“All Writers are Depressed”

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I wish I had the reference now, but a few months ago I was reading a successful writer’s blog and came across the unhedged statement that all writers are depressed. A quick google search shows that there’s an element of truth to this.

Me, I’m happy as a clam, except when I’m miserable, which mostly centers around my job as a pathologist. It’s always been that way, even during residency.

And there are a few other things that have “always” been there for me.

For instance, I always feel much colder than other people – unless I’m in cold water with a wet suit on, then they’re colder. I’m always more anxious than most people I know, though I try hard to hide it and often succeed, I think.

These things should have been a clue. Here are some other clues that could have helped me:

Slow movement
Slow speech
Prominent bags under my eyes
Cool skin
Slow pulse
Low blood pressure
Loss of the outer third of eyebrows
Brittle nails
Red face with exercise
A tendency to be slow to heat up even in a sauna
Hoarseness for no apparent reason
Accelerated worsening of eyesight or hearing
Mood swings, especially anxiety
Gum problems
Various burning or tingling sensations that come and go….
Bottom line: you could be depressed and anxious due to hypothyroidism and yet have normal T4, T3 and TSH values, and a brilliant, concerned MD standing beside you telling you that you definitely do NOT have hypothyroidism.

Trust me on this.

I was close friends with a psychiatrist who told me that he never could understand how to interpret a thyroid panel. He likened it to the macroeconomics I was trying to beat him over the head with in the context of an ongoing political argument that finally destroyed our friendship.

I mention this so you won’t write off undiagnosed “mild” hypothyroidism as a fad or a fringe development. It’s a complex issue for everyone involved, myself included.

I’m a pathologist, for goodness sake, a clinical laboratory guy, and I did not know how easy it is to miss this diagnosis by “treating the numbers instead of the patient.”

I discovered that I have hypothyroidism of long standing. It has gone undiagnosed all my adult life because my blood tests (TSH and thyroid panel) have always been within the “normal” ranges (up until the last test which showed only a slightly elevated TSH).

I recommend you read Thyroid Power by Richard Shames, M.D., et al. if you’re overly anxious or at all depressed, even just intermittently about specific things.

Long story short: I took my first thyroid meds (a T3 and T4 combo, not just T4) yesterday morning and within five minutes felt my legs go from cold (the usual) to warm. Yesterday I felt as normal emotionally as I ever did when I was a kid. I could think about my job without a sense of impending doom, disaster, and free-floating fear. I suddenly wanted to go out and do something outside, rather than sit in the house. I suddenly wasn’t craving food and caffeine all day. My mind was sharper, despite a poor night’s sleep the night before. I scored in my top 5 scores on a Lumosity game, for heaven’s sake!

The book claims that 10% of the population has hypothyroidism. If true, it’s astounding. Not everyone who’s depressed or anxious has hypothyroidism, and vice versa, but wow, with numbers like 10%, there’s bound to be significant overlap. There was for me.

Hypothyroidism can run in families. It’s difficult to diagnose because the tests are not as sensitive as most docs think. And the doctors, myself (previously) included, almost all believe that a normal TSH and a normal thyroid panel exclude (rule out) hypothyroidism. Baaaaaamp! Wrong answer!

Chances are, if you have “mild” hypothyroidism that is causing anxiety and any degree of depression, your numbers are going to come back “normal” and you’re going to need to educate your doctor. That is going to be next to impossible, but if you read the book and memorize parts of it, you may have a fighting chance if you’re a confident person and an effective talker.

A better approach would be to shop around for a doctor who already knows what’s going on with the latest thyroid tests and current knowledge of the disease. Even though I’m a pathologist, I went that route, and found a doc who isn’t an MD. I forget what he is, I’ll go look it up…

He’s boarded in Naturopathic Medicine.

My dad was an MD – so was his dad – so am I. We kids were raised to believe that there are MD’s and there are quacks. Nothing between. I don’t believe that anymore. Hopefully you never did.

Sometimes the “experts” are not at the cutting edge. It’s like that in every field I’ve explored, including fiction writing and archaeology. Being able to think outside your own box is possible only if you discover that you’re in one. Then you’ve got to value objectivity more than the sound of your own voice.

