16 November, 2012

Rosacea and depression

Rosacea and depression

Read part 2 of 'Rosacea and depression' here. It is widely documented how rosacea can affect someone's self esteem, confidence and mood. The following publication in PubMed struck me:

"Delusion of disfigurement in a woman with acne rosacea. A 36-year-old woman with newly diagnosed acne rosacea is presented. Her skin changes were noticeable only under closest scrutiny, but she quit her job, became despondent about her acne, and developed suicidal ideation. The diagnosis and treatment of this patient allow a broader discussion of the somatically focused patient whose ideation reaches delusional intensity."

This article not only underlines the amount of distress that even a seemingly subtle case of rosacea can cause, but also the response that many rosaceans that I know got initially from both doctors and friends and family: you are being delusional. Or overreacting. They base their opinions usually on the amount of redness they see in your face. Nowadays most people and doctors don't fail anymore to pick up on my own red swollen cheeks, but when it all started for me, in 1999 and in the years onwards, my redness would come and go, yet my face burned pretty much all the time. I had similar burning and flushing as I have now (with a permanently red or flushed face these days), but it just didn't show as bright in my face as back then. I explained what I felt though, but most of my family and friends and even GP doctor, didn't take my words serious. And thought I was overreacting and making fuss over some 'blemishes'. Another case that comes to mind is the recent suicide of a 20 year old student who suffered from ongoing facial blushing for most of his teens and who wrote in his goodbye letter:

I am tired of blushing. It is exhausting to wake up every day and have to find little ways to avoid blushing situations.

This must be the most horrible thing to read for any parent and my sympathies are fully with the family. But while reading the article I couldn't help but notice that the parents also seemed in a similar state of fog and haze for a long time. That is a bit rash to say I realize, but that was my first thought at least. However, in this case the boy himself had been hiding his problems from the outside world. They said that they rarely saw Brandon Thomas blush, and if they did, it wasn’t a worry considering he was fair skinned and blonde. "It wasn't even happening here at home" his dad said, "I think this was his place of comfort.” When Brandon confessed to them how he’d been struggling with crippling, chronic blushing for four years, they were stunned therefore. They soon realized that Brandon was fighting a daily battle with what experts describe as pathological blushing; facial reddening that goes far beyond the typical flush of embarrassment. Mum recalled when her son called her in tears last fall: “I was sitting there trying to make sure I chose my words carefully:‘OK, Brandon, you know we all blush.” “And he said, ‘Mom, no, you need to just go look it up." Online, she discovered what Brandon had found: blogs, anecdotal reports and a few scientific studies that described people for whom routine blushing had become unbearable. The biggest thing for him and the biggest thing for all the people who suffer with chronic blushing is the shame,” she said. “People do think of it as trivial because we all blush. And what’s the problem?” From the age of 15 on, Brandon had been dealing with bouts of blushing that came without warning and he'd flush bright red from his neck to his ears. “He would be laughing with people and someone would point out, "Oh, look how red Brandon’s getting," said Dawn Thomas, recounting what Brandon had told her. “And he’d be thinking, ‘I am?' Because he didn’t realize he was turning red.”

Friends recalled that the color was noticeable, but that Brandon had been such a funny, energetic and well-liked guy that it didn't draw too much attention. Some friends may have joked about the blushing, but it was never mean-spirited according to his friend, and no one ridiculed Brandon. "He was the last person in the world you'd think would do this." His mum recalls however how the friendly pointing had made Brandon embarrassed, after which he started dreading the blushing that he couldn’t control, leading to what experts call “erythrophobia,” or fear of blushing. “Since it’s visible and uncontrollable and frequent, you are always on the alert. You dread blushing or the possibility of it happening,” Dr. Enrique Jadresic explained. Jadresic is a Chilean psychiatrist and an expert on the disorder who wrote “When Blushing Hurts: Overcoming Abnormal Facial Blushing.” He states that “Blushing, which presumably is a minor symptom, cab erode not only self-esteem, but also the will and desire to live” He mentions ways to treat chronic blushing, including hypnosis, therapy, anti-anxiety drugs and, for some, a controversial surgery (ETS) that snips or clamps the nerve in the torso that controls flushing. But like Brandon, many so-called blushers suffer silently, ashamed to admit to the condition that colors work, romance and other crucial parts of life. “Clearly, we do not all blush the same, to the same extent and severity,” he noted. When people blush more frequently and intensely than normal, it can trigger severe psychological and social reactions. Sixty percent of blushers in one study and 90 percent in another study met the diagnostic criteria for social anxiety disorder, or SAD, he added. Before jumping from the 11th floor balcony of his Seattle dormitory last May Brandon wrote a five-page note, blaming his suicide on despair caused by his facial blushing. “I am tired of blushing. It is exhausting to wake up every day and have to find little ways to avoid blushing situations.” “I blush several times a day. It doesn’t have to be when I am embarrassed either,” he also wrote. He would blush in class, on the phone, while driving in his car, late at night when he recalled blushing during the day. He would take the stairs instead of the elevator from the 11th floor in order to avoid meeting someone he knew entering the elevator on the way down, which he knew would trigger a blush. All of this agony was kept secret, Brandon's friends and family say. Once they knew about the problem, Brandon’s family did all the could to help him get rid of the blushing. They took him to doctors who put him on low doses of anti-anxiety drugs and beta-blockers. They discussed the possibility of endoscopic thoracic sympathectomy, or ETS, a highly controversial surgery that is sometimes used to treat both excessive sweating, or hyperhidrosis, and pathological blushing.

Jadresic, who had the surgery himself, believes that it can be an effective cure. He led a study of more than 300 patients published last year that compared surgery, drug treatments and no treatment. Among those treated with ETS, 90 percent reported being either “quite satisfied” or “very satisfied” with the results. However, the surgery is also very controversial and there have been countless patients who reported serious side effects, including unusual sweating or weakness, sometimes without controlling the blushing. There are webpages and forums dedicated to the victims of ETS, some who claim to have become crippled by it, so please read their stories before even considering this treatment. Brandon wanted the surgery, but reluctantly agreed to try drugs and therapy first, his parents said. During an anxious meeting in Seattle, a doctor told Brandon the surgery had only a 50 percent chance of success. In response, the family planned to see a new doctor in New York this summer, one who was more familiar with the operation. If that didn't work, they planned to visit an expert in Ireland who claims to cure chronic blushing. Before they could take those steps, however, Brandon was gone.
“He was so hopeless by the time 
[he told us],” his mother said. “He believed
 in his mind that he was never going to
 have a successful career, and that he 
would never have a successful 
relationship because of this.”

Now they’re speaking out about chronic blushing, hoping to create a website that gathers information about the condition all in one place, providing links to Jadresic’s book, which may have provided hope to Brandon if he’d seen it earlier. The website is still under construction. People who want to know more -- or to contact Brandon's parents -- can send an email to info@chronicblushinghelp.com. “One of the reasons he took his life is that if he took this drastic measure, it would raise awareness,” Dawn Thomas said. “He wanted his death to have an impact.” (Source
The suicide of Brandon was also discussed on The Rosacea Forum. I also read more public comments under the articles in media on his death, and they were often rude and ignorant responses (stating that if thát was all that pushed him to such an action... dragging in worse diseases some people are suffering and insulting him). In the end, even the boys own parents seemed to find it hard to understand for some time how such a small infliction could have resulted in such drastic measurements.

I found this powerful and very sad article. It was discussed in a thread on The Rosacea Forum

The parents of a 31 year old rosacea patient who jumped off a bridge to her death were baffled as well. The young woman Vicky Norfolk had recently developed rosacea and the distress over it and her fear of it becoming worse apparently drove her to her death. In an article in the local paper, her parents blamed the construction of the bridge ('fence too low') mostly, and dismissed the cause of her psychological stress to a degree in my point of view. Her mother recalls how Vicky had a warm upbringing and had been a very happy girl, until she developed rosacea. The mother is quoted saying that her daughter struggled to look past her skin condition, even though it was only visible if you looked closely. In the four to five months that she had rosacea, Vicky became very depressed and obsessed by it. Although I feel extreme sadness for the parents, their own conclusions in this paper strike me: "The bridge is far too accessible, with no suicide barriers. "We want valuable lessons to be learned from Vicky's death. "We need to stop allowing this to happen over and over again." I doubt that the problem lies here with the bridge, although I don't hesitate to believe that it will indeed have had low barriers. The problem seems to have been the rosacea and the distress of this woman over it. Perhaps there might have been also an already existing (predisposition for) depression and anxiety, that fired all the distress up. I assume she had looked rosacea up online, had a read about the grim treatment options and long term diagnosis (no known cure, progressive nature) and stressed out perhaps. She might have suffered from the terrible pain and burning in her face, that some people with rosacea suffer from on top of skin outbreaks or redness. The burning nerve pain can be bad enough to make you want to run screaming onto the street and find the nearest fire station hose.

Mrs Norfolk told how she had gone with her daughter to see doctors on two occasions in the months leading up to her death. She said: "Vicky was good at covering up the fact she was suffering from depression but, over time, she couldn't see anything else in the mirror any more. We had planned for all of us going away together so we had a lot of nice things coming up and we tried everything we could to show Vicky there was nothing to worry about." "It overtook us all. Not knowing how to get the help we knew she needed was so distressing." Mrs Norfolk said Vicky's sister, Colette, tried to convince her there was nothing to worry about. "Colette took photographs of both Vicky's and her own nose and asked her to choose which one she thought was more attractive. "Based on the photographs, Vicky chose her own nose, which is so saddening. "She was in need of a confidence boost and we thought things like this would help, but she had illusions it was going to get worse." After hearing the statements and evidence at the hearing, coroner David Rosenberg said: "While she might have been stable, it was clear Vicky was suffering from depression. My verdict is that she took her own life while the balance of her mind was disturbed." (SourceHer mother seems to calls the fear for worsening of her rosacea an 'illusion'. The fact that she even now, more than a year after her daughters death, still doesn't seem aware that rosacea can be in fact a progressive disease is a little bit disheartening, given the distress her daughter went through over this. The Daily Mail also reported on the story with the 'fabulous' heading 

'Woman, 31, jumped from Humber Bridge and killed herself over fears her minor skin condition would deteriorate.' 

 Like I said before, I think that the family might have underestimated the cause of her psychological stress to a degree. They certainly spent very little words on the rosacea, and the same happened for the many reporters who wrote about it and the countless responses from the public. Blindly picking the most attractive nose goes beyond the worries and pain patients have over their skin problems, although I am sure it was meant well. We discussed this story on the rosacea forum as well.

Rosacea can bring on strong feelings of anxiety and stress for some patients. 

Some people had lingering facial blushing for years before the rosacea started, and others got it out of the blue. Even the early stages of this condition can usually cause distress, as soon as the patient starts to realize that this is not a transient skin rash or a ‘simple’ acne eruption. Once the verdict is read and there has been googled, searched and read, it becomes clear that rosacea has been noted for many centuries, but it is still not clear what causes it and there is often no cure for it. And even worse; the condition is labeled as progressive. This can be enough to cause a lot of fear and distress. Often rosacea gets worse over time, when the patient starts trying out different treatments or contrary does nothing. Antibiotics are generally prescribed without much critical selection of subtypes, and many subtype 1 blushers and flushers, burdened with overall redness on the cheeks and burning, will not benefit from this. Or even become worse. The same goes for topical creams, that are usually too harsh for the delicate rosacea skin of subtype 1 (erythema and flushing). Then the real stress often starts: doctors are unsure what next step to take, the stress itself can worsen the rosacea and in time many patients will start to avoid triggers in a bid to get some control back. This can have obvious consequences for their social life. Some people can start to have problems at their work place, when the temperatures are too high, when there is no fresh air or they have to sit for prolonged times under bright fluorescent lightning which can stir up the facial inflammation. Not everyone can handle make up to cover the redness and most people become very self conscience, to the point where some will avoid social confrontations all together when they havea flare up. Many rosacea patients that I know personally or through forums mentioned that their social life was hugely impacted by their rosacea sooner or later. Going out is not quite the same when you can’t drink alcohol with your mates (huge flushing trigger), when the dancing will make you overheated or when your burning face makes you unable to leave the door altogether. Even when to others your cheeks might look ‘rosy’ and fine, the burning sensations can be intense and I found it personally extremely difficult and daunting to explain and convince my family and friends of this. The fact that they said they didn’t see what I meant and suggested that I was (initially) obsessive over small blemishes was very hard to digest, when I already felt anxious and isolated. With my sister(s) and mother it took over 5 years before they started to really see how severe my flushing was and how much pain and despair it gave me. I have spent one Christmas alone in a room upstairs with the windows open whilst putting cold packs on my cheeks with a blanket around me and a plate on my lap, while the family downstairs didn’t want to put the heating down and my face felt like it was severely burned.

Many people with rosacea deal with a lowered self esteem, avoidance of social situations and a restricted life style. Until they have control back over their condition. And although there are many treatments out there, the condition can be reputedly difficult to control and treat. Even friends who got control back and got relief over the years have been impacted by it. I personally had many years of stress and doom and gloom, when I tried to figure out my skin problems, neglected parts of the student life that I had so much looked forward to. It was a shift from what life used to be like but I found ways to get happy again and get things back on track. Then one year followed of utter despair, when my flushing and burning was 24/7, and I felt like I was burning up and in hell. This was after a failed IPL treatment. I saw many dermatologist, asked about operations where they would remove some blood vessels, skin transplants even, anything, to make this inferno stop. No one could help or had any suggestions. You can read in much more detail what I tried in the process of finding a treatment, and all the (sometimes lame and desperate) messages I posted on Rosacea Forums before and after this dreadful IPL treatment I received in this blog post. At the bottom of that post I also summarize everything I tried in the past, from acupuncture to traditional Chinese medicine and healing crystals. Luckily a great friend took me to Dr Chu in Hammersmith Hospital London, who had some suggestions on anti flushing medication that took the worst off my rosacea, but I still have periods where I feel very limited, confined, burned and hot and sore and most of all, ugly. Well, most of all sore actually. I don’t tell many people about my rosacea, only my inner circle knows and many facebook friends have no idea, although most will have noticed it by themselves by now, if I even make appointments with them in person. It is one of the reasons however why I try to avoid meeting ups with long lost new found old friends.

