [apple] 10/24/03; 3:10:20 PM

Wednesday, October 29, 2003

"Marco" writes (I've taken the liberty of doing some minor copyedits):

I want to explain my problem if I may. First let me just say this website is amazing. I feel so much more positive just reading it. Well, I'm 23 years old and my wife is 27. We will have been married 2 years in November. I can honestly say we haven't had sex in over 9 months.

We have Severe financial problems! My average house income peaks at about 10k a year and I have school debts of over 40k combined between us. Neither one of us ever finished college however and as of right now I really don't have any money to go back. Neither one of us have jobs. I'm not lazy I'm trying, I swear. We all but have to totally rely on her parents for money.

Her parents are VERY emotionally abusive, controlling and refuse to respect her marriage and "let her go." As you can see I care nothing for them but they just kinda add to the main problem in this case. She has no idea what she wants to do career wise, and I believe her parents are to blame for this as they gave her no choice of what school to go to or major. She has a severe self image problem and again, I believe I stems from her mother constantly mouthing things like "you really need makeup," or " I don't like your hair today." She is extremely stressed out at this point and so am I.

I know it seems obvious at what the problem is but should I be worried? I've honestly grown to deal with the lack of sex but will this cause permanent damage to our relationship? I mean we been sleeping on a damned air mattress all but the whole time we've been married. I can't expect much, that's why I don't say much. I guess the biggest fear of mine is that she doesn't seem concerned about our lack of sex and she even talks about the subject like there's no issue.

Honestly, marriage is work and I had no idea what it involved. I have no friends that are married and not many period. We live in Louisiana and hate it here so that means we are not having a chance to meet people who we find interesting and stimulating. It just seems like we have so many problems, should I focus on the sex at all? It does bother me. Sometimes I just don't feel like it bothers her. I mean we just got married didn't we? I wish I could paint a better picture. Please ask any questions and I know there are people here that have valuable advice and much needed reassurance.

I'd like to encourage other commentary, but here's a bit of what I'm thinking right now, Marco:

You're probably right that your wife doesn't consider the lack of sex to be much of a problem at the moment.

Stress is a total sex killer for women. Men tend to respond to tension and anger and fatigue with a desire for sex, because it soothes them, makes them feel loved and helps them to relax. But many women have exactly the opposite reaction. When they're angry and tense, they don't want to be touched at all. It feels invasive or overwhelming. They don't want their bodies to be penetrated, and when their libido switches are in the "off" position they can perceive a request for sex as another "command performance" or an added "duty" in the daily grind.

But frankly, I think you see the problem very clearly. Just the thought of having sex on an air mattress in my parents' home makes me cringe and shrivel up inside, and given that your mother-in-law appears to be a member of Harpy Local 666, I can hardly blame your wife for shutting her erotic self into a closet under the stairs as long as her surroundings are so anti-sex. (If you haven't yet, check out the Distraction article from earlier in the blog.)

If you're really and truly stuck where you are for a while, the ONLY change you can make is to yourself, inside. Right now you're understandably dwelling on what's wrong, how badly everything's going, how hopeless everything seems, and how it seems impossible that things will ever get any better. I'm sure some of that despair and fear is transmitting itself to your wife and adding to her stress.

She's probably feeling scared and guilty that you're in this spot together, and believe me, that's not helping her feel all relaxed and sensual and eager for lurrrve. She knows she's not giving you sex, too, and although she probably believes it's a minor problem in the grand scheme of things, she knows it's EXPECTED, and there's more guilt there. The guilt makes the thought of sex even more associated with "duty" and less with "fun," and the turn-off gets worse. Vicious spiral, booster stage.

So the first goal is relaxation. How can you relax, and how can you help HER to relax?

(Any commenters wanna speak up? Anyone? Bueller?)

RESPONSES

Even though this blog is about sex (or lack thereof), I think most of us could agree that Marco needs to change in many other areas before we get to the sex issue. Neither he nor his wife have jobs. They have $40K in college debts, yet neither finished college. They are still living with, and, it seems, almost completely dependent upon, her parents. They sleep on an air mattress. Here's my 2 cents, in what you see is somewhat of a backward fashion: Advice #1. Buy a bed. Advice #1a, buy it from a store far away from Louisiana. Advice #2. Put it in a room, far away from Louisiana, that you either are buying, or pay rent on. Advice #3. Pay for the bed and the rent with money that you earn from jobs you have far away from Louisiana. You have to leave Mom and Dad...especially Mom. Try to do this without borrowing any money from them. I know this may be hard for you to hear, and it may seem impractical given your circumstances, but you have to get out, and move on. If you love your wife, and want to stay together, it's got to be your first priority...no CD's, no concerts, no new clothes, until you can pay for it with the money you earn from your job (say it with me) far away from Louisiana. Then, on your new bed, in your new room, in your new State, have sex. But first, it's time to grow up and leave the folks.