Be happy. Keep writing. Your story could open minds and save our species from itself. You are that good.

M. Talmage Moorehead

If you’re interested in glimpsing strategies for depression, and don’t mind hearing from an opinionated nineteen-year-old girl in another universe, my in-progress novel may be a helpful read. She’s a genius geneticist with a younger brother who struggles with depression. Her evolving story starts here (as a “one-page” document).

It’s an experimental novel called, Hapa Girl DNA, and is a “hapa” thing itself – a hybrid of fiction / non-fiction. Hapa is Hawaiian for “half,” and Johanna, the protagonist, is half Japanese and half Jewish. In writing her novel, she and I ignore some important fiction-writing rules, because we both like to question dogmas and test things.

But the “rules” are essential knowledge to anyone crazy enough to either break them or follow them thoughtlessly.

So you could download my e-book on fiction writing, the second to last chapter of which gives my current opinions on many of the dogmatic rules of fiction writing. Downloading that will place you on my short list of people who wouldn’t mind being notified when my traditional novel is done – possibly before the next ice age. (No spam or sharing of your info. I haven’t even written to my list yet. It’s been over a year.)

Next time you’re writing emails, if you think of it, please tell your best and hopefully weirdest friend about my blog (www.storiform.com). Thanks! I appreciate your thoughtfulness.

Talmage

36 thoughts on ““All Writers are Depressed”

  1. Hello,
    Thank you for following my blog. Your blog is interesting as well! I can relate to what you are saying in a small way about leaving your profession in the medical field. I also was trained in the medical field as a nurse and felt it was the wrong profession for me.Later in life I discovered I liked to write and am waiting for first book (Sure Mercies:Hope for the Suffering) to be published by a small publisher (4RV Publishing.com)in the near future.
    Your honesty about leaving your field of pathology was refreshing to read. I struggled with some of the same feelings as a young nurse. My son is now a much better nurse than I ever was.
    Megan

    • Megan, thank you for the compliment. Congratulations on getting your book published! Wow, that’s fantastic! My wife was a nurse for three years and would come home crying sometimes. Just about everything in the medical field is difficult because of the stressful life-and-death environment. Glad you’re a writer now! I hope to become one, too. 🙂

  2. This article is inspiring. I had my operation last year, “total thyroidectomy” due to numerous nodules found in my gland. Irritations and depressions; two things that I felt during those times. It was a sudden change and it was quite difficult for me and to those people around me. I had to look for another doctor for consultation. I even went to see a psychologist to have it cured.

    As it turned out, dosage in my medication was incorrect thus depression and irritation manifested for a few months. I am glad that I found another doctor to help me with the recovery. For me, having an operation is not just about treating physical illness but also mental (psychological, maybe) and emotional sickness.

    • Thank you for sharing your important story. Another person said that he/she had been placed on thyroid meds but they led to a panic attack so he/she quit taking them.

      The dosage is critical, it seems. And the doctor needs to titrate the dose to the patient’s emotional status, not just the numbers from the lab.

      I’m so glad you found a doctor who knew how to help you. Doctors range from dangerous to amazing and everything between. It’s tough to find the really outstanding ones.

      🙂

  3. Thanks for following ZimmerBitch; not least cos it’s led me to your blog. I’ve had so many thyroid tests come back “normal” … oh well. No need to elaborate. Thanks for this post, and for “forgiveness.” Actually, just thanks.

    • Thank you, Su. It’s difficult to find a doctor who will treat a patient’s symptoms rather than her lab values when it comes to hypothyroidism. My tests were always normal, despite obvious symptoms. Even when I finally got the diagnosis, my T3 and T4 levels were “normal.” It was just the TSH that was a bit high. If you live anywhere near Portland, Oregon, there’s a Naturopath doctor there at a place called “Thrive” who helped me. Good luck! 🙂

      • Thanks. Unfortunately Portland is a bit of a distance for me – though having been there once many years ago, I liked the place and would happily go back. Having said that, I’ll probably try to find someone a bit more local. I’m in Auckland, New Zealand 🙂

  4. Thanks for the follow! I have been reading some of your posts and am happy to hear you took the plunge to leave the day job that was draining you. So important to do what you like and where your talents are.