What bothers me a lot, is the harsh response that part of society has nowadays on everything, including skin conditions. I read comments on the suicide news on some forums and the way people wave it away, mock it and laugh about it is systematic and exemplary in my view. I don’t have to have suffered from cancer myself to sympathize with patients, or MS to show understanding and interest. But many people out there, especially the ‘successful’ ones who think they created their own success and happiness and health as something that you can extort single handedly,  can be very rude. Another thing that makes rosacea difficult to deal with, is the impact it can have on the lives of people around you. I ask my friends to put the heating on low when they invite me over, and many rosacea friends of mine hand out blankets and warm water bottles to friends who visit them, while they have a small fan on low blowing on their face themselves and the heater OFF. Going out to restaurants or clubs is always challenging I find, and something I have to drag myself to, usually to my own relief in hindsight when it turned out less hellish than I anticipated. However, there are some things that you can do to alleviate some of the depression I found.

First of all; try to accept that this is what you have to deal with. You have rosacea and no wonder cream or pill is likely going to take it away again. (Although for subtype 2, ivermectin/Soolantra cream are doing wonders currently!) Although there is no harm in trying, and there are cases where a simple measurement can control your symptoms, this is not the case for everyone. Especially flushing, blushing and burning of the skin can be very difficult to treat. It helped for me personally, to stop being in denial and just try to accept that this is my burden from now on. That most people have burdens and this is not the end of the world. Instead of asking yourself "Why me?!" I rather ask myself "Why not me?" I had to alter my expectations of myself, of my life and my future and adapt them to my physical needs, at least for the time being. I am perhaps freaky in this, but it helps me slightly to read the news, hear about people in worse situations, dying prematurely from cancer, you name it, and you can read it in the paper every day. I needed this sort of horror scenario's for a while to put the rosacea in perspective. Yes, it is a horrible condition to have and yes, I would still give my right arm or leg to be rid of it (for real, ok not my leg but my arm perhaps), but there are still many things we can enjoy, perform, be and become and there is still outlook on improvement, in many ways and departments. It can indeed be a lot worse. But the reality of living with it can still be challenging for many.

Reading about my rosacea helped me, although the vast amount of information and opinions initially stressed me out. But knowledge can be power and the rosacea communities online are all wonderful places of information and support. Don't hesitate to join one and share your story.

Realize that some anti-depressants can help rosacea in more than one way: certain antidepressants can help reduce flushing of the face and redness, and also reduce anxiety and depression which by itself can be rosacea triggers. Please check my more in debt post on rosacea (flushing/redness) medication here. I take mirtazapine (Remeron) - but there are more antidepressants that have a good record for helping with facial flushing, citalopram (Celexa), Zoloft and Effexor for instance. SSRI anti-depressants in general can help, probably in a similar way in which they can help to combat menopausal hot flashes. People with rosacea also mention citalopram to help with facial flushing, redness and burning. Celexa (Citalopram) can help cut down on the facial flushing also anxiety, which can flare up rosacea in itself. Here is more on citalopram for rosacea. There are also antidepressants that can cut down nerve pain, like amitriptyline. Ultimately, I heard from my derms that mirtazapine is one of the best antidepressants for cutting down facial flushing. However, all antidepressants can come with side effects. Therefore I'd only take them for rosacea if your quality of life is really affected by flushing and burning and anxiety. There are also antidepressants that can cut down nerve pain, especially amitriptyline. The migraine and headache pain killer sumatriptan has also been used with some success (100mg up to 3 times a day). All these medications tend to come with side effects however, so make sure to always have them prescribed and discussed with the doctor.

My own personal experience with mirtazapine was that I went within some weeks of using it from a 24/7 flusher, at my wits ends, to a ‘part-time’ flusher. It seems to heighten the threshold for flushing. I have heard this from several other forum members, including WrinkledClue. From the 3 meds mentioned, Mirtazapine has the best scientific studies backing up it’s positive effect on facial flushing. Positive note: even on the low dose at which I use it (22,5 mg a day) Mirtazapine works strongly against anxiety and depression. It can lift your darkest rosacea-induced clouds and the better spirits and reduced anxiety help combat my flushing and inflammation even more. It also helps you sleep long and sound. 

My take on suffering and depression

I have dealt with different gradations of depression since my teens - probably more sullenness or melancholia in my late teens - and developing rosacea certainly didn't help. During my adolescence I started to develop feelings of melancholia and disappointment in the people and things around me. About the bulshit of people, as I saw it at least, the unpleasant human ways, the cynicism of the modern world, the inequalities of a capitalistic society, but also simply the annoyance (as I experience it) of group dynamics. My parents had divorced and my father taken to a mental hospital for some time, after not being able to cope with the break-up. It was not an easy time. But in my teens I had also good friendships and the freedom to explore, grow up, go out, spend weekends dancing in the city discotheques. meet new people, travel and feel free in my body. Overall I was happy a good amount of the time as well. Unfortunately once I developed rosacea, in my case flushed burned up red cheeks, I lost that freedom. I felt caught in a cage as so many every-day things made me flush and burn. It was like a bad Kafka book, like a new room with low ceilings and impending walls that I could not escape from; very claustrophobic, yet this was my life now! Everything I used to love made me more red, which fired up my anxiety and depression. I tend to withdraw from social life when I feel like crap physically, so the fact this all hit me in my student years was just disastrous. But it was not until 6 years later that I had my worst year ever, after a failed IPL made my flushing unbearable. My beloved sister had also just died unexpectedly then from a missed appendicitis and my world was extremely dark and bleak. I couldn't leave the house or my ventilator and cold packs, even to get some groceries, I was looked at and laughed at for being maroon red. I became a shell of my former self and stuck in survival mode. In that year I couldn't stop thinking about death. This seemed a living hell and I saw no light at the end of the tunnel. I was lucky to have a tremendously awesome dad, who did everything humanly possible to drag me through this. He would be on stand by on the phone, drive to my house at whatever hour of the day or night in case I was overcome with anxiety and hot burning flushing (as I said, that year my flushing was never ending and I had lost ALL sense of control over it; I was burning up from the inside and felt like set on fire, all the time unless laying on icepacks, which in the end fired back at me and irritated my skin and blood vessels). He would watch movies with me or let me sit on the back of his bike and go for hours out in the countryside for some fresh air and to get out of the house. It was just a pathetic year and life. I couldn't see myself being so humiliated and powerless for much longer. I don't think most people want to actually be dead, when they suffer like this. They want to escape the status quo. They want another life. And because they don't see any way to get another life, they want to take control back and end their current suffering. 

I was literally, and I'm not exaggerating here, saved, by a friend from The Rosacea Forum, Peter Waters, who had me fly over to England and see his dermatologist, professor Anthony Chu. It was a god-send and the medication he prescribed me (clonidine, propranolol, mirtazapine and an antihistamine) practically within a week lifted my bad flushing. Or lifted the worst of it I should say, I saw about 60% improvement and now didn't flush all day every day anymore, but from triggers. So if I stayed cool calm and collected, I could have fairly pale skin again. I felt elated, like I had been given a new life. The side effects (drowsiness mainly) lifted within a month or two of getting adjusted to the med and even the 15 kilo or so (!) weight gain from mirtazapine didn't bother me. I was so happy to be able to meet friends again and go to the shops again, be able to go for a walk without blowing up in fiery red flushed swollen skin. My dad always pepped me up back then. He would say that I need to hold on to the small things. If I could enjoy something for even 15 minutes a day, may it be reading a book, watching a movie, listening to music, then I should cherish that feeling and see it as enough to keep going on. And to never give up hope for future treatments. I am so glad I stuck through it, even though today I am still housebound often by the rosacea. But I have a sense of control back now. I can keep my skin cool and in not too much pain as long as I avoid triggers, stay cool, eat healthy, have no stress. And because the flushing has calmed down, I can now also handle evenings out, dinners with others, because even if I flare then (usually the case); I can cool and calm it right down again at home. I no longer have a week long monster flare from the slightest of triggers. I am glad now that I didn't jump off a building at the time, as I had imagined. I share in this blog post testimonials from other people with rosacea, skin diseases or chronic pain even, who struggled with depression and the will to live. Not because I want to encourage anyone to go that route (if anything; take inspiration perhaps from my route and that things can improve as long as you keep pushing and trying new treatment options), but to underline that it is human and fairly normal to get overwhelmed by physical suffering. And that it happened to others too.  You can read more about how medication, including mirtazapine, helps my rosacea here.


Below I share some stories I read in the media about people who suffered under unbearable pain and who chose another path than me. Who could no longer take it. I don't share them to 'inspire' anyone suffering from rosacea pain to go that same route. I urge everyone to exhaust all other medications/ treatments/options and to never give up. Life is precious and worth living, even when you suffer from daily pain. I don't know what happens when you die, but there is as good a chance that there will be nothing as there is a chance there will be something. And if there will be nothing for eternity after death, then life is the brief exception of that nothingness; something to experience, not to shorten even further. Life means chances for change. Death is the end. So I'd always try to keep going, try new things if possible to hopefully ease some of the physical pain. But at the end of the day, we cannot understand and 'feel' what levels of pain others around us are suffering and how much they can endure. I want to share these articles because they touched me and because physical suffering like this is not rare or uncommon. There are many people out there today who are bend down under pain, just like you might be.

Also helpful for the rosacea related nerve pain: certain antidepressants like Cymbalta (duloxetine) and Paroxetine (10 mg daily) might help
In 2008 Duloxetine became the second drug approved by the FDA to treat fibromyalgia. Used to treat treat depression and generalized anxiety disorder, Duloxetine is also used to treat diabetic neuropathy. Duloxetine is class of medications called selective serotonin and norepinephrine reuptake inhibitors (SNRIs).

Diazepam/clonazepam - and similar calming anti anxiety medication has helped people with facial flushing as well. I have used it in the past but diazepam made me so dizzy and tired that it wasn't really for me. A friend of mine takes one tablet before having an alcoholic drink, very occasionally, and it helps blunt the flushing he normally gets from alcohol. Both medications and all 'pams' are typically addictive. Best not to use structurally and long term due to dependency and addictiveness.

Christoffer1997 wrote on May 5th 2016: "Hi everybody! This is my first post. I have had rosacea for about two years, i'm 19 btw. My rosacea is pretty mild i think? Before rosacea I had absolutely perfect skin, no acne no redness nothing. I used to be a very polite, open, tolerant and happy young man before this horrible disease, now, I'm always depressed, anxious and tired I cancel many things I would like to go to because of this disease. My biggest triggers are cold waether and hot weather as well as oral presentations. Speaking a foreign language like english in fornt of people makes me go bright red, because i hate my dialect even though my teacher says i'm very good. I can no longer look people in the eyes or have a normal conversation. I am very good at hiding my depression, only my mom knows just have I actually feel. And I know she's tired of my constant moaning. I have thought about killing myself, because it's so exhausting to pretend like you are happy for 6-7 hours every day when I'm at school. And the worst things is that I know it won't get better. I can have really good days, where you can't tell i have rosacea, but the good days just make the bad days way worse. I have tried everything. Steroid creams, pills, a healthy diet and exercise but it didn't help. Because living a healthy lifestyle didn't help, i started smoking cigs and weed every day while listening to Nirvana, I can really realte to Kurt I understand his pain in a weird way. I know it won't do my rosacea any good, but what's the point in trying when it's chronic and there is no known cure. Have any of you guys managed to live a normal life while having rosacea? To me, it seems absolutely impossible. I know i'm gonna die at a young age, I just don't know when, but i really don't think i'll be 30 that's for sure."

Andy_uk replied: "I know how hard it is mate, but saying things like that are continuing with your negative cycle. You need to break the cycle, keep trying a different regime with your skin until one works a bit then stick with it. There was a woman who had it chronically the cured her self with the kalme skin range and now she leads a normal life. There's hope out there for us all. I have a constant bright red face and people are constantly asking me if I'm alright. Some days are good some are bad, just need to develop a thick skin and carry on. Most good people look for the beauty within and what type of a person you are, not what you look like. Chin up pal"

Christoffer1997 replied: "I don't know what started my rosacea. My mom has facial redness, but she says it's sun damage, since she didn't wear sunscreen while on vacation (it wasn't invented or something.) She used to go to the Black See for 10 years and she was on holiday for more than a month. I have been to Turkey and Spain once, i didn't wear sunscreen which was very stupid. She says two years aren't enough to get sun damage. My mom is convinced that my redness is caused by puberty and not rosacea. I have seen a few derms, i'm very lucky it's free to see them in Denmark. The dermatologists all say different things. However, my redness has gotten better since fall last year, during that time it was very bad. My other four siblings who are all older than me don't have this disease and they don't take care of their skin, and it frustrates me, don't get me wrong i'm glad they don't have rosacea! My absence % at school is higher than the school tolerate, but since my grades are alright and they won't kick me out of school plus the can't afford it, they get paid when studens graduate. So i'm hanging in. But i just can't see myself studing for another six years... I am very anxious when writing tasks cause I think the teachers laugh at my writing for some odd reason. I really hope you find a cure, Andy!!"