Harry • 10/30/03; 6:06:05 AM

See the movie The Amityville Horror - the tagline is "For God's sake, get out!" Go somewhere and make a life.

Look my wife had an abusive mother and, as she was starting to suffer depression, backaches and sometimes disintegrating, I pushed her to move a long way away. It took her some time to get back on her feet emotionally but that move saved her and saved us.

jonathank • 10/30/03; 5:02:11 PM

Someone (not Marco) noted to me in email that maybe Marco and his bride were not in fact living WITH her parents.

In any case they do need to get off that damn air mattress FIRST THING.

Julia Grey • 10/31/03; 7:41:54 AM

I believe the most important advice was given - make a change to yourself. A woman wants to be taken care of and it is your responsibility to address that need as much as she should address your sexual needs. Make a REAL change, become more assertive in your financial life, become bold and really achieve. You will know you've made an actual change when you've been consistent for 3-4 months straight. Once you've gone through this period of change (and not before because there is no going back after this next step) sit down with your wife and apologize for all you've put her through. Tell her you want to fix things and then continue just as you have been for the past few months. Bottom line is that you need to achieve a stable atmosphere.

Edwin Barnes • 11/4/03; 9:00:07 AM

Regarding Calcium. I recently read that your body cannot even absorb more than 500mg of calcium at one time, and even then that's only if you have vitamin D at the same time.

catnmus [apple] 10/24/03; 6:01:42 PM

SLEEP LINK, as promised.

October 30, 2003

I used to know a lot about depression before I experienced it myself in the late 80s. I had all the glib psychobabble talking points down. Once when I was talking to a guy who told me his wife had recently been diagnosed, I told him "Depression is the result of anger turned inward," and he laughed bitterly.

"With my wife, it's just the opposite. Her anger is turned all the way outward. At me."

Oddly enough, depression doesn't always manifest itself in passivity or a lackadaisical downshifting of outwardly expressed emotion. Many times it shows up as a volcanic irritibility and free-ranging rage. Part of a depressed person's sense of hopelessness makes her feel that it doesn't matter what her partners, children and social acquaintances think any more. There's no energy left to be "nice" or "reasonable," and no need to even try, because the whole world sucks pointy granite rocks and there's no point in trying because I'm hideous and nobody will appreciate a single thing I try to do anyway and gaud I'm so tired and why can't they just leave. me. the. F*K ALONE!!!!

Some women's response to the onset of depression will be frantic efforts to stave off all uncomfortable emotions and unwelcome realizations with obsessive external activity: toothpick-level housecleaning, time-consuming volunteer work, and overcontrolling or overprogramming the children. It's the old Power problem again. Whenever we feel insecurity creeping up on us (doubt about whether we are Adequate, fear about whether we are Loved), we start looking for ways to get a handle on something. Pretty soon life is all tension, speed, tension, grasping, tension, hurrying, tension, and did I mention TENSION?

Depression, however it manifests itself, either in the angry "coverup" or the more recognizable and debilitating "hibernation" form, is a message to ourselves that our ability to cope is being overwhelmed. We first need an escape or timeout from the unproductive mindspiral we've gotten our heads into and -- this is the important thing -- following the break, an alternative way of approaching our problems. For a lot of people, medication helps with the initial breakthrough in the circular wall they've built inside their own heads, but there are problems with the "pill only" approach, not least of which is the fact that some of those pills can literally turn you off.

November 7, 2003

Drugs to the Rescue?

CNN's "American Morning" had a brief segment yesterday on drug treatment for female sexual dysfunction. They discussed mainly Viagra and DHEA, which turns into testosterone in the body, and noted that the difference between treating sexual problems in men and women is that men's are way easier. In men it's mainly a matter of fixing the hydraulics and in women it's...complicated. Ha.

They interviewed a woman who had some initial success with Viagra, but for her it "stopped working." This seems to be a common phenomenon. To my mind that means one of two things: the initial success was merely a placebo effect, or, more likely, the deeper problems that had interfered with her sexual enthusiasm raised their heads again after the initial physical boost from the medication had grown routine.