    As far as the medical stuff goes, I am a former widow and my late husband’s blood work was always within normal limits but he was dying of Melanoma. So ever since then, ‘normal’ blood work doesn’t mean anything to me.

    Good luck in your writing endeavors and it is such an encouragement to see someone quit a career that wasn’t a good fit.

    • I’m very sorry you lost your husband to melanoma. There are no words.

      I do have a personal story I could share. Maybe it would be more appropriate for a post, I don’t know.

      Anyway, I had my first “atypical nevus” (called a “dysplastic nevus” in those days) removed in my mid 20’s when I was in medical school. A pathology resident told me that he’d seen a handwritten note by the pathologist who signed it out saying, “Not willing to call melanoma, but almost.” Several years later when I was in training, a brilliant pathologist offered to look at the slide with me for interest’s sake. A transcriptionist pulled the slide from the files, but she made a mistake. It was the wrong slide. The number was correct, but the year was off by one digit. I didn’t notice. I’m not good with time and dates. By amazing coincidence, she had pulled a thick melanoma, mitotically active and deeply invasive. The brilliant pathologist across the scope from me turned white and began talking tactfully about a very specific practical preparation for my death… life insurance.

      Honestly, I was already so stressed with the residency that the thought of dying didn’t scare me. It seemed like an acceptable, respectable way out of pathology and medicine. As he looked at the slide, he found it difficult to believe that the diagnosis had been missed by the pathologist who signed it out a few years earlier, so he had the transcriptionist double check the numbers on the slide. She discovered her mistake and brought us the right slide. We looked at it together and he agreed that it was not a melanoma, not even close. He seemed more relieved that I was. My lack of appropriate response made him suspicious that the whole thing had been a practical joke. I assured him it wasn’t, and he believed me.

      Since then, I’ve had over a dozen nevi removed, almost all of them have been called “atypical,” which is still an area of pathology that national experts argue about. I guess this story is another one of the “signs” that I ignored as I went foolishly into a profession that I wasn’t cut out for. I’m not sure that it’s even appropriate that I bring it up to you in this context. Having the “atypical nevus syndrome” puts me at increased risk of melanoma, at least according to some experts. So I worry every time I take off my shirt and look at the brown spots. Last time my daughter, my son-in-law (a family practitioner) and my primary doc at Kaiser saw a suspicious looking “mole” on my back and sent me to a dermatologist, the doc glanced at it and declared in disbelief that there was nothing worrisome about it at all.

      Medicine is still in its infancy. Still subjective. But doctors are expected to be perfect.

      Thank you for your comment. All my best to you! 🙂

  5. Hey Doc.
    I don’t know how you came across my blog, but thanks for the follow. Made it easier to find you.
    And this post?
    You’ve been reading my charts.
    I gotta call my doctor now. Time for the almost-sixty-three once-over, and I will need to bring this up to him:
    we’re two days into the hottest month of the year in the San Joaquin Valley of California and I still carry a windbreaker in the car.

    Good meeting you, my friend.
    Harris

    • Harris, It’s good meeting you, too. I hope your doctor treats the patient and not the lab values. 🙂

      Take care,
      Talmage

      PS…
      I really like this piece of wisdom from your 99th blog:

      “I noticed something I was doing that I have noticed others do on occasion, and when it’s not done gracefully, it’s very noticeable:
      I tried too hard.
      I was looking for the words instead of letting them find me.”

      http://nocturnaladmissions.net/

  6. Now that I’ve really taken the time to read some more of your posts… wow. You certainly have a way with words. I’m very happy that we’ve crossed paths and am excited to continue reading your work.

  7. I know quite a bit about hypothyroidism as I have it myself. Was diagnosed with it at 23 with a TSH of 6.5. But my symptoms started two years before that. I had really bad constipation. Like only having a bowel movement once every two weeks. I was freezing all the time, so I wore my coat even in summer. If I was at home I wore a heating pad on my stomach. I was previously anorexic, so I was great at calorie counting, and I couldn’t eat more than 1000 calories or I would gain weight. I wanted to sleep all day long. My temperature was 96.5 degrees Fahrenheit. My pulse was in the 50s, and I wasn’t athletic. My TSH was about 3 when my symptoms started. My mom has it, and 3 out of my 4 grandparents had thyroid problems. My sister got lucky because we found an endocrinologist who treated her with a TSH of 3 just based on her symptoms and family history.

