[Guest DTM post by Desmond White]
On May 1, 2013, I played a gig with a singer at the Bubble Lounge in SoHo. I don’t remember it being unusually bad or good, just an average standards gig. It passed without event, though I do remember feeling slightly odd at the end of it.
I got home, went to bed, and a few moments later my legs started shaking uncontrollably. It came in waves and wouldn’t stop. I didn’t have a fever or any other symptoms that might indicate something viral or food poisoning. My girlfriend suggested that I should go to the ER, even though I didn’t have insurance, as I was supposed to fly to Peru the following day for a 4 or 5 day engagement with a group I hadn’t played with before. At 1 AM I harassed a doctor friend on the phone and she agreed that I should go to a hospital.
I didn’t have to wait very long at St Luke’s, they put me on a bed after checking vitals, which were all normal. The doctor eventually came and found nothing except mild dehydration, so he put me on a drip and maybe there was some painkiller in there too. I was still having the leg spasms, but the attending nurses didn’t seem too concerned. In the end, even though I was starting to freak out a bit, the doctor decided I was to be discharged and said I could fly if I could get some sleep beforehand. He prescribed me a few Valium. (My first benzodiazepine but not my last…) I was almost delirious at this point, but I was determined to go on the tour, the kind of stubborn and stupid behavior of a musician who hates the thought of letting anyone down even with a legitimate reason. My girlfriend was vehemently against it, so I managed to get the Peru bandleader on the phone and he seemed oddly pretty cool with whatever I decided to do. Despite all this my “professionalism” still wouldn’t allow me to bail. I went home and slept for a couple of hours, legs still shaking.
At 5 AM my roommate helped me pull myself together and get me in a cab to the airport. By this time I was just feeling generally unwell; an indeterminate and overbearing illness of an intensity that I’d not encountered before. I arrived, haggard, at the hotel in Lima, where a young guy was waiting in the lobby to deliver the bass we were borrowing; he and his buddy were in fact hoping to take me out drinking, but they took one look and granted me a pass. The other two band members had arrived already, and when I met them for the first time the next day, they were startlingly sympathetic and understanding. At this point the working theory was that I had some kind of virus or infection that just needed time to resolve itself. The doctors in Lima concurred, and I fumbled my way through the next few days of gigs and workshops.
After a week back in New York I still wasn’t any better. At a friendly and free clinic I was tested for every conceivable ailment from vitamin deficiency to endocrine-secreting tumors, and everything came back normal. At this stage it was posited by both the clinic doc and other doc friends that this all could be a physical manifestation of anxiety and/or depression. This hadn’t occurred to me at all, and I initially refuted all such diagnoses. In my native Australia there is a negative stigma surrounding mental health and depression, and at one point I believe I had Chopper Read* come to me in a vision and advise me to harden the fuck up.
Anyway, on May 15th, I was on my way to a gig at the Bar Next Door when I had what must have been a panic attack on the subway – an indescribable mix of dizziness, fear, a sense of doom, nausea, shaking, plus countless unstoppable thoughts of the worst happening. At the gig I wasn’t able to play more than a tune or two, a bass player friend kindly came down to relieve me. Naturally, I was presented with liquor to calm me down: Naturally, it did more harm than good. In the breaks, that bass-playing friend and another mate he had brought along tried to reassure me, in typical Aussie fashion, that all would be ok – “What do you want us to do with your ashes? Should we take them back to Australia and spread them over X’s grave?” After the gig they escorted me to an urgent care clinic, where once again a doctor found no signs of any physical illness before prescribing water and sleep.
When I went back to the free clinic, the doctor was now reasonably convinced that it was something psychological, and wrote a prescription for a low dose of Xanax to “ratchet things down a notch.” I protested strongly, but was eventually convinced that it was a temporary measure only. At first Xanax seemed to help. However, while I bear no ill will towards the doc for getting me started, I was later to realize that Xanax was — for me at least — dangerously addictive and not in itself a solution to my unhappiness.
Over the next months some of the physical symptoms went away, but I still was in constant GI Pain, couldn’t sleep, a tremor that oscillated in severity, and had absolutely no appetite. On a diet of protein shakes and whatever fruit I could stomach I dropped to about 138 lbs. I reluctantly acknowledged that this wasn’t some virus that was going to go away and accepted a friend’s recommendation for a psychotherapist.
The numerous different terms for mental health professionals are confusing. Only psychiatrists can prescribe drugs, whereas psychologists and psychotherapists generally cannot, although they may be willing to discuss medication in broad terms. My first therapist was a psychotherapist or LCSW (Licensed Clinical Social Worker). Since I was still at the time resistant to the idea of medications, we proceeded for a year or so with talk therapy only, plus the small dose of Xanax prescribed by my doctor that I had come to need for sleep and normal daily function. Psychotherapists are also usually more affordable than psychologists and psychiatrists. I was paying around $70 a session, which was pretty much the limit of what I could afford at the time. (Since then, many insurance plans, even the cheapest Obamacare ones, have been expanded to include free or subsidized mental health treatment, a good indicator not only of the prevalence of the issue but of the general willingness to treat/be treated.)
It took me several sessions to even come close to letting my guard down. I found it very difficult to accept that the therapist was not there to judge me and find me wanting. (This was no different than how I felt out in the world, where I was convinced that everyone was judging me, close friends included.)