Oleva replied: "Dear Christoffer. Sorry to hear you are so down. I have had rosacea on and off since I was 17. I am now 57! So I have managed to live a normal life. In my case it takes the form of very severe flushing. I live in London and was on the tube the other day when I had a massive flushing attack. A woman actually asked me if I needed a doctor! I expect you can imagine how embarrassing that was. In London the tube seats face each other so it means that you have a whole row of people facing you. Guaranteed to bring on an attack. But I can deal with it much better mentally now. When I was 17 I hadn't met the vast amount of people I have now and so I didn't know that EVERYONE has some sort of problem to deal with. In England, nearly 1 in two people are struggling with depression. So when we think everyone is focusing on us because our faces our red they are probably actually thinking about whatever is worrying them. I also learnt that people tend to really like people who flush. Just look at Lady Diana. She was nearly always flushed. I think it is because as I said before life is really tough for most people so when they see somebody blushing it makes them feel as if we are all in it together. That there is somebody like them who isn't perfect. It really helps most people to talk about it when they are really down so I am quite sure there would be lots of people who would reply to you on this thread if you wanted to let off steam. I hope this helps a bit. best wishes Oleva"

Here you can read testimonies from rosacea patients, telling about the impact rosacea has had on their every day life and their feelings of depression:

-Trying out treatment options gave me some sense of control, outlook and strength. Trying out different things at the same time might seem appealing (you are spreading your success chances), but often makes it all much more complicated. When you do see improvement you are unsure what exactly caused it, and when you are getting worse you have to dismiss all the things you are trying out, when in fact only one thing might be causing the problem. So I would advice to restrain yourself and try out one thing at a time :) I try to keep my diet, stress levels and other factors as stable as possible during the trial period, and I keep a little diary, because in a week or two time, you will not remember most of the details.

-Stay active, even if you don't feel like it. Try to keep seeing friends and bring your cold pack if needed. And when you don't want to face people, make sure you make a daily walk at least. Get some fresh air, walking can order your thoughts and make you feel a bit more fresh and alive.

-Consider taking antidepressants. The problem is usually, that many rosaceans are sensitive to many triggers, including some medication. There are however antidepressants out there that won't make your flushing worse, and some are even noted to improve matters. Antidepressants can make things seem to much lighter and when you are on the brink of a real depression, try to see it as a 'nothing to lose' situation, where you can take a chance with medication. Don't despair when one antidepressant isn't good for you, cause there are many out there and some people only find the right one after many trials and errors.

-Explain your friends as good as you can what you are going through, and the aspects of rosacea that they don’t see. Let them read some information or patient stories if possible. Having understanding and loving people around you, will make the struggle half as hard.

In many of the threads posted online, depressed rosaceans are told by well meaning respondents that they should be so happy that they don't have cancer/heart disease/Spinocerebeller Atrophy/...

I doubt those type of remarks will help. At some point people are just too depressed and suffering too much to find any solace in that type of 'pep talk'. Having a burning face that is out of control is much, much worse than most non rosaceans can comprehend. Luckily enough. Cause you don't wish it no anyone. And every patient has to deal with his or her limitations and challenges, regardless of how 'serious' they are classed and ranked by others; it doesn't change the status quo, which means dealing with the pain and discomfort and adaptation day in and day out. Finding the right medication is what helped me to take the worst most nasty edge off it all, although I still have a lot of bad days/weeks/
seasons even. Antidepressants might be just the thing that can help you bounce back from the edge, giving you that extra zest of life and energy to fight and combat it all. Therapy might help... although I had some years of it, with different very good/qualified psychiatrists, but it didn't help me at all... But I analyze too much anyway and perhaps it can help people who are feeling lost in their own emotions and who need more insight and such.. I do think it can be very helpful. But it won't solve your rosacea. It won't take away the daily inflammation and pain and the limited life style. It might give you insight in the way you deal with it emotionally and help you deal with day to day life, it might help you to find balance in your way of dealing with it. Be proactive when you feel very depressed about your rosacea however, either by trying out new medication that might alleviate your symptoms or/and by talking about it when you need that with a specialist, or by changing the way you designed your life around the rosacea if you can. By all means, talk about it, with other patients, with your family and friends, on forums, with a psychiatrist...

Something else I found recently, is that some people link inflammatory diseases to increased risk of depression. A substance called cytokine IL-6 is to blame transparently. It has been linked to depression in many inflammatory diseases where it has been found to be elevated (also rosacea). (Link)

I also like to give the link to the a BBC documentary on the effects that acne can have on teenagers and the use of roaccutane. My own dermatologist Dr. Tony Chu is in it as well :)  For those interested, here the documentary is discussed on The Rosacea Forum. 

If you suffer from depression and are considering suicide perhaps even, please realize that things in life can always change. Always improve. That life is not guaranteed to be one happy road. Not for you, and not for anyone. We may have more challenges than some others, but things CAN be turned around. Things can change. Billy Joel wrote a song about this. Joel, who had once attempted suicide himself, stated in a 1985 interview, that he wrote the song as a way to help young people struggling with depression and thoughts of suicide. In his original draft, he was concerned that the song sounded too depressing so he re-wrote it with a bouncy, joyous beat and melody with lyrics that stressed personal forgiveness and optimism about life. Joel donated all the royalties from the song to the National Committee for Youth Suicide Prevention.

Below I will make a small inventory of the positive (understanding/ supportive) and the negative responses on both news items, in papers and on various forums

Understanding responses:

Davem81 wrote: "I have returned to the online rosacea community today after a few months away, and found this article. I myself have experienced many, many thoughts of suicide over the past 5 years, purely and exclusively linked to my rosacea. Don't get me wrong - I've never been close to being actively suicidal, but the idea has often been there. This condition has completely changed my life, and I don't mean for the better. From my experience, I believe that there is very little understanding of the mental anguish that this condition can cause. Even from doctors and other medical professionals. It would be nice to think that this poor girl's terrible suffering and ultimately her death may go some way to changing that, but alas I fear not. If anything, I fear that the psychological aspects of this condition are even more poorly understood that the disease itself!"

Ghost: "It's so sad. It doesn't seem like the guy joined a group on the web for support. Yet, his family was supporting him and helping the only way they knew how (which is a lot), taking him to docs. One of the comments is that perhaps the drugs he was given altered his mind. It is possible. And truly horrible and horribly ironic. There just aren't words. rip"

And: "Horrible news. But I am not surprised. So many rosacea sufferers go through life feeling like

the living dead -- we cannot fully participate in the life that we see is out there. We feel ashamed, dirty, ugly, unworthy; the brunt of remarks. I'm sorry this lady didn't know how to get out from under that."

Brady Barrows: "It is odd to me that rosacea never comes up in the article. Flushing (or blushing) is usually the chief differentiator in a diagnosis of rosacea. Apparently his doctor felt the other signs of rosacea were not present. Very sad case."

Melissa W: "What a tragedy. It breaks my heart that so many people have to go through such pain. 
No matter the diagnosis this poor young man felt intense emotional pain due to his condition and he couldn't fight it emotionally anymore. Truly breaks my heart. I hope everyone here realizes that with each and every day there are new breakthroughs in so many diseases and one should never give up. Life is too precious and no matter how bad things might seem at the time they will always get better. If you just let the bad time(s) pass. You will start feeling better. A study was done with failed suicide victims and I believe almost 100% of them (if not 100% of them) all said as they took that step to suicide (eg jumping off the bridge) they instantly regretted the action but it was too late. They thankfully survived (that's the only way the results of the study was possible obviously) and got a new lease on life. I don't know the stats on if they were able to get therapy and go on to lead happy and productive lives but at least they had the chance. Suicide is final and there is no going back so no matter the pain one feels at any given time you should always know it will pass and you will feel better. There are new treatments on the horizon and if you are feeling depressed I urge you to seek therapy/counseling and talk it through with a professional and with your loved ones. Think of them- how terribly missed you will be and what an impact your death will have forever on those left behind... "
Mistica wrote, in response to this: "Its sad but people forget that as bad as you think you may have it there is always someone worst off than you who would kill to be in your shoes....... Id gladly trade my crimson red mask for a "blushing" appearance any day. DennyB: I do understand what you mean, but in this case, be careful what you wish for! Blushing can turn into severe, debilitating flushing, which can be horrendously debilitating! Some of the extreme flushers here, me included, are crippled by the disorder. It goes way beyond a matter of appearance. As for the poor lad in question, it is a pity he didn't join this forum. Judging by the article, he only looked at blushing sites."

CursedForALifetime wrote: "I know exactly what he was going through... Turning red ten times a day ore even more often for no reason. People not only making fun of you but telling you if they were you they would jump from am bridge. It´s just living hell. The only reason I am still alive is ETS surgery. Now the blushing is almost gone though I still suffer from permanent redness and flushing due to rosacea. And of course I now sweat pretty much as a side-effect to surgery."

Bloem wrote: "Very sad. I find the term minor skin condition in the headline sort of misplaced."

FlushedBean: "It makes me a little angry that they blame this mostly on mental health. I think we've been over this before, some people handle hardship better than others and are more prone to depression and pessimism, but her death was caused by an incurable skin condition on her face that she felt she could not live with. Was she in pain? I know I am. Just a little more understanding about the ramifications of rosacea and maybe a push for better treatment might have been helpful in the article. Not saying what she did was reasonable, just want some more attention given to this disease. I hope her soul finds peace now and that somehow her family finds the strength to carry on. Such a tragedy."

Franses wrote: "Oh my this news just brakes my heart, I read it yesterday when I was really down already, and had those suicide-thoughts that always pop up automatically when my rosacea gives me bad times. I always tries to overcome those thoughts, and this forum (and my music - can´t leave cause I have my albums to record etc...) have helped me a lot with that, it gives me hope for some reliefs in symptoms, as been written here, it take time but you can get better, even go in to remission. My condition is steadily getting worse, this were the first winter I haven´t been able to go outside, and yeah in Sweden we have winter like more than half of the year, and now I even can´t tolerate a little windy summer-day either, I´ve noticed, better than winter however. And the rest of my body is also getting symptoms, like the hands and feet, well that's for another thread, just got caught by the moment....sorry... I wonder if she knew about this forum(s), if she was a member here? What was the reason for her losing hope? Had she tried everything already, an so on, I wonder..... I think it is important to discuss and highlight this possibilities, or such things, so that people here on this forum doesn´t get inspired by this kind of action´s.... Maybe It can be like anorexia, it´s not contagious by some virus, but psychologically.

And yes, the statement "minor disease", are the fu-ing kidding me. Oh my god that really pisses me off!!!! This shows how much lack of information the world having about this disease, so frustrating that this is not already a world wide knowledge. Even if not all of us rosacean´s are experience pain and parasthasia (like I do, not severe pain, yet, but parasthasia-like thing, and a pulsating nose) doesn´t mean it is´nt a hard diseases to have. A disease have to be in counted (or what is the word? included?) in to a context, that in this case is not just a matter of feeling pain, meaning the body´s feeling in itself, but also that what society´s and culture´s feelings have about bodies, the expectations of abilities. In our world/culture/society, ability also can be about look, that become your body´s feeling of the society...Well as in her case a possible future with red all over the face, pimple and such, or like they said the disease was just noticeable when looking close, and feeling depressed about that is not a matter o vanity I think, but as her being a human and a woman; I see attractive men with rosacea all the time, I wouldn´t care less, but as a women I don´t now if men will find me attractive, woman are more "body" then men in society (men also feeling the must of looking good, but at a different level as women, men also have more opportunities to also be seen as "brains" that reflects over to there appearance, this not includes all men but men as a group) and maybe that what she was feeling to? Her bodies feeling of society. I have no idea, men dies from this disease as well of course, just me as a woman and former gender student reflecting my thoughts. And my feeling of society of course, and when I am in it also hoping that I´m somewhat wrong. "

Sally wrote:  "A few months ago I sent my dermatologist a photo of the mental hospital I once found myself locked up in - Parkside, Adelaide, Australia, 1973. I had attempted suicide because of my dreadful skin and was 'sectioned'. The building was a gloomy Gothic looking edifice and I wanted my derm to realize how low one could become. I haven't seen him since I did this but I hoped it would make him treat my complaint with a little more compassion, although I doubted that it would. He's now left the NHS and is very much into making money since he opened his private skin clinic. Any empathy he might have had is fast diminishing. Very sad."

Arlene wrote: "Once or twice I've gotten angry enough about something in the newspaper to go through the effort of tracking down a reporter ( I was able to get their Email address on the paper's website) and written to them. I don't know if it would make any difference, but at least its cathartic. I wish , somehow, we could get the press interested in writing about how devastating the disease can be especially when it's compounded by the ignorance of doctors, insurance companies, governmental agencies, and the public at large." 