    Those two years were really tough. And this was my first run in with doctors who would tell me nothing was wrong. In the months following up to my diagnosis, my joints felt so achy. This was before the joint problems started, so it was the hypothyroidism. It felt like I had the flu everyday, just without the sore throat. I definitely felt like a new person after I started treatment. I’m glad you improved as well 🙂

    I’ve had several episodes of depression and anorexia, but I’m not depressed now or anorexic, so I’m happy for that. I do have pretty strong emotions :$ And that’s cool that you are a pathologist. I’m a healthcare provider too, but I just don’t feel comfortable sharing that for now. Makes it easier to identify me :$ I had to take pathology, and I really didn’t like it 😄 I like most life science classes, but I just didn’t enjoy it. Immunology was a lot more interesting.

    • I’m glad you’re not depressed. That’s huge! I know what you mean about “strong emotions.” I think a lot of writers have that gift. When I was on SSRI’s for a few months years ago, I learned what it’s like to have weak emotions. I much prefer my own baseline of feelings.
      I quit my profession on the 27th of last month, by the way. The job was killing me, in combination with some other issues. I’ll never go back to practicing any branch of medicine. I’d rather be poor and have something of a life. I’m going to be a writer when I grow up. 😉

      • I think it’s definitely better to not have as much money and do something that makes you happy than be rich and unhappy. I admire you for making that decision. I used to think money was important. But I’ve come to realize it doesn’t make one happy. My husband and I have talked about moving to Japan in the future. My degree would be useless, but I could spend all my time writing. Hubby is still a Japanese citizen and I don’t think it’s fair for us to spend the rest of our lives in America. Of course I need to pay off my student loans, but after that it doesn’t matter. And learn Japanese XD. Nice to know I’m not the only one with strong emotions. I think it helps with writing, especially since most of what I write is angst. Although sometimes I have to be careful because I go overboard with my character’s emotions 😄

        • That’s awesome that your husband is still a Japanese citizen! My wife is 3rd generation Japanese American and doesn’t speak the language, so going to live in Japan, as much as I’d love the adventure, isn’t in the cards for us. I wish it were.

          Despite the fact that money doesn’t equate to happiness, I think that writers should be paid well for their important work, and should not feel bad about earning great wealth if it comes to them.

          Poverty is stressful in a unique way, it seems. Hunger and homelessness are legitimate negatives to happiness – obstacles that earned money can fix. Free money? Maybe not so much.

          I’m guessing that balance is key to all things where happiness is concerned. Same deal with money… I’m still guessing. 🙂

  8. Hello! Thank you for following my blog! I had suspected my hypothyroidism in my early 20s after I saw similar symptoms that my mother had. However, I was not diagonosed till I was 25, last year, by an orthopaedic. He also diagnosed me with severe vitamin D deficiency. I went on the meds and even now continue with a 50 mcg of the thyroxine hormone. Initially, I had felt much better, had more energy than I had in years, but I think my depressive symptoms cannot wholly have physiological origins. It feels all-pervading in a way and I’ve accept it like it is the weather.
    I have recently written a post on writing and depression. It would be wonderful if you could check it out!
    http://ofopinions.wordpress.com/2014/07/08/of-writing-and-depression/

    • Wow, it seems that hypothyroidism is truly missed a lot by the medical establishment. I left a comment about depression on your wonderful blog: http://ofopinions.wordpress.com/2014/07/08/of-writing-and-depression/comment-page-1/#comment-23
      Great article you wrote!
      It’s possible that your thyroxine dose was high enough previously, but is now not high enough. That would be my guess. I really urge you to get that book, “Thyroid Power,” and see if you don’t suspect that your dose is too low, even though your doctors might look at your numbers (thyroid panel) and tell you that everything is within the “normal” reference range.
      I agree that your depression does not likely have wholly physiological origins, but that’s a good thing. That means that cognitive behavior therapy and things of that nature can help you a lot more. It’s the people who have depression coded into their DNA who find it most difficult to get relief. But they sometimes do, too, if they don’t give up. It seems to me that depressed people should never give up. There’s too much that’s new coming over the horizon every year on depression. Someday every depressed individual’s cure will show up. It quite possibly already has arrived for you, but your doctors don’t know about it yet.