It took time, but my first therapist taught me that depression and anxiety are absolutely treatable. Everyone has a different emotional reaction to depression, but one common theme is that when you are in it, you feel that it will never go away, and the rest of your life will be this miserable or worse. It’s a toxic and cyclic thought pattern that feeds itself. But once I realized that progress was possible, things did get better. Not quickly and not without considerable effort, but things did indeed get better.
“Co-morbid” means that anxiety and depression are occurring concurrently. I would fixate on anxieties about career, money, health, relationships, longevity, the environment/state of the world, and anything else. My worst anxiety was about suicide. During the time my depression was at its worst, I wasn’t suicidal, but I was possessed by a crippling fear that I would become suicidal, eventually to a point where not 15 minutes went by where I wouldn’t think about it or visualize some horrible outcome, including my number one uptempo hit single (fully orchestrated with back-up singers): “Dragged Kicking and Screaming by Feet to Padded Room After Shamefully Unsuccessful Suicide Attempt.”
Therapists may refer to a particular treatment approach as a modality. My first therapist employed a mix of supportive and CBT (Cognitive Behavioral Therapy) modalities. We would examine the anxieties as a logic problem with a systematic analysis of data, the goal being to illustrate to yourself that most of these catastrophic events are extremely unlikely to transpire (and extremely unlikely to be the end of the world even if they do). We also explored unpacking my childhood upbringing in order to identify traumas that were still resonating in my subconscious today.
These modalities were helpful but they did not provide sustained relief. However, my first therapist helped me conquer my stubbornness and accept that my depression was an illness that could potentially benefit from medication and/or a more clinical approach to treatment. I was subsequently interviewed, evaluated and accepted into the resident program at Columbia University/NYSPI, a program that provides free therapy and treatment by supervised graduate residents at the clinic; all of whom are qualified psychiatrists (in the same way that medical residents of any discipline are qualified doctors).
I can’t say enough good about this program. While the three residents I worked with often employed CBT and supportive therapy modes, they were also able to switch to or incorporate a more analytical approach. The dexterity and grace with which they were able to navigate my past impressed me no end, and I immediately felt that this was the right place for me.
Medication. I arrive now at the part I find the most difficult to talk about. I didn’t want to go on drugs, I definitely didn’t want people to know or think that I was on drugs. I could easily imagine taking medicine for a conventional body illness, but it was so much harder to leap to giving medicine for my mind.
The doctors at Columbia did not seem to be pushing me in one direction or the other, but in an informed and matter-of-fact manner, they did table the option of medication. In the end I thought it was worth the risk.
Disclaimers: What worked in my case (talk therapy + anti-depressants) may not work or even be necessary for the next person. Indeed, it is inappropriate to for me to publicly endorse any one drug or approach, although I’m willing to discuss my history one on one with the curious. I do suggest proceeding very carefully with benzodiazepines like Valium and Xanax. They are commonly prescribed and effective for short-term relief, but I did not like being dependent on them, the problems were still bubbling beneath a sedated surface, and they were extremely difficult to get off.
It took many attempts and a lot of patience to find the meds that worked for me. Let me thank again the staff at the resident program at Columbia University/NYSPI.
However, it wasn’t just the meds. I don’t believe any one thing on its own helped me overcome depression. It was a combination of therapy, support from friends, diligent exercise, medication, study of CBT techniques, and reduction of alcohol intake. The first three of these elements (therapy, exercise, support) are universally acknowledged as helpful, with people experiencing mixed results with the others. Something else that helped get me through it all was to try to maintain some levity and the ability to laugh – to not take oneself too seriously. You may notice traces of that in this article; you might also find that something completely different is helpful for you.
Most people have heard statistics dictate that we are all likely to either experience some degree of depression/anxiety ourselves, or encounter a friend/family member/colleague who is afflicted. I was staggered at the amount of support, advice and positive energy that I received not only from my immediate friend circle, most of whom are musicians, but also from pretty much anyone I happened to mention it to.
Now that I am more or less out the other side, I occasionally get a sense when talking to someone else in the jazz community that they might be also looking down the same tunnel I was.
I’m here on DTM to offer reassurance. Before I took this journey I thought that if I admitted I needed help with my depression that I would A) lose gigs and B) generally go down in my level of creativity and output as a player and composer.
Neither of these fears were realized. If anything, the opposite took place. When I look back on the whole experience, I wrote more music, got a bit better at the bass, and — most importantly — strengthened almost all the friendships and professional relationships that I cared about.
No one laughed, no one beat me up, no one filed a complaint at jazz small claims court, and no one took to social media with, “omg d white is fucking losing it, don’t call that mf.”
More than a few said they had been through or were currently going through something similar. Everyone who lives here knows the potential physical and emotional tolls that living in New York can take on a person, artists especially.
I made it out and I feel stronger, and I’m here to promote the freedom to talk openly about mental health. In fact I might be all too ready to munch** you about it, but I am also a resource. Whenever I summoned the courage to take another person into my confidence, they were resources as well. It was a new start for me, and, if this issue is striking a chord, it could be a new start for you, too.
*Chopper Read = Iconic Aussie tough guy/murderer caricature
**munch = Melbourne jazz parlance for “talk annoyingly and at length in someone’s ear”
My sincere thanks to the friends who proofed earlier incarnations – your counsel and encouragement were invaluable – Jochen Rueckert, Alex LoRe, Guilhem Flouzat.
Please feel free to get in touch at deswhite _ @ _ gmail.com.