Viagra works mostly by improving pelvic blood flow, so it probably enhances a woman's awareness of her sexual organs and increases their sensitivity. It's not surprising that after a long period of sexual quietude, simply becoming reawakened to that part of her body was probably pretty amazing. But I can also understand how it might not have been enough to sustain her sexual interest after the first few weeks. The exciting newness of the sensations would wear off, and her erotic SITUATION would still be the same.

Testosterone seems to work better in directly enhancing libido, because testosterone is absolutely essential to the whole mechanism of sexual desire, but it is difficult to get just the right dosage, and for many women the side effects can be insupportable -- even the very, very subtle ones. I remember reading an article some years ago in one of those defunct midlife women's magazines, Mirabella or Lears, I forget which one, which recounted one woman's experience with testosterone supplementation. She liked the stuff because in addition to helping her understand why men's sexuality was so urgent and causing her to begin to very much enjoy her own again, she also felt it made her slightly more gutsy and less willing to put up with bullshit in her career. But in the end she gave it up.

Why? Because it seemed to interfere with what she called her "charm," her ability to sense people's inner states of mind and to respond to them instantly, automatically, appropriately, without even having to think about it. When she was "testy" there was something subtly "off" in her social feedback mechanism, and she found that she just didn't get along with people as sweetly and naturally as she usually did. Take that strictly subjective observation for what it's worth, but now there is also some scientific evidence that sex hormones might have some effect on social sensitivity or ability to read subtle body language.

The other drugs mentioned very briefly by CNN were the localized estrogen delivery system Femring, and antidepressants. Vaginal estrogen is especially valuable for lubrication problems and to halt the thinning and breakdown of the vaginal walls that also happen with normal aging. Antidepressants are a mixed bag, of course, and even when they work initially they can also "stop working" with continued use. If your wife is using an antidepressant which is interfering with her sexual responses (a common problem is an inability to reach orgasm, and no orgasms means a lot less incentive to have sex) she might be able to switch to another one.

COMMENTS ON THIS POST:

My wife's on Prozac, and while I'd like to point to it as the cause of her lack of libido, I think, at most, it is just a contributing factor. However, as I've been able to gather information from my perusal of medical sites, I have heard that Welbutrin is an antidepressant that seems to have the benefits of Prozac without it's libido-killing side effects. Viagra for women is talked about at length in a book called "For Women Only" by the Berman sisters (one is a gynecologist, the other is a psychologist, I think). They tout its benefits but don't mention the "wearing off" effect of which you write. My wife took some holistic pills which were supposed to increase her libido, but they just decreased her checkbook. As with a lot of holistics, I think you have to WANT them to work. I'd also like to hear anybody's opinions on Avlimil, which I think is a lot like the holistics, but which the Avlimil company wants us to believe is the new Viagra for women.

Harry [apple] 11/7/03; 9:27:38 AM

Sorry, this has nothing to do with sex'n'drugs. Just an article that offers some interesting insights about sex and marriage:

http://www.salon.com/sex/feature/2003/11/07/quan_marriage/index.html

This could make a post in itself.

Raging Bee [apple] 11/7/03; 10:02:38 AM

I wonder if those Quan pieces are fiction. They don't ring true, but anyway . . .

I'm not sure that comparing viagra to treatment of women's sexual problems is apples to apples. Viagra relieves a physical problem where the mind and libido are intact. It doesn't create sexual desire and, from what I read and hear, men put up with the side effects because it enables them to have sex.

Treating sexual desire is a whole nother ballgame. Pun intended.

jonathank [apple] 11/7/03; 11:07:01 AM

I made a personal rule in the "Manhattan Call Girl" days never to read Quan again under any circustances. Not only did her persona (real? unreal? who knows?) have the moral and literary qualities of pitted chrome, she was BORING.

Sorry, ain't going there.

Julia Grey [apple] 11/7/03; 1:19:21 PM

November 17, 2003

Alternatively medicated menopause?

Although most women of a certain age are familiar with the benefits of soy for the hot flash symptoms of incipient (or full blown) menopause, recent research indicates that the herb black cohosh not only has better efficacy for hot flashes but can help to prevent osteoporosis, too.

By the way, extracted soy isoflavones work no better than soy foods (tofu, for example), and dosages of 50 milligrams work no better than dosages of 25 milligrams. That's good news, given how expensive these non-prescription supplements (and therefore not covered by insurance plans) can be.

Soy and black cohosh are also showing significant promise as hormonal "smoothers" for PMS. If you (or your wife) are suffering through monthly episodes of teeth-grinding crazies, look into it.

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