  9. I have a different endocrine disorder which caused me extreme fatigue. Primary care doctors kept trying to push antidepressants on me, which I declined. Then, I saw an ad on TV that listed all of my symptoms, got tested, and now I’m fine with treatment. If I’d taken the antidepressants, my body would be falling apart, but I guess I’d be happy about it…

    • How interesting! Might I ask what condition you had? My son is a psychologist and we’re always talking about depression, anxiety and endocrine deficiencies. But I don’t want to pry, so I take it back. I’m not asking. 🙂 I took antidepressants for a while, but they made me feel mentally sluggish and my sentences became incurably short and choppy when I’d try to write fiction. Those were SSRI’s. Later I took a low dose of a medication Lamictal that is mainly for people with seizures. It helped lower my anxiety but it slowed my mind, too, especially my speaking. So I quit taking it. Now that I’m not practicing pathology or any other aspect of medicine, my anxiety is not a problem at all. The meds for my hypothyroidism seem to help sharpen my mind, increase my mental stamina and elevate my mood, though it’s a complex emotional environment around here now, so I’m not able to speak objectively. In six months, I’ll be able to give a more useful report on the thyroid meds and the mood. Until then, hey, I’m glad you got treated and you’re feeling great.

  10. I can’t speak to hypothyroidism, but I can speak to the subject of writers being depressed. I am not at all depressed, and I think that is because my writing is so cathartic.

    I agree with you about work though. Work can make me feel down and trapped, which is why I am so committed to writing.

    Good for you for moving forward. I find affirmations very powerful and keep me on track on the writing game as there is so much negativity about making it etc. I also love to listen to people like Ray Bradbury and Stephen King who had so much belief in themselves as writers, and did a lot of grunt work and wrote a ton of short stories to get going and loved every minute of it.

    We have to keep our selves positive on the writing front. If you are / were a pathologist you have so much to write about. I could go to town with all that information 😉

    Keep in touch

    Kym Darkly
    http://www.thehorrorinmyheart.com

    • I find my background in pathology pulls me toward writing things that are idea-heavy and, I’m afraid, light on emotion. But I yam whad I yam, as they say. Got no choice but to draw on what’s inside.

      I find writing really drives away the blues like nothing else. Especially when I read over something I’ve just done and feel like it’s working. If that feeling could be bottled and sold, I’d drive to the drug store right now.

      Instead, I’d better get back to writing. Blogging is a different positive feeling for me, not as deeply satisfying, but still a joy.

      All my best to you,

      M. Talmage Moorehead

  11. HOT DIGGITY! Another doc who knows the truth! I’ve had lifelong hypothyroidism, first treated as a child, but later mismanaged by MDs and a couple of DOs who destroyed my health by their refusal to treat me, despite my having a personal history, family history (this monster has galloped through my family at least since my great-grandmother’s days), and an astronomically high antithyroid antibody titer. I’m now in the care of a DO who has prescribed compounded slow-release T3 (T4 stopped working after 20 years on it, so I may have developed peripheral deiodination difficulties). It’s nice not to feel like a corpse on a slab any more.

    I’m sorry you had to suffer so long, too.

    • It’s amazing how often experts, the people on the pedestals who dictate our thinking if we let them, are wrong. The diagnosis of hypothyroidism is a perfect example. Darwinism is another, in my view. “Don’t be a whore and write anything that would make money,” is another dangerous piece of advice preached by another class of experts. The Pap Test that has reduced cervical cancer incidence in women in a miraculous way was shunned by the experts initially, the pathologist who “knew” you couldn’t detect cancer, let alone pre-cancerous states without a tissue biopsy…

      Sorry, I’ve had too much coffee. I’m so glad you found a DO who’s doing right by you! Somebody needs to educate MD’s on hypothyroidism.

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