Expert: Dr. Hughes - 2/12/2007

Question
Hi, thank you for your response.  I did try to respond earlier but the system said that you had maxed out on messages.  

I'm not sure what other information you were hoping for but I can fill in the details a bit in this e-mail.

I'm 37, openly gay and have been living in Japan for the past 12 years.  I LOVE my life here.  I was lucky in that I came just before the bubble burst and so secured my financial freedom.  That maybe has been a blessing and a curse.  

My typical day is wake up at ten or so, read or listen to music, go to the gym.  I love children and since I'll never have my own I fill that, what can you call it 'need' by teaching English from roughly 3 - 7 Mon - Thurs.  After that, I either meet friends or go home and watch TV, cook or some such.  

Weekends I used to find great joy in going to art exhibits and concerts, watching movies, meeting friends, training at the gym.  These days the zest has gone and I don't know why.

I've read up on depression on the web and I really don't have depressive symptoms:  No self loathing, no hopelessness, etc.  Honestly, if I lived in America I wouldn't hesitate to see a therapist for a little one on one but here the VERY few practicing therapists that are here have dodgy reputations.

You mentioned a boyfriend in your last mail.  Well, I've never had romantic luck -- that is very true.  And yes, you can attribute some of what I feel as loneliness but not the whole.  Even when I'm in a relationship I have the general feeling of banality.

One of my good friends says that the thing I need is a new challenge.  He also says I should consider Art School as I love expression and have a unique outlook.  The problem with that is motivation:  I just don't have it.  Did you ever read "For Whom The Bell Tolls"?  I want to feel passion for doing something useless like blowing up a bridge, too.

Lastly, during my last physical I had the doctor run a testosterone check.  Normal.  After I even started taking Saw Palmetto and DHA (AWESOME physical response to that, btw.  I always wake up with a morning erection -- I just wish I felt joy in sex or even desire.)

So, that's me in an e-mail.  When I'm at work I'm generally happy but when I'm at home or wallowing in my free time I'm, well, bored.

I don't know that I have any expectations from writing to you but it does help to see it all before me.  Any suggestions or advise or observations you have would be appreciated.

Cheers,
steven  

Answer
Hi Steven~
This additional information was extremely helpful.  I have a diagnosis for you:  depression.

Yes, I know you are not crying, miserable, hopeless and all that.  I want you to change your definition of DEPRESSION.  Stuff you read online is good, but not always accurate, especially for someone like you who is clearly intelligent and emotionally competent.  Depression is empty.  Depression is vacant.  SADNESS is full.  SADNESS is teary and yelling and crying.  Depression is boredom, ennui, futility---without the drama that you think you need to have.  Depression is not a feeling.  Depression is the absence of feeling---of any feeling, really.

So you, dear Steven, are depressed.

Perhaps you enjoy exercising (to the extent you do at least) b/c it releases endorphins which temporarily infuse you with feeling.

You need a good therapist and if you were in Chicago I'd see you this week.

Since that is not possible and it sounds like therapists are not on every corner where you are, do a little self help.
1.  rile yourself up physically.  Exercise, jump in a cold shower, train for a marathon.  The goal is to feel something physical.  It's a start.  Even if what you feel is unpleasant, it will open you up to the experience.
2.  rile yourself up emotionally---don't start with happiness and joy--start with anger.  Anger is relatively easy to come by.  Find a cause.  Something with kids?  Know any abused kid?  Upset about children in Africa?  Find something that really ticks you off.  It might be something as minimal as a loud cell phone person in a store.  Whatever it is, get upset.  Blow a gasket.  Make a mental line that you draw.
3.  If that doesn't work, try to feel things vicariously (which is what you did previously).  Use art or music.  Sometimes it is easier to get amped up over non-interpersonal things at first.  But then move onto getting riled up in real life.
4.  Now that you can express anger, the real fun begins.  You get to spin that anger around and work on feeling sad.  NOW you'll feel depressed and probably worse than ever, but this is what you need to do.  Think about your life, your limitations, your family of origin, your path, your relationships.  
5.  Now you have started feeling again and really, your life will take on a whole new palate.  Now you can be pissed off or despondent or elated or content or tired or anxious.  All of it.  Good and bad.  But you will be alive and I guarantee, the "boredom" of which you speak will be miles away.

This whole process, with a therapist, will take you 6 months, in my estimation.  On your own, it's much harder to do----but if you try and keep your eyes open for a therapist, you can make great strides.

Feel free to be in touch.  Yours is a favorite post.