And: "Looked up the interview that was referred to and as usual it's in the context of "what is my skin routine" etc. Like Cynthia Nixon they all talk about having Rosacea that was quickly fixed by a pill and a lotion and all is well in their lives. This kind of stuff is a mixed blessing. While I appreciate that they have given more recognition to Rosacea, it can also reinforce the idea that it's a "minor skin condition". I'm talking about an in depth article (like in the times Tuesday science section)where there is a serious discussion about the full spectrum of the disease and the serious impact that it can have , psychically and emotionally on people's lives. This is the stuff that people really don't know about."
Babdab wrote: `I've read some of the comments and I don't understand the need to place blame in

this tragedy. I don't believe anyone is to blame, especially not the parents their grief is no doubt unbearable. Brandon's parents took action concerning his condition by taking him to doctors, counseling and also considering surgery. That doesn't sound like parents who have "failed" their son as some have suggested. I've read several comments from others who have this condition although they vary in age and gender the common thread seems to be the anxiety, isolation and depression. I'm grateful they shared their stories in order to help others understand how it has changed their lives and that it's not the same as most of us experience when we blush. I do not agree that Brandon's suicide was taking the "easy way" out or that he was "weak". Brandon was obviously in pain, unfortunately he probably believed the only way to stop that pain was suicide. A close family friend of ours committed suicide 3 years ago, he had great parents and people who loved him very much. However, in that moment I'm sure he felt totally alone I wish he knew he wasn't. It's not that kids today are "soft" bullying isn't the same thanks to technology, now others can continue to harass and bully 24/7 to many people through social media, texting and internet. My heart and prayers go out to Brandon's family and friends, thank you for sharing Brandon's story.` 

Wuloso wrote: ´Most people dismiss this, and I doubt this will do much to change things, though it is
nice to see it getting some mainstream coverage for once, even if it had to come under these circumstances. This problem, while it may sound minor, can be debilitating. If you have a problem in social situations where you turn bright red and stay that way for several minutes or even hours, the reaction people may have is to avoid social situations altogether. It can be a very lonely existence when you have difficulty carrying on any more than random small talk because of the vicious circle of fear of turning red. The worst part is when some idiot tries to build themselves up by pointing out how red you are, compounded by their assumption that you are embarrassed, guilty, or another negative emotion typically associated with being red. Guess what. Their face feels like it's on fire, and they are suffering physical and emotional pain because of it. You don't need to be an ass and point it out. I guarantee you that, if they suffer from erythrophobia, you are causing them days of depression and anxiety (during which it would not be surprising if they think about suicide), as well as contributing to the severe damage of their long-term mental health, all because you wanted 30 seconds of pleasure by saying they are red. Hope you got a good laugh or whatever you were going for out of destroying them.´  

The blushing one wrote:  ´Ugyan, I feel your comments on this thread are a little tasteless if I may 
add. Instead of expressing any sort of sympathy for a young man who has had his life literally taken away due to a blushing disorder, you just wanted to try and say this was an infomercial for ETS surgery. With all respect, you must not realise the devastating impact that a blushing disorder can have on a person. I don't want to have a slinging match, I just want you to understand that people can suffer just as much or much more than you with a blushing disorder, even pre surgery. By no means am I for people just having ETS nilly willy but when it comes to fruition that you have literally tried every possible means to get rid of your blushing, and lost your ENTIRE life because of it, like I have, then I do not  think trying ETS surgery is a completely stupid idea. Because of blushing I lost my education, love of my life, family, any shed of confidence that I have ever had, money and much, much more. ETS surgery has not worked completely for me, but over this past year I can see that it has helped A LOT with the blushing, before I did not believe it had helped, probably because of what they call 'phantom blushing'. And yes, I have suffered side effects because of the blushing, and would probably swap the last remainder of my blushing for more side effects, even though you may not believe so. Back when my blushing was at it's worst I would have easily decided to have my legs amputated if meant get rid of my blushing. That is my no means meant to belittle amputees etc, but I would of personally made the choice based on how much I was suffering because of the blushing and no one understanding. I attempted suicide more than once, due to going red literally EVERY time I made eye contact with anybody, my face burning and hurting to the point of agony.  I could literally not even see my own mother, who I am closer to than anybody in the world, due to the blushing disorder. I really don't wish to sound as if I am having 'a pop' at you, all I ask is that you please just show sympathy for people suffering from blushing, and do not blast them for them being interested in ETS surgery.´

Amo011098 wrote: ´I actually have this and it's no joke. I'm not even through my freshman year of high school and its ruined my life. I'm afraid to go to sleep at night because I know when I wake up I'll have to face a situation where I blush. I feel the same way he did, I just hope I can find my way out.´

taalia22 wrote: ´I'm really fucking mad seeing people calling this guy a pussy for killing himself over "just blushing." It's not JUST blushing. You blush full on beet red when: your crush walks into the room; you're worried about the zit on your cheek; a sexual thought passes through your mind; you see somebody attractive,. Regular people have the subconscious controls to not do this. It would have been impossible for him to even have a small secret. Couple that with a phobia of blushing, and rethink things.´

Negative/less understanding responses: 

Kiss My Feet wrote: "blushing is a physiological manifestation of your emotions. Its a sign of mental health that you CAN blush. You don't want to "swallow it down" by dissociating. You need to learn to accept it and reroute the energy with words. Don't be quiet if your face turns red. You have to digest the arousal with language."

John Hazelton Smith wrote: "wait, chronic blushing?"

critterzdad2 wrote: ´Most guys would like to BE him!´

Leon 45 Jones wrote: ´Way to go Brandon, you nailed it! Word Brandon Thomas: Nutjob, 20, commits suicide after struggling with uncontrollable blushing for 5 short years.´

CodeTwo2 wrote: ´Poor guy. If there wasn't such a ridiculous perception of there being some sort of "ideal" human... and let's face it, people sadly, are becoming more regularized almost by the month - then this guy would still be here.´ 

SpecterWSA wrote: ´you must have been very frustrated, and red in the face. AHAHHAH´

EmpathyWorks wrote: ´if you're going to kill yourself because you're embarrassed of blushing?? Good fucking riddance. there are people out here with WAY worse ailments and less support and potential than this waste of flesh, and those people are soldiering up everyday to create a better quality of life for themselves. 1 lless moron.´ 

M1NDR34D3R wrote: ´Blushing appears when a person is either anxious or embarrassed. So I'd think most people have a "fear" of blushing (more or less). It's basically a fear of embarrassment. That's my take on it.´

electronicoffee wrote: ´This is stupid. Seriously? Some kid committed suicide cause he blushed a lot? This is Darwinian. I have no pity for someone who kills themselves over something that stupid and if his parents knew he had a problem they shouldn't have let him live in a dorm with 11 floors, much less a a shared space with others.´

komoriaimi wrote: ´I  had no idea there was a blushing condition and phobia. I thought it's a cute thing to blush. Who knows when you're the one blushing all the time. This is so strange. Too bad we have such a hard time accepting ourselves and not letting what others think get to us. This should be a cautionary tale not just to people with the chronic blushing but to everyone, "I'm fat. I'm too skinny, I have a big nose, I'm too pale, I'm too dark, my hair is too frizzy, to straight" etc etc´

Clanki wrote: ´Tragic sure, but like WHAT THE FUCK?! Kids who suicide because they are bullied I can understand (hell I have wanted to die more than once during my elementary & high school years) But because of BLUSHING?! Good Lord! I don't even feel bad!´

DasGine420 wrote: ´ive got stomach issues that make leaving the house difficult because I'm always throwing up and need to be around a toilet almost constantly. if my biggest problem was that i blushed a lot, my life would be so much easier. kid was a complete pussy.´

jobzombi wrote: ´I'm sorry but this is just ridiculous. The only impact his suicide had was on the pavement below. Really? Bulls!@# first world problems. Glad there's a little bit more oxygen for people willing to fight than idiots that need to visit a 3rd world country or just the ghetto in his area. Americans and their stupid problems. Tragic? No way.´

rasnac wrote: ´I am a painfully empathetic (literaly, if I see a person in mildest discomfort, I got cramps in my gut) person, yet I find it so hard to feel any sort of sympathy for this guy. He should have painted his face red and continue his life.´

pixienoname wrote: ´He killed himself because he hated blushing? :O
There are people who go through worser things, yet they're trying to survive. I'm pretty sure the last thing on their mind is suicide.´

Alaskanmes wrote: ´The dude deserved it. I knew him, and he was a fucking dick.´

Foat Lux mentioned that rosacea is a very treatable condition and that there are a lot much worse crosses to bear, Ann wrote that her dermatolographia is way worse than rosacea and Vicky wrote why this young woman wasn't prescribed Roaccutane, which has an extremely high cure rate according to her. It cleared hers up in 2 months.

More threads about this topic:

More articles and posts on rosacea and depression:

Forum thread Can someone help, I just can't take it anymore. 

"Hi all - I am so completely frustrated and depressed with this condition. I have been trying very hard to change my diet to try and reduce the symptoms but still I see no progress. This morning, crying while I was getting ready for work, already in panic about having to go there with my huge pores and red face, I just said to myself "I really don't care anymore...let this disease consume me!" There was a little celebration here at work so I had a very small piece of cake...again becauase I was so tired and just stopped caring! So where am I now....in worse condition then before. I cannot focus at my desk. I am so terrribly upset. It is so hard to see any kind of future with this condition when everyday you don't know what you are going to feel or look like. How do we continue to muster the strength when I just want to say I am done...that I just don't care anymore. Can anyone help?! Thanks."

"I know exactly how you feel. I'm 15 years old and I have rosacea and seb derm. They have both ruined my life. I have seen many derms and tried SOO many products but nothing has worked for me. I started a month ago on changing my diet and I still see no improvement. My rosacea and seb derm have been getting worse. And I cry all the time too. I'm doing online school now because of rosacea since whenever I'm out in public I start crying because I don't want people to see how ugly my face is. I think you should see a therapist, I go to one and she's amazing. And I wish I could give you advice but at the moment I have no strength because of rosacea. People keep on telling me in time things will get better but I've had rosacea for 9 months so far and I want to die. But it's a good thing you found this website so you can talk to other people who are going through the same thing as you. wish you luck! If you ever need to talk, you can message me"

"Hi. This is my first post ever on this site. I was on the keratosis pilaris forum before.Sorry for my English. Well, this thread is really getting me because I know how do you feel and I know it well. I have rubra faceii (some derm said it was more Rosacea) for nearly 12 years now. I must admit its an ultimate test to sanity. Its started when I was 17, first year of college, the beginning of fun, youth and life. I remember even if its long before, feeling more and more about a pressure in my face (my nose is a little red, but its mostly my cheeks the problem). Than rapidly, I had more and more a red face, starting with hairs growing on my face. I know there is much worse in the world, wars, genocides, tragedies all this stuff but you are still stuck with that and this condition, is one shit hell. Except PDL or any type of laser, I mostly tried everything, every cream, diet, even fasting. I don't smoke, very healthy, doing jogging five times a week, training, 5'11, 168lbs. No smoke, no junk foods. Fish oil omega 3, green thea, black thea, everything. Didn't do a thing. I won't lie that my 20s ending next July, were pretty hell on earth. Its a little better now because after 25, you feel less the crazy explosion flushing. But the permanent redness is there and I feel damages have been done until my death. The worse is on the psychological effect. Even if I can work and feel lucid and rational, there is mark and a real deep wound that will never go away. The first years were horrible since the flushing was constant. Any social event, meeting, shower, running, putting you're shoes on, masturbation (no joke), the sun, the cold, anxiety, hot room, metro, crowded place, hot drinks, alcohol, shaving, were triggering the heat. It was crazy and in you're mind every second. Its taking hours before going away and you are still stuck with it 24 hours a day. Its invading you're mind like being brainwash, you even fear mirrors, cannot concentrate properly, and you're praying every minute while being with people that the heat won't start or getting worse. The only good time is when you sleep.

I won't waste my time talking about love and social relationship but back than, I became really boiling inside. There is always someone telling you if you're feel hot or how bad was the sun today? It never stopped. You feel first completely out of control of you're life. There is shame, anger, questions and no answers. Mostly in all those years, I felt desperation and oh man, bad toughs are going like a train in you're mind. And even if someone nice or yourself is saying "Forget it, live with it," everything and I mean everything is giving you back the tough of it in every situation. I was not in the adult world yet. When you are 17-20, people are dumb, impulsive, they don't give a shit about feeling or anything. I even gave a nearly death threat to someone. I isolated a lot, drink alone like a maniac. I consulted once but I felt it was just the same bullshit (not saying its a bad thing, I know it can help a lot of people and I encourage you to do it). I even quit university years later, not just because of that, but along with many other factors, one being the accumulation of this constant, dark depression, lost of any power in me. This condition is really taking out you're vitality and without the support of a love that is near you or calling you, you just lost the motivation. You want everything to end. I won't talk about my life today. Like I said, I am 29, still stuck with that. I kind of let go for some years. I am just tired to the point of not even searching or trying again. I tried meditation, it helped a little, but there are scars in a time that should have been dreams and joy, that are just there. I look to the future, try to forget the past, not that easy since its what you know about the world and life. You only know bad days and bad weeks. Its make you something, construct you're identity.
I tried to just let it go. Sometimes I remember when I was a happy kid, than I this blackout came out. Pain can change someone.

What is hard, is that I really felt I couldn't do anything. I changed my mindset and my behavior. I became very open, funny and gentle with everyone. But being in this world of competition, greed and narcissism, I saw I didn't have my place and I was more annoying than anything else. Indifference mostly was the general feeling. You can be the most honest, loyal, and nice person in the world, if the girl you are interest in doesn't feel anything (and there are ten guys with a white no red and beautiful face around you), even charm and seduction has no power over this condition. Now, at least being a very cultural and thinker guy (I read a lot in these twelve years, write and became good at conversations and philosophy), I can have some good relations with wiser and interesting people, but that's it. Its just temporary friendship. I really miss good times that I never get or relations that were never possible. And I don't lie. I cannot invent a life that I didn't have or talking about relations or good moments that didn't happen. Again, you feel cheated but also, there is a shame about you that destroy you're confidence and fate about everything in this world. I will just say to find something that you love, that can become you're island. It could a project. And just let it go. Try a more Buddhist way of not feeling any ego or attachment to yourself. I know its hard, I could not do that until I became very free and more older. I know its impossible when you are young and everything around you is about the look. But try. I am focusing on being calm because hate, pain and anger destroyed too much. Thank you for this, I am happy to know I am not the only one and there are nice people here."

I replied: "What a very beautiful and touching post.. I can relate with so much you wrote and I think everyone here on this forum reading it will. I think a lot of people with rosacea go through the phases you described. I have the same, after almost 14 years with this horrible condition I also went through anger, desperation, anxiety, shutting off, trying out anything I could get my hands on, becoming indifferent to everything and anyone around me. The worst part for me is the total lack of control, the full impact rosacea has on every aspect of your life and the many things you miss out on and can no longer do because of it. This lifestyle doesn't match with my personality. I also agree that for some, focusing your attention on something you can still actually do and be good at, is one of the ways out of this dark place. It takes a lot of time. For me the first 7 or 8 years were absorbed by trying out creams, treatments, medications, laser/IPL, diets and just fretting about it constantly and finishing university. Only once I found some sort of control back with medication, I could build up some small things that give some meaning and structure again to life, like going for walks when its cloudy and cool or late in the day, picking up work you can do within the rosacea restrictions, patching up friendships again with those considerate and caring about you (generally the long term friends) and stuff like that. First thing should be to find a good doctor and start trying out treatment options step by step. My life is still ruled by rosacea, but I take advantage of the good periods and go out and do things I enjoy then, and I accept the bad periods. It gives a lot more sense of calm and control. Good luck"

The notable English essayist, wit and clergyman, Sydney Smith (1771-1845) wrote in 1820, on learning that his good friend, Lady Georgiana Morpeth, was suffering from a bout of depression, advice for tackling it. His letter lists 20 wise, practical 'prescriptions' — all of which are relevant today. He explains: 'Nobody has suffered more from low spirits than I have — so I feel for you.' 

Foston, Feb. 16th, 1820, Dear Lady Georgiana,

Nobody has suffered more from low spirits than I have done—so I feel for you.

1st. Live as well as you dare.
2nd. Go into the shower-bath with a small quantity of water at a temperature low enough to give you a slight sensation of cold, 75° or 80°.
3rd. Amusing books.
4th. Short views of human life—not further than dinner or tea.
5th. Be as busy as you can.
6th. See as much as you can of those friends who respect and like you.
7th. And of those acquaintances who amuse you.
8th. Make no secret of low spirits to your friends, but talk of them freely—they are always worse for dignified concealment.
9th. Attend to the effects tea and coffee produce upon you.
10th. Compare your lot with that of other people.
11th. Don't expect too much from human life—a sorry business at the best.
12th. Avoid poetry, dramatic representations (except comedy), music, serious novels, melancholy sentimental people, and every thing likely to excite feeling or emotion not ending in active benevolence.
13th. Do good, and endeavour to please everybody of every degree.
14th. Be as much as you can in the open air without fatigue.
15th. Make the room where you commonly sit, gay and pleasant.
16th. Struggle by little and little against idleness.
17th. Don't be too severe upon yourself, or underrate yourself, but do yourself justice.
18th. Keep good blazing fires.
19th. Be firm and constant in the exercise of rational religion.
20th. Believe me, dear Georgiana, your devoted servant, Sydney Smith

How sensible of him to suggest to the depressed Georgiana to spend time with 'friends who respect and like you'. To read 'amusing books' and avoid things that are likely to bring the spirits down. In other words, folks — ditch toxic people, depressing TV and stay off Twitter! When he advises 'short views of human life — no further than dinner or tea', he's tapping into that universal wisdom (from Buddhism to Mindfulness) which advocates living in the present. I like this: 'Don't expect too much of human life, a sorry business at the best' — because it's healthy to accept the shortcomings and disappointments we may experience, and to be realistic about what we can hope for. At the same time, he advocates fresh air, 'good blazing fires' (NOT advisable for rosacea patients!), making your sitting room 'gay and pleasant', avoiding laziness, keeping busy. Here are my favourites: 'Make no secret of low spirits to your friends, but talk of them freely — they are the worst for dignified concealment.' (Don't bottle it all up!) Then, for essential self-worth: 'Don't be too severe upon yourself, or underrate yourself, but do yourself justice.' He suggests comparing 'your lot with other people' —not to envy but because you may think yourself lucky in comparison (I keep creepy files with photos of some young people who died and whoms cases were mentioned in the media.... for when I am particularly somber and sorry for myself: see you stupid, you could be worse off, you are still existing at the moment, see that as an opportunity, you can be dead for eternity to come). And his first: 'Live as well as you dare.' 

“Though antidepressants are effective at managing negative emotions, they don’t in themselves provide the sense of meaning and direction that a person equally needs in order to find her way in life.”

Update September 29th, 2017

I have felt some deep sadness and melancholia this week, after one of my friends took his own life. He had rosacea. We'd developed a friendship over it for years. Shared tips, ideas, fears, dreams and mostly we met up regularly online to watch tv series and movies we loved together. Then dissect things with our analyses. Let it stream over in our own thoughts about life. It is surprising how attached you can become to another this way. After last years death of my friend David, this death now is haunting me even more, because of the nature of our contact and the nature of his death. I also feel that I have nobody to share my grief with. Because male friends aren't interested in talking about another man for more than 2 minutes, and the women in my life didn't know him, and assume he was just like the many highly talented but over-sensitive artist types who simply had enough of the strains of life. I don't think he was typical like that, and I find the abrupt tearing away of him very hard. This has hit me like an earthquake. There is a sense of shock, disbelief, deep sadness but also betrayal. That he could leave me with a normal sounding message; it even had a smiley. Business as usual. I feel guilt also; why did I check in half an hour before he sent it, but not half an hour afterwards? Why wasn't I online to talk? Asleep, while on the other side of the world he..  There is something fundamentally different I find about mourning someone who died through illness, accident or through own doing..  I'm also experiencing the child-like pain from sending off more chat massages, but no longer receiving a notification that he saw it. I am still sending some messages now and then... As if through some magic realism, a miniature picture of him will light up, telling me he read it. Despite it all. I just cannot yet get used to not catching up like that.

There is something very obsessive about death in general I found.  For me at least. I had it happen before, in 2004 when my sister died, and last year when my friend David died. Everything these people wrote me, sent me, gave me, becomes heavy with meaning and emotion suddenly. I am reading things back and come short to slapping myself while reading over some parts, because only now I see how many pressing things he brought up, between the lines, which got buried under an avalanche of chats, ideas, links. How my cheerful mood and attempts at banter might have been enjoyable, but how they also overshadowed the serious notes that were added by him. I see them now, much more clearly. Because of the time difference -if we talked it was usually well after midnight for me, when our movie or series had finished - it was sometimes hard to be 100% sharp and awake for me, given my own packed week during the day. It was clearly worth the lack of sleep, or I'd not have persisted with it. But still. I am in heavy guilt mode at the moment. I have to think of some Hemingway books I've been reading. In his Banal Story he talks about all the romance that is going on, right now. So many people at this very moment somewhere in the world are meeting for the first time, having their first pizza, maybe enjoying the last meal of their life. Knowing sometimes that it is their last, and thus savoring every bite. People are seeing new cities for the first time, enjoying conversations with friends, riding bikes, climbing mountains, laying on the beach. So much is happening that is wonderful at this very moment. Hemingway took a moment to be aware of this. It's almost Stoic in a way; relishing your daily experiences like they are the last time you will have them. Something that will also create a sense of appreciation.

I am not spiritual, nor religious, but still think it is a huge theme, especially in today's society; to be mindful, to have concentration, to give things the attention they deserve. Yet, I failed here. I am feeling it deeply now, while reading back the many convo's with my friend and I can literally see where I was distracted, where I was fast forwarding, where I was multitasking and where I jumped over attempts to bring up certain personal subjects. Not out of disinterest, far from it, but by being just too tired, having a racing mind because of all those other pressing things, wearing me down and tired. Since having chronic health issues, my battery is low fairly quickly in general. But sometimes, you cannot undo things. You cannot do them over, as I always assume. I can always make up for things if I want to. Unless time passes you by.. I think it is actually better to have a limited amount of friends who you can forge a deeper connection with, than the multitude of shallow friends we build up. But even with them, modern time makes most people jittery, on edge, "triggered" (ohh what a terrible Millennial's word) by the ongoing pings and pongs from their smartphones. We're all so damn important, in our own bubbles. We can learn a thing or two from how things used to be, in that respect.

I will keep my friends name private, so that I can write some things about him. The pictures of him were sent to me by him, and aren't 'googleable', from what I have found. I cannot handle disappearance well. Things need to be documented, in my life and world. he has his academic writings out there, but they are cold and clinical. Interesting, sure, but I got to know him personally. I want to write something about him here. He is Romanian but had studied on a scholarship in the USA and just finished his promotion writing, PhD., successfully. He had worked so hard for it. Was given a good teaching job at a university. We had to screw the tv series watchings back the past months, he was drilled to work 16 hours a day. I had no issues with this, sometimes working life takes over for a bit, but surely things would get easier soon and he'd have more free time again. Surely? I still received updates and pictures, but he seemed more strained. Less boisterous. I tried to not take it personal and do my usual thing, taking distance. For some reason I am good and prone to do that, probably out of a deep fear of being rejected or something like that. Or just wanting to be one of the guys, no-drama, easy coming easy going. Now I seriously worry that I gave off the wrong vibe. That he took it as disinterest. The whole thing is making me tearful.

Reading back, the moments I actually expressed anything close to actual affection are few and far between. They were there, I am just such a rational being that I cannot even imagine that anyone would want to hear them. Yet I received them from him, signs of appreciation. I regret not shouting out NO you are not a loser. No, you're not insignificant, and not unattractive either, and not high maintenance, and not doomed for failure, and not irrevocably damaged. When you talk like a bunch of academics as we tended to do, with some political incorrect digs here and there, the switch to vulnerable is a very big one I suppose. Now I regret things and I break my mind over what happened and what he must have struggled with, unbeknownst to me. What sort of a friend does not pick up on that?? Especially since he said he didn't open up to most people.

It reminded me of a movie by I think Almodovar, Julieta it's called, and this woman sits in the train one day, and a man tries to start a conversation with her. And she isn't interested. She brushes him off a bit. Then a little bit later, the train makes an emergency break and the conductor says that someone jumped in front of the train. Turned out to be that man. And she gets emotionally hit by it, starts to imagine that this man just wanted a friendly word, a human touch and that she denied him that and was directly responsible... I think these emotions are very natural, albeit warped. I like to dwell on things to this point too. What makes matters worse is that he and I were deep into analyses of stories. We'd dissect plot lines, motives, symbolism. About Fargo (we watched all three series the past half year and absolutely loved them, 4 or 5 episodes a week often, he said he liked this deal, that it kept something regular in his life while finishing his dissertation) he'd say for instance: "I like the series because instead of gathering all threads together at the same time and unleashing hell, somehow it develops stories sequentially and leaves space for each character to do their best. Separately, unhindered." he'd make brilliant connections, reducing series 3 of Fargo into being one big Reagan metaphor. Money is now to be made in economics, no longer in crime; the consolidation of businesses and human spirit. Mergers and takeovers are hard, bloody work. Regular people will pay the price, butcher shops will close. But the rewards, for a few anyway, will be too many to count. For the rest of us, including Mike Milligan, the "warm champagne of corporate praise" is nothing more than a mid-level desk job and a 401k.

He also liked 80's movies, with their naive inspirational films such as Top Gun, or Cocktail or even some 80's romantic movies ("I love melodrama!"). Movies without irony but full of optimism and vitality. Films in which effort is rewarded in full. No wounds, no antiheroes. He would sell them to me with the promise: "If we soon discover we can't stomach it, and that we're too far away from childhood, and that we're too corrupted by life / enriched by culture, then we give up. But what I'm saying is to just give it a try."

He would say about America: "It's interesting; in the US it's actually the rich who don't care about style, unless they are very rich or in some art industry. Yes, it was confusing at first, all those guys have gigantic annual incomes and some of them serious studies. I used to bring American professors in Bucharest for summer schools; with a good sponsorship I was able to bring the very big names. They only wore loose worn out blue jeans and one dollar fifty ridiculous caps. I think one root is the class system. In Europe clothes used to have a signaling function. They signaled status; for centuries each social group was bound by law to dress in a certain way. Americans never cared about this, plus there is Protestantism. Quite frankly, since I am in the US I mostly only wear training trousers, but in Romania if I don't dress nicely, and walk the streets after dark, I get stopped by the police mostly." [..] "XX Univ. has 40,000 students, roughly half girls and it's been a while since I have seen one in a dress :)) Only training trousers, shorts, or jeans. However, compared to Europe, they actually smile at you - they are not afraid. It's a safe place, America. They are also super vocal and friendly, very expressive and extrovert and they speak loud as hell. Obedient to the system... not so much the husband. And robotically hard working. That's confusing with them. Exuberance which last 5 seconds and then they look away and leave."

His rosacea was the last year mainly revolving around his nose flushing. His face had become fairly pale after IPL treatments and also after using roaccutane, although he felt it would still swell, when triggered. But his nose would turn very red and burn and swell due to a lot of triggers. His teaching also caused nose flushing (indoor temperatures, the act of standing in front of a class), and this was a problem for him, understandably. He would take several herbal and vitamin supplements, but after asking me about it he brought things back to a more simple approach: "If I were to draw a line below what you said and write a one sentence summary, I would formulate it as "more caution, and less supplements" or something like that. I use to gobble up turmeric like crazy. I'll stop for a while and see how it goes." He was actively searching for better treatments. He wanted to have laser treatments on his nose but also experimented with (fairly limiting) diets. Raw vegetables, fish, seeds, fruits. "Dedication is part of the explanation but I think I do this also because I stopped caring. If can't have the food I want, whatever foods are left for me taste the same, raw or cooked. And then, why bother cooking." He had inherited the rosacea from his father. His father had always been red, but back in Romania, where he came from, nobody cared. At least, nobody cared enough to call that a condition that needs treatment. He regretted not knowing sooner about rosacea, because then he could he prevented it from deteriorating. he wouldn't have spent that much time in the sun, or chosen to build a life on adrenaline (which read "stress"), he would say. He had always been slightly more red than other people, but he never cared until a year or two ago, when on top of the redness he started noticing rashes on his cheeks, felt his skin burning, and was told he had rosacea. The disease progressed fast, and he said he didn't adjust accordingly. Continued to have his usual 'one meal per day, all I can eat', which lasted 2 hours, in front of the computer. Eating histamine-rich or niacine-high foods like nuts and seeds. Not knowing that in his personal case, they made his flushing worse.

The rashes were never a problem he said. Soolantra got rid of those for him. But by wintertime his facial skin started to show edema, and his nose started to play up. Rhinophyma kicked off. He tried oral antibiotics, but they weren't able to do much. IPL treatments later did help, but treating the nose with IPL is very difficult. It stayed red. Nothing seemed to control the swelling. By this time he started to discover that his eating habits plus what he called a life built on adrenaline, were probably the main culprits. He found these triggers extremely hard to control. He found support in his Christian beliefs. Isotretinoin (roaccutane) also helped control the redness and edema further. However, the rhinophyma continued to be a problem. Both the flushing and burning of his nose, but also the overall shape of his nose had changed, he said. It was triggered daily by usual rosacea triggers we mostly all encounter. But with a big intensity. Even small variation in mood could flare his nose to be red and painful.

He had some lost loves and he considered America another lost love: 

"I fell in love with America on two channels. Firstly because of its freedom. I grew up in a post-communist country where totalitarianism was grafted on a thick historical layer of patriarchal, primitive traditionalism. The anti-communist revolution occurred when I was 10. Things moved fast. My father brought a video tape player. A cheap video tape rental place was around the corner to my block. Video recorders showed America. At 21 I became a libertarian studying political philosophy and some economic theory with a celebrated and regretted professor in Bucharest. I made this into a profession and realized that America and its freedom are fragile like a puny flower in the way of the political steamroller. Glorious and fragile. Something worthy to live for, and live in, like you said, "be in America with America". Migration to America was extremely difficult. Coming to the US was possible only with studies. By the time I finishing undergrad I had been already for many years in a relationship and in love with a girl who wasn't quite motivated to leave to the US. That kept me back. I also had to work, so I couldn't study properly for a GRE that required a level of math of which I could not even dream. I literally was stumbling on the multiplication table. So my attempt at coming here failed. I made a compromise between leaving and staying - moved to Budapest for PhD. Far enough to be gone, close enough to continue being with the girl. By the time I finished that program and went back to Bucharest, everything was crumbling." 

"Once I got here, I was alone, with a PhD program so tough for me that i had no time to undress when going to sleep, and in the "city" of XX, so rural that I was looking at foxes and deer out my back window. And I was also getting old. In short, the dream had broke in pieces. By my second year I reverted to Christianity. And recognized "America" as my idol. Denounced it, renounced it etc. I will finish the program soon, but what is now left of America from that broken piece is taken by - boom - rosacea, now a year old affliction that keeps me indoors and does to us the many things you know it does. Besides, I feel too old and defeated for dreams, too old for being anywhere, and that includes America. I think I lost the last pieces of America to rosacea. Superficially, yes, I'll finish this program and stay here. This year I'll be on what they call the job market. When I got here I bought a thick book called America. Put it off until I'm free to read it and LIVE it. I feel that book is useless now. But the story of Frank's America is greater than my story of America."

Rosacea played a huge role in his life. I think it's only people like us who have this condition, who can understand how it can ruin even the best seeming lives. Especially when your face burns and flares at the slightest trigger.
"Rosacea, yes, it is a nail in the coffin. Otherwise the rest of my body is fine, craving to exercise like it used to etc. Memphis, Yosemite... sure, I've dreamed about all of these. Even with rosacea, I guess a hands-off, few hours guarded trip in early autumn is still feasible. And worth the price, especially if I won't have a family of my own. You seem to be travelling a lot. How does your rosacea cope with that? (I visited my parents in Romania last year and it was a nightmare, all I remember I did was to confuse and frustrate all around me by constantly refusing their propositions to go out and to try out foods.)

Teaching was his dream job. It's what he came there for. But rosacea took away his stamina he said,  his intensity and motivation he thought he would... radiate. Rosacea emptied the teacher's role of its vitality, he said: 

"I wanted to live Americas all at once. And I think it is possible, if you're healthy. And if you have sufficiently diverse friends and acquaintances. But these can be acquired easily if you're healthy. What is likely to happen though is that I get a job in a small American township, and do round trips to school and back three times a week as a college professor. But that's not the America I wanted, simply because, as you observed, it is not the whole America."

To me it seemed that his rosacea and perhaps also his doom (or let's say; all or nothing) approach was keeping him from properly emerging into that 'American culture'. Which seems to me a mix-match of immigrants, extremes, rich versus poor, cities versus nature, rednecks versus vast suburbans and then some intellectuals (like in any country more or less). I got the feeling from him that he came to America with high hopes, but turned demoralized. Relationships ended, health deteriorated. He felt a passive observer, being tied down by rosacea as so many of us are; triggered by the heat, the sun, by alcohol, by passionate everythings. Whereas he wanted to experience America first hand. To me the sense of freedom that is attached to the USA seemed to be more about the vastness of the land and the amount of nature, and not so much about the actual life there. The American people I know look at their own country very differently from me with my European pair of glasses on. More darkly, more critical, lamenting the streams of commercialism and consumerism, the cheap media, the 1% owning most, the corruption and manipulation, the flashiness. But I'm sure it totally depends on our surroundings; living in some quaint part of New York or San Francisco will be entirely different from living in the Detroit ghetto suburbs. I'm not buying the American dream much personally, it has no flashing effect on me. To me, America seems a highly conflicted and struggling country, but of course I would love to make a road-trip and see Tennessee and Texas and Yosemite park and all those wonderful stops along the way. And I come from a wealthy, super highly organized country, not from a former communist country, and I understand that Romania is still pretty poor to EU standards, it must be a different sensation of freedom than for someone from the Netherlands. Where it's all about progressiveness and freedom, just packed into a tiny bit of land with 17 mln inhabitants and no natural wonders whatsoever. My father wants nothing more than to make a road trip through the States before he dies. I like to join him of course, I know I loved New York with its endless energy and aesthetic appeal, and I am sure that the Midwest, the deserts, the plains of Wyoming, the Minnesotan winters, are all fantastic to experience some time. But living there, I have zero idealization that it is intrinsically any different from living in the Netherlands. Or France. Life can be deducted on a daily basis to very basal stuff.  But he was afraid that things would fall apart if he was not extra-careful and continued to work with great discipline after getting into the US. And that apocalyptic fear became a reality too for him, in some respect, as the person he came to the States with, had to go back to Romania. In that sense history and the dream ended.

"The second reason why I fell in love with America is because of its rawness, massiveness of civilization but also its desert and landscapes. This is what Robert Frank seems to capture [we had discussed his pictures of America, made during his road trip in the 50's, after I worked on a text on Frank for work], and probably what the Beat generation covered too, although I did not allow myself to read them yet. Why not? For the same reason: Why allow myself to go in so much depth when that depth is forbidden to me? I definitely don't want to be an admirer - an external observer. I wanted to be in the heart of things. And if not - put it off. Put love and interest off until SHE, America is interested in me."

The tragic bit is that America wás interested in him. He had a solid job, after years of studying and writing. He had achieved his dream, in a way. But his health condition was lifting along too. Uninvitedly. And a month after achieving it, and enrolling in the daily grittiness of this American life, he signed off.

"But mostly, it's my personality. When I start something I find it hard to stop. But life forces you to stop. And then, the half unfinished project persists in your soul. As time passes the mind becomes populated mostly by such resilient ruins. Since they are so many, solid and diverse, that their matter cannot be recouped, converted, reshaped or reborn into a new integrative project as they would in a more lively ecology. Then, you either freeze life and become a ruin haunting your ghosts, or you run the whole area with a giant bulldozer like religion to level it and cleanse the soul. Or is it that I lack the imagination to find a place for them into a new earthly puzzle? Perhaps. But for now the bulldozer satisfies me, gives me sleep at night... But... i think you are right that at some point life might creep back. When I go to Baltimore for a concert , and I see young colorful people and blocks of flats rather than suburbs and townhouses, I feel alive."

So now I am sad. I got to know this man and his fears and dreams, we had some serious talks as represented here, but most of the time we simply has banter and fun, reviewings things we watched, bashing things that happened in our lives. He was mostly lighthearted, maybe because of my approach, maybe not, I do not know. The only change came the past month or two. He had trips, he had his teaching job now, he was severely pushed. He sent me messages of staff, the way he was pushed to perform and I accepted that our days of night series watchings were over for now. And I'd not been responding as much the past months either, as I was busy with work, health flares and things as usual and respected his space. I missed some rare movie watching dates; it was summer, I was travelling myself, we had lost our strict habits. I apologized, he apologized when he couldn't make it yet another time. He started to sound very tired. And to make matters worse, I missed his last messages. I also missed some social media comments from him about not doing well.. Only read them later. Made me feel very sad afterwards. Like I failed. And now it is a full stop. It's really haunting me. I read things back and see hints and double messages everywhere suddenly. Selfies he sent that now look macabre suddenly instead of goofy. Photo's from a blue sky seen from his roof window. A Dead End road sign he pictured. And I keep wondering; what if I just had been online that night and responded. I realize that some people are hard wired for depression, that some things cannot be prevented. That I cannot make my own importance any bigger than it should be, which is probably very small in this whole story.

It's the same sort of guilt I had over my sisters death, all over again. I missed signs there too and let her talk me out of bringing her to hospital with her suspected "heavy flu" (was appendicitis). He also knew about Davids death last year, a person fairly similar to him in many respects. How could he do this. When I talked with a female friend about it, as well as with my mother, they both were quick to shake me out of my self-centeredness; people do not take their life because you (me) were online half an hour too late. They don't do such a thing because you failed to emphasize how much you appreciated him being in your life. It's fascinating why we even take on blame in such situations... I had to read about this. This triggers my obsessive side big time. I've been reading about it most nights of the week actually. As if reading about suicide, the technicalities, somehow brings you closer to the person. I'm starting to feel like some pathologist now. Reading accounts from people who tried and failed and how they experienced the act and also the leading up to such a thing. It's graphic but I like to really go deep in, and somehow I feel better at the end of the tunnel. Like piecing back a puzzle. My own interpretation of that puzzle, of course. And of course I don't know this person from living day to day together either. I only know what this person chose to tell me.

Yet, his death reminds me of another death, and another, and I was wondering the other day if this is what adulthood is like. Deaths and deaths reminding us of other deaths and other people that left their marks. Years being tied now to 'The Year that X Died'. It is like a single wave that impacts so many lives, in his case across continents. Yet another person joined the club of brilliant people who will never age, who will always stay thirty-something, forever. A friend comforted me by saying that most humans go through a challenging despair in their lives, and must decide how to cope with it. If we begin with the premise that we don't deserve " this", whatever this is; or we deserve happiness; or that suffering is intolerable and we should not be included in that world; or worse, that we deserve to be a part of the world of life that is Happy, then we suffer great delusion and we are bound for death spiritually or physically or both. God or no God. Life isn't fair because it was not designed to be fair. It was not designed to be happy. It was designed for life. Life to be lived, on life's terms. She thinks that life is about suffering and challenges and pain and hardship, and that the choices you make with that will give you great joy or unbearable sorrow. Life does not guarantee you a damn thing. "What a wealth of humanity you have encountered. Virtual as it may be!"

I'll finish with a few Bukowski quotes: 
“Some people never go crazy. What truly horrible lives they must lead.”

“I've never been lonely. I've been in a room -- I've felt suicidal. I've been depressed. I've felt awful -- awful beyond all -- but I never felt that one other person could enter that room and cure what was bothering me...or that any number of people could enter that room. In other words, loneliness is something I've never been bothered with because I've always had this terrible itch for solitude. It's being at a party, or at a stadium full of people cheering for something, that I might feel loneliness. I'll quote Ibsen, "The strongest men are the most alone." I've never thought, "Well, some beautiful blonde will come in here and give me a fuck-job, rub my balls, and I'll feel good." No, that won't help. You know the typical crowd, "Wow, it's Friday night, what are you going to do? Just sit there?" Well, yeah. Because there's nothing out there. It's stupidity. Stupid people mingling with stupid people. Let them stupidify themselves. I've never been bothered with the need to rush out into the night. I hid in bars, because I didn't want to hide in factories. That's all. Sorry for all the millions, but I've never been lonely. I like myself. I'm the best form of entertainment I have. Let's drink more wine!”

“For those who believe in God, most of the big questions are answered. But for those of us who can't readily accept the God formula, the big answers don't remain stone-written. We adjust to new conditions and discoveries. We are pliable. Love need not be a command nor faith a dictum. I am my own god. We are here to unlearn the teachings of the church, state, and our educational system. We are here to drink beer. We are here to kill war. We are here to laugh at the odds and live our lives so well that Death will tremble to take us.”

May 29th 2018

The ex girlfriend of my Romanian friend who took his life last year, has followed his path. I look through her photos, many beautiful ones, and in every 'previous post' I click on, she becomes younger and moves further away from that fateful day. Her texts were amazing and poetic. She befriended me after his death and I bit my tongue and made fists of my hands, avoiding to bring up the things he told me about their relationship, which was already in the past then. I did not want her to hear about it, knowing in what mysterious ways the death can move in our minds. I did not want to create another  phantom there. It was all water under the bridge anyway. Now I am inexplicably sad about the departure of someone I hardly knew. Only by association. Two extraordinary, different and talented people, glamorous beyond belief, so young, both gone, I am lingering in the sheer tragedy of it. And feeling the pain which she must have left behind, the pain of her loved ones, her fiance, parents.. I know first hand what the loss of a child and a partner does to people, and when it is a self chosen one, the pain must be even deeper. I stood myself on the edge of a building too, no that is not true, at the foot of the building. The high rising flat where my sister was supposed to go and live, if she had not died unexpectedly and tragically of a missed appendicitis. The guilt almost too hard to bear, and that year my rosacea was all consuming, burning me up without respite. I could not even go to the shop without being stared at and asked if a doctor should be called, as people were fearing I had a heart problem, I was that red. Hope is the last one to flee, but fled it had. As Emily Brontë said it; hope was but a timid friend, watching how my fate would tend. She was cruel in her fear; through the bars one dreary day, I looked out to see her there, and she turned her face away! She would sing while I was weeping; if I listened, she would cease. Hope, whose whisper would have given balm to all my frenzied pain, stretched her wings, and soared to heaven, went, and ne’er returned again!

Luckily in my case there was still some hope. Medication later would make me in less pain, less flushed and gave me more hope. I also kept being reminded that life is not supposed to be happiness and fun and sparkles every day. That this is a social construct of these times. But that our grandparents would have been through both great wars, and were content just to have bread on the table. That I should radically screw down my expectations of life, yet keep hope for improvement. I am glad that I turned around that fateful day, afraid of the shadow of the flat. Life did become a lot better soon after. Although I still suffer from depressions. I don't find life all that great often, despite having a lot to be happy with. But sometimes it is also a state of mind, something inherited, something hard to shake off. I loath the ways in which my face still hurts, throbs, demands from me to live like a vampire, to be stuck at a desk with a fan so often. I am sad about not having children. I could have had them, or one, probably, but it hasn't been easy in the past. And I struggle too much with day to day life and don't want to pass this shit on. I was scolded once by a man in one of the rosacea facebook groups, for speaking out about this. He is an unpleasant figure anyway, but added insult to injury by calling me 'disgusting' for uttering this opinion. As if my own choices were supposed to brand and judge all the other parents with rosacea out there. Which is of course ludicrous. So many people, so many rosacea cases, so many different symptoms and severities and so many different attitudes and opinions. I struggle with it and doubt my own decision many times a week. I just can't be sure that if this flushing and burning problem gets any worse than this, that I won't look for that flat again. It seems self destructive therefore. Too big a risk, given that I've pretty much exhausted all treatment options as it stands now, and I am photosensitive and not a good candidate for IPL and laser. It can be hard to find purpose and meaning and satisfaction in life now, but I have my ways. Reading, writing, some friendships, family, my cats, connecting with nature, walks, gardening, avoiding social media where possible :)

Albert Camus: "Life continues, and some mornings, weary of the noise, discouraged by the prospect of the interminable work to keep after, sickened also by the madness of the world that leaps at you from the newspaper, finally convinced that I will not be equal to it and that I will disappoint everyone—all I want to do is sit down and wait for evening. This is what I feel like, and sometimes I yield to it."

You can read her blog here. It goes many many years back and is both beautiful and poetic. This is a beautiful homage to her, written by a friend, an ode to people who dare to be different and to the fragility this brings 

Some words from Raluca:

"I’ve learned dysfunctionality from Amanda Palmer. I’m not sure it was running through my veins before our encounter. I was giving up pink cotton T-shirts and washed out jeans when she came yelling and showing off her long wide teeth, stained with some red lipstick from the night before. It was summer and I was waiting for a boy, we always wait for boys at the corners of our lives, and sleeping with the telephone next to my bed. His call would wake me up and I would listen to Amanda. Then somehow everything fell apart and I would trade love songs for bitter refrains. I liked Amanda from the start because her music would always tell a side story about worst case scenarios, like always keeping a suitcase half ready beneath all the beds you happen to sleep in.

I’ve learned dysfunctionality  from the best. There were so many people all around me, dancing and screaming and laughing and drinking and showing off their scars and crying their hearts out. There were other people watching them with contempt sparkling in their opaque eyes, like veils of prejudice and lack of understanding. They still stand now watching silently, they haven’t learnt to talk yet, they drink only on special occasions and start to quietly sob, thinking of all the madness they’ve missed.

Dysfunctionality is only temporary, one should bear this in mind.
Dysfunctionality is never a destination but an honest starting point which helps you build yourself.
Dysfunctionality is when Amanda starts writing a song, with a horrible hangover , her make-up running all over her face. You have to stick with her, then you have to watch her sit at the piano and start turning everything into gold.

There were days when I wanted to paint my face white, there were so many days when I used to wear black and white striped knee-socks. There were days I didn’t want to live inside myself anymore, there were days when I wanted to live inside her songs but she would always kick me out. She would sing and I would know I’ve got to get out and get back inside myself where there’s all that gold and sweat and love and madness waiting to be explored."


Sleeping next to a white rabbit (source)

Ambivalence crawled into the wall of the bathroom as I crammed my body when I was sleeping. He put a blanket between me and the wall, between me and the world. She covered me and sang while I was asleep. Between us and the world lies a thin wall through which we hear the tireless voices as close as we close our eyes, and as closely as we hold our arms. That's why we put a soft blanket between us and the world. We hear nothing, and the cold comes only through cracks that we leave open. I fell asleep on the cat, kept his white fingers on his chest and snoring, just to remember in his sleep that he was not just a child.


I had to confess…I want people to see the insecurity, the constant gulping and all the rituals and my fear of shallowness. It’s not easy and I feel weak and numb and horrified when I sometimes peak and see the world of perfectfabricsperfectgirlsperfectpouts, but then I want to kneel , but then I just want to stare to wear to care.  I want everybody to see right through me. I’ve stopped hiding behind my clothes for some time now. I want everybody to look and smile, I want them to shine like the sun reflecting on my skin and skirt and then…the  dreadful afternoon, sitting on cold floors and not recognizing your own hands  or the way your nails are always growing. I want people to see the pure terror that sometimes paralyzes me, the Frank Booth in each of us, the Frank Booth standing at each corner of our lives, waiting  to be denied so he can burst into them with unfiltered rage. And then I want them to look the other way, but still knowing Frank Booth is underneath it all and see all the robins flying up in the sky. They’re be always eating bugs, that’s for sure.

—Sandy: I had a dream. In the dream, there was our world and the world was dark because there weren’t any robins, and the robins represented love. And for the longest time, there was just this darkness. And all of a sudden, thousands of robins were set free, and they flew down and brought this Blinding Light of Love. And it seemed like that love would be the only thing that would make any difference. And it did. So I guess it means there is trouble ’til the robins come.

—Jeffrey: You’re a neat girl.


—Sandy: Look. (She points toward the robin, as Jeffrey joins Aunt Barbara and Sandy.)

—Jeffrey: Yeah, I saw him outside. (smiling to Sandy) Maybe the robins are here.

—Aunt Barbara: I don’t see how they could do that. I could never eat a bug. (Ironically, she places a piece of beef into her mouth)

—Sandy (looking at Jeffrey and smiling): It’s a strange world, isn’t it? (Jeffrey nods in agreement.)

‘’The little robin (symbol of love and harmony here) eats a disgusting bug (a symbol of evil at the beginning of the film). No matter on which level of reality it is, what Sandy might have learnt about the world is that beauty and ugliness do not necessarily exclude each other.’’
(movie blue velvet)  (Source)

I have been writing as a penpal to a guy in prison in the US since 2010 and he wrote about this topic:

"Depression is a cold bitch. This may sound callous but I hope she weighted the pros and cons of her decision, and acted completely out of her free will. You must understand; I have been in prison for some time, and I'm not all that against suicide. I actually think about it at times, but my balance sheet is still skewed towards life. If I ever have more reasons to step out then I guess I may do it as well, and that has nothing to do with depression for me. Why every suicide is linked to depression I don't understand, because sometimes suicides are based on cold, calculating facts and personal choices."

July 5th 2014

Touching, this girl made photo's of herself for 6,5 years while battling deep depression. 

"There are days though, where I struggle to take photos, due to depression, suicidal periods or due to low self esteem caused by my marks and hair loss."

July 27th 2014

There is a song I heard a while ago. I think it reflects both in tune and lyrics the feelings many with a bad rosacea might have at times. I can float away on it. Thanks to my friend B. who also likes to listen and discuss music with me and we came to the conclusion that this song would be a pretty good fit for a piece of art we both love, the crows in the field by Van Gogh. The melody is haunting to us but beautiful at the same time, and we like the ongoing bass/guitar melody, like some funeral tune, in the background and it all floats like some horrible nightmare.  

Rows of houses, all bearing down on me
I can feel their blue hands touching me
All these things into position
All these things we'll one day swallow whole
And fade out again and fade out

This machine will, will not communicate
These thoughts and the strain I am under
Be a world child, form a circle
Before we all go under
And fade out again and fade out again

Cracked eggs, dead birds
Scream as they fight for life
I can feel death, can see its beady eyes
All these things into position
All these things we'll one day swallow whole
And fade out again and fade out again

Immerse your soul in love

And some other songs that always fit well with my darker moody days:


And then to cheer you up again :)


8 October 2013

Article on anxiety induced skin problems and burning:

Anxiety That Provokes Burning Skin

Scientists are only now starting to understand the way the mind affects the body. Many of those that suffer from serious anxiety and anxiety attacks experience a burning sensation – a feeling of burning skin that can be frightening. That burning sensation really can be a symptom of anxiety. It may occur with or without an anxiety attack, and it may even be associated with skin flare ups.

Causes of Burning Sensations in Skin

When you experience anxiety, your body is in fight or flight mode. That causes a rush of adrenaline as your body prepares for "action." Adrenaline affects people in different ways. Some people experience more of a weakness or a tingling. Others experience a burning sensation all throughout their body. This is your entire body responding to the increase in energy. It's a normal part of anxiety attacks, and may occur even when no attack is present.

Burning on Areas of the Skin and Skin

Anxiety also causes the skin to be more sensitive. Because the skin is sensitive, it may be prone to skin reactions with no discernible cause that lead to issues like itching and rash. Anxiety also creates a great deal of stress, and stress can trigger skin disorders that were already present, such as eczema, herpes, and psoriasis. These skin disorders may cause a burning feeling. In these causes, anxiety would not have caused these skin disorders, but may contribute to them.

How to Stop the Burning

You can't turn off your adrenaline. If you're in the middle of an anxiety attack and it's causing your skin to burn, you need to wait it out. But you can control your anxiety. The best way is with prevention – using anxiety reduction techniques to keep your anxiety and anxiety attacks from occurring, and the burning feeling will go away. Also, while you're suffering from anxiety, use traditional relaxation techniques to calm yourself down. Deep breathing and visualization are both very effective, and can keep your anxiety from becoming too stressful.

And there has been written a good article in the RRDI website about rosacea and its psychological impact:

Rosacea And Psychology

RosaQoL is one of the first QoL reports on rosacea. One report done in 2002 on this subject puts the matter clearly, "Dermatoses may have a significant impact on a patient's quality of life, namely the relationship to others, self-image and self-esteem.' The same report concluded, "Improvement of quality of life reached statistical significance among patients with acne (2.8 versus 7.8, p = 0.0078) and among individuals with a less severe initial impairment of quality of life (2.4 versus 4.2, p = 0.007)." It has been stated that in "some cases, rosacea patients are so psychologically disturbed that that they may be unable to form a therapeutic alliance with their dermatologist or other skin specialist. In such cases, psycho-tropic medication and/or psychological therapy are essential." Another source says, "The problem is that many dermatologists are operating in the dark when it comes to how badly rosacea might be impacting their patients' quality of life." However, another report says just the opposite, and states, "In treating patients with rosacea, we are well aware of the psychological effects of this disease, and the depression, anxiety and social isolation it can cause," but both reports substantiate the psychological factors. No one likes to think that rosacea is all in our mind, yet, there is evidence that at the very least your mind can aggravate this disease. Could rosacea have a psychological factor? One report says, "Recalcitrant dermatoses may be a manifestation of a symbolic transition object. Psychologically, the patient uses his skin eruption to assure himself that he is a separate person with his own boundaries." A whole field of medicine, psycho-dermatology or psycho-cutaneous medicine, addresses this aspect of rosacea and how experts in the field may be of help to some rosaceans. One article on the subject encourages health care practitioners to consider their role in the treatment of a skin disease saying, "Quoting W. Mitchell Sams, Jr., 'although the physician is a scientist and clinician, he or she is and must be something more. A doctor is a caretaker of the patient's person--a professional adviser, guiding the patient through some of life's most difficult journeys. Only the clergy share this responsibility with us.' This commitment is and must always be the guiding force in the provision of comprehensive and compatient patient care."  This is very important to a rosacean because if a physician is not trusted then this can have a detrimental effect on treatment. Note what this article pointed out: "If the dermatologist allows the contemptuous patient to use his disdain to discredit him, the patient loses, for he can no longer respect his doctor." If the physicians 'bed side manner' is not respected by the rosacea patient this can damage the treatment. Many rosaceans complain how physicians seem to have little compassion for their problem or little time to listen, moving quickly on to the next patient, sending a message of disinterest in the individual's feelings. Trusting your physician or treatment has a huge impact on whether the treatment works. When rosaceans find a treatment doesn't work and this happens over and over again, depression can set in and disappointment in a health care practioner, treatment or regimen can be affected. This can add stress to an already frustrating emotional mental state triggered by rosacea!

One study showed that "patients who were prescribed combination therapy had significantly greater improvement than those who were prescribed azelaic acid gel alone," which was a study designed "to examine both the short-term clinical efficacy and quality-of-life changes resulting from treatment of rosacea with regimens that reflect the participating physicians' standards of care while incorporating azelaic acid gel." Another psychological effect not to underestimate is the placebo effect, which has been researched extensively. One paper says, "Potential biological mechanisms for the placebo response are discussed, including the possibility of genetic predisposition to be a placebo responder." While this editorial doesn't go into the placebo effect, this often misunderstood mystery is worth mentioning here since it is a psychological factor in rosacea. More on the placebo effectPascoe's article on the Placebo Effect is worth reading. Several research papers conclude that emotional and psychological factors are involved in skin diseases. One report done in 2005 says: "CONCLUSIONS: (1) Patients with rosacea in the period before the occurring of first symptoms of the disease, comparatively with persons from the control group, they experienced the bigger number of critical life events. (2) The stress intensity resulting from the number of critical life events, is significantly higher at sick people in the relation to the control group. (3) At patients with rosacea emotions resulting of the estimation of the primary stressful situation tightening symptoms of the disease. (4) The subjective estimation of patients' health is essential predicate of psychodermatological therapy releasing potential health possibilities at the patient."Another report in 2005 about quality of life says, "Change in Investigator's Global Assessment score, measuring the severity of rosacea symptoms, from baseline to follow-up, and change in scores on the RosaQoL, a rosacea-related quality-of-life instrument with 4 component measures (Overall, Emotion, Symptom, and Function) completed by patients at both baseline and follow-up. RESULTS: Over the course of treatment, the mean Investigator's Global Assessment score dropped from 3.52 to 2.10 (P < .0001)." One report in 1986 on anxiety and skin problems said, "The test results proved a marked correlation between psychological factors and the activity of the adrenergic system. High level of activity, emotional unstableness, as well as tendencies to neurotic activities are connected with increased secretion of adrenaline and decreased secretion of noradrenaline++ and dopamine." 

The Mind-Skin Connection

Does stress cause your acne or rosacea to flare up? Or do you chew your nails to the quick? Experts say emotions can have an impact on your skin. (link)

Any time Amanda feels nervous, she breaks out all over her 13-year-old face. Jeremy often feels so sorry for himself that he has eczema that he shuts himself off from the world during bad flares. And the only way that Kim can stop her obsessive thoughts is by pulling out her hair. In these and many other ways, the mind and the skin are intimately intertwined. You name it: acne, eczema, hives, rosacea, psoriasis, alopecia (hair loss), vitiligo (depigmented white spots on the skin), richotillomania (hair pulling) and self-mutilation disorders, many skin disorders take their roots from or place their roots in the psyche. Experts are calling this new field "psychodermatology." "Psychodermatogy is a field that addresses the impact of an individual's emotion as it relates to the skin," says Karen Mallin, PsyD, an instructor in the departments of psychiatry & behavioral sciences and dermatology & cutaneous surgery of the University of Miami/Jackson Memorial Hospital in Miami. "I think [psychodermatology] is going to be growing by leaps and bounds [because] dermatology is ready for a more integrated approach with other fields such as psychology, psychiatry, and even complementary medicine," says Mallin, who recently completed a postdoctoral year in psychodermatology at the same hospital where she now works. Such an integrated approach allows for new treatment possibilities including antidepressants, relaxation therapy, or counseling that can alleviate the mood problems that result from or cause skin problems. [..] "The mind and skin are connected on many different levels," Mallin tells WebMD. "A lot of nerve endings are connected to the skin, which wraps around the organs, so as emotions are played out neurologically, they can be expressed through the skin just as stress can be expressed through gastrointestinal symptoms, increased anxiety, or hypertension." Take acne, for example. When you are tense, your body releases stress hormones including cortisol, which may increase the skin's oil production, making you prone to pimples.

And, Mallin says, "in some autoimmune diseases such as alopecia (hair loss) and vitiligo, scientists now show markers that a stressful event can trigger the autoimmune reaction. "If appearance is impacted due to a skin condition, you can end up having to deal with self-esteem issues and social stigma, which, if unaddressed, can lead to depression," Mallin says. "If they truly have depression or a diagnosed anxiety or psychological disorders, medication can be helpful and so can a brief course of cognitive behavioral therapy that works at changing reactions and behaviors," Mallin says.Relaxation training can help as well. [..] [During development in the womb], the brain and skin are derived from the same cells, so there is a connection," she says. "And the other immediate relationship is that when people experience stress in life, quite frequently, their skin becomes a reflection of the stresses."  

Song about hope


Below are some articles I gathered about people who suffered from physical pain and who could not go on with that pain. Not to bring anyone onto ideas of that sort, but more to underline how difficult it is to deal with chronic pain. 

If anything, I think people should find things to still enjoy, to hold onto, like loved ones, kids, pets, friends, work, talents, hobbies, music, movies, other things you still enjoy. And to realize that lifr is short and a drop on a hot plate in the big scheme of things, and that we should always try to hold on to it. To live it as it comes our way and to find the strength to deal with adversity. But these (by now) weekly or sometimes daily stories in the news of people taking their lives, show that we are not alone in our suffering. 

There was a story in the newspaper today of a woman committing suicide, after she had a simple mole removed from her face, and ever since had experienced burning pains. She wrote:

"Unfortunately I can no longer endure the physical pain of burning flesh in the face, neck and chest."

She blamed her surgeon for causing this. She had the procedure in November 2011. The article says that she had beforehand written to officials in the Swiss clinic Dignitas for help in ending her life. She complained of a 'regular stabbing pain' in her forehead and a face that was often red and painful. Her confidence had been left so damaged she said, that she was unable to leave the house. She also wrote to Dignitas: 

"I have had enough of this hell and it is time to move on. (..) Therefore instead of facing daunting future prospects fighting with the condition I have now made the most important end of life decision."

Her husband said: "Obviously the impact from the surgical procedure had a huge effect on her and she was only 44. She was getting the odd line or two here and there and she hated it. She was looking at her face every day. She would sit looking in the mirror for half an hour to an hour every single day. I believe the blame is down to the doctors and the clinic and I am going to pursue the clinic for my Victoria. I want justice for her. I'm not bothered about the money side, just as Victoria wasn't. She just wanted to make sure that nobody else suffered like she did. I'm sure if she had had a bit more care and aftercare she might still be here today. Before the procedure she was fine. She was such a bright, beautiful woman." He added: "It was only supposed to be a 25 minute procedure to remove a small mole on her forehead. During the operation she said there was a lot of blood pouring from her head. She didn't think it was normal. A few weeks after the procedure she realized she had been left with a scar. She wasn't happy at all. She presumed it would fade away in time but it didn't. She went back to the clinic to complaint to the doctor. Then the scar started healing, but she started suffering with pins and needles in her face a few weeks after the operation. She kept going back and they didn't want to know. To me I couldn't see much of the impact of the operation. You could see redness in her face sometimes. She said it was eased by a hot shower so she was always showering and putting creams on her face. She said she was in a lot of pain. She described it as a burning sensation on her face and neck and she would sit there with her head in her hands and her eyes closed.

"As time went on she became more and more determined to get back at the doctor. She would say "I'm oing to get that b******. He has wrecked my face." She didn't want other people to go through what she was going through. She was always writing letters to different solicitors. She wanted to sue on the grounds of medical negligence because she believed she had suffered nerve damage. It went on for over two years. She became very reclusive. She started reading the Bible a lot and wouldn't go out anywhere. She didn't want to see anyone. She never gave any other reason than her face and became a completely different person. Then she started talking about suicide. She would say "I've had enough, I can't cope anymore. I'm going to kill myself." I didn't know what I could do to help." A spokesman for Transform Clinic said: "The treatment we provided in November 2011 was of a high standard and this has since been corroborated by other independent medical professionals including her own GP. Following treatment, we had extensive correspondence with Mrs. Meppen-Walter. It was apparent her issues were deeper rooted than with the actual treatment and care we provided. patients concerns and after care are paramount to us and we are very saddened by this tragic news."

What a very sad story. Its impossible for the reader to determine how severe her facial pain really was. And how much of her distress was the result of the cosmetic side of it, and the lack of control. But this is how a lot of people with rosacea feel as well I think. In daily pain, with burning faces. It reminded me a lot of the reaction from the horrific and dreadful Dr. Mervyn Patterson from the Woodford Clinic in Danbury, UK. He used an old IPL machine on my face, absolutely ruined it and I am still, 8 years afterwards, a lot worse rosacea wise than I was prior. He ruined my life afterwards and was the most uncaring, rude person ever when confronted with what he did. I can't believe this crook was awarded Best Aesthetic Clinic of the Year... See video here. His wife even says in the thank you speech: "we have happy costumers and that's the way we like it to be." The irony. You can read more about his nightmare of a treatment and attitude here, in a previous post. Please people be careful when you do rosacea treatments involving laser and IPL.

Video's on Dr patterson: video 1, video 2. Lets hope he sticks with fillers and botox from now on and stays away from rosacea patients. Article; "I want the evil surgeons name on my headstone"

There is one report of a young man who committed suicide due to his not being able to deal with blushing. Vicky Norfolk threw herself off the Humber Bridge because of her rosacea. A report concluded, "In all groups of patients partial correlation between the examined determinants of psychological and subjective assessment of symptoms and effects of its treatment was shown. The higher rating of the variables was most associated with a higher intensity of stress and anxiety." I found this interesting quote which appeared in an article published in 1886;

"The depressing effect on the mind of the patients produced by the steadily lasting eruption, kept up by the thought that the disease was incurable, and thought upon by others as possibly venereal, has frequently been noticeable. I fully believe that patients with this disease suffer, in mind, at least as greatly as those afflicted with the most serious maladies, not even excepting smallpox. I have known patients to lock themselves from the gaze of the world for months, to forego all society pleasures, to become as treatment after treatment failed, as physician after physician gave up the case, utterly despondent of ever becoming rid of their tormenting malady."

A new subtype has developed called, Neurogenic Rosacea which is related to this subject. And: 
Anxiety structure and catecholamine parameters in patients with rosacea, alopecia areata and lichen ruber planus

This is an article about a young guy who took his life. His sister recalls how he was very distressed about thinking he was losing his hair (link). He seemingly had it all but had underlying mental struggles.

19 December 2013

Nick wrote on May 31st 2010: "It's only a matter of time before I kill myself, because of the way my life has turned out due my Rosacea. 

I Know I'm going to commit suicide over this...

MarkH replied: "Hey there mate. Iknow exactly how you feel. I to am 25years old and i've been suffering from rosacea since i was 15.When i was around 18 and all my friends were going to uni,i got really low and depressed as my rosacea held me back from going.There was atime when i thot ididn't want to live another 60 odd years if iknew id never be happy. I used to say id prefer to have cancer because at least u eitheir got treatment or you dont.It was the uncertainty of never knowing if id be cured that really annoyed me. But here i am 7years later and im certainly glad i never followed through on my thoughts.Im by no means as happy as icould be but im definetley 100times happier than i was.It is hard to stay positive but you just need to put more thought and effort into things. For instance on the days when my rosacea isn't as bad i just go out and do things.Go shopping and meet my friends.But then i might have afew bad days in arow and ill just watch afew films on dvd or play my xbox.The hardest thing is when your feeling ok and someone says something cruel and it puts you right back low again.Don't get me wrong i still get annoyed when drug ridden wasters walk past me with clear skin and i think how could people waste their life when id give anything to have normal skin but if ididn't have rosacea,id just have another dozen imperfections id hate like everyone has."

MissD gave the number of a suicide hotline and added: "Rosacea is nothing to kill yourself over."

There are many more replies from other forum members to be read here.

Portcharles wrote in 2007: "Rosacea is giving me thoughts of suicide? 

I have rosacea, had it all my young life, two months ago, i got a mild sunburn and now my face &cheeks and nose) are permanently red. I look like I have a sunburn and I have red lines. i am a 30 year old female. Divorced with no kids. I have not left my house in days..I can not even work. I have tried everything (antibiotics, creams nothing works....I feel like killing myself...my reflection is soooo ugly. I have lost sooo much weight because everything is a trigger...I have no friends only a mother who has lost hope on me.."

This is an article about Social Issues Related to Rosacea:
Some quotes:

"Although most governments regard rosacea and other skin disorders as mild ailments, there is credible evidence that this classification is wholly inappropriate. Contracting rosacea will have adverse effects on the life of the sufferer, and this is something that must be looked into. Rosacea should never be taken lightly because it can cause disability just like asthma, bronchitis and angina normally do. In addition, rosacea and other skin diseases can have significant effects on the family of the sufferer as well as on the career of such people. Although many people take this disease lightly, many sufferers have said that they suffered psychologically and were even isolated socially." "Another thing is that people affected by rosacea face the prospect of being discriminated against because of their appearance. This can in turn lead to such people withdrawing from social activities. For instance, they shy away from attending social gatherings such as parties, being photographed and are reluctant when it comes to meeting new people." "When it comes to career choice, rosacea sufferers are limited in terms of what career they can choose." "People suffering form rosacea are also at risk to develop other psychological problems, and these problems are likely to stay even after the situation has subsided." (Uhm... for most they don't subside). "Such people should be attended to by psycho dermatologists who can help them to erase the effects of scars left by rosacea." "According to American Academy of Dermatology, one of the main results of rosacea and other skin disorders is major depression. People with this skin disease tend to think of suicide as a means to ending their suffering."
"Studies show that people who suffer from rosacea have no option but to change or stop their normal daily activities. These people also face high chances of never being employed due to widespread discrimination by employers."

This article is about the Burden of Disease and the psychosocial impact of rosacea on a patients quality of life.

Some quotes: "The facial skin manifestations of rosacea have significant implications on patients’ well-being and social and emotional health."
"The clinical severity of rosacea does not correlate with the level of psychosocial distress experienced by the patient. This psychosocial impact has been documented with studies reporting