BLOG No. SIXTEEN

Welcome back to my 16th blog anxiety and depression. Yes, I am still in Cabo San Lucas. I have a local Chardonnay near my beach chair, and now and then I see a tiny pair of swimwear walk past me, exposing an exact size to the wearer’s genitalia. And after that, I see an occasional bikini. Sorry, those Speedo’s just gotta go!

So I’m sitting here, relaxing, watching a grotesque cruise ship, floating in a sea of tranquility, but also floating in my view of Land’s End—one of the most beautiful sights in world. And there is an aged man of much greater beauty, curious to know what I am writing. I get that a lot, as I do write a lot of my novels on vacation, utilizing time—both in a bloated fuselage and a comfortable beach chair—to pontificate ideas that hopefully someone, somewhere, we’ll find appealing or helpful.

So, I tell him I am writing about anxiety and depression—in a blog. He tells me that he thought a blog was a large, square piece of wood. But when I explain that it is a way to reach out and help—possibly enlighten people who suffer from anxiety and depression, or another issue—he perks up.

“Why would anybody be anxious or depressed?” he asks, looking over a tranquil bay full of salty, blue water.

A Russian oligarch’s yacht, helicopter on the back, sits off to the right, why I formulate my answer. We see the yacht every year. And my wife and I have stared at this beautiful Bay of California for more than a score. (That is 20 years for those of you who haven’t memorized the Gettysburg address).

“You do not need to have anything anxious in your life to have anxiety, or anything depressive in your life to have depression,” I say. He looks puzzled, and takes another sip of his Mexican beer.

“It is genetics,” I plead. He nods, but I know he does not understand.

“Some people just have anxiety and depression—no reason,” I say. But again, my words go unnoticed. I am unsure if he is hearing impaired, or if he is just ignoring me. Or perhaps he just doesn’t believe what I am saying, but it is just being polite. I tip my Chardonnay glass to him and he manages a nice smile. I pick up my pad and my pen and begin to write again, trying to avoid the European tourists in Speedos.

But I know I am right, even if he doesn’t believe anxiety and depression can come without provocation. It’s just probably not on an 87-year-old man’s cerebral radar. But I see it everyday. And I frequently receive a bright smile, sometimes punctuated with a little tear, that says, thank you when my concoctions lower D2 dopamine and my patient gets better. For them, I only asked for a return to normalcy—not a high—but as I spoke of in previous blogs, homeostasis.

For all of you out there floundering in anxiety and depression, know that there is hope. Trust me, it’s probably not in the form of another SSRI, especially if you’ve tried a few. If you don’t have an understanding primary care provider, find a friendly psychiatrist, print out a few of my blogs, and see if they will want to try you on something to balance GABA and glutamate. Or if they wish, add a direct D suppressor, like Vraylar or Abilify, to your current SSRI.

Okay, I actually did spill my Chardonnay on the way to the loo. It is time to grab a shower and head out to dinner. Until next time, when we discuss some clinical cases I have seen, this is Dr. G saying keep the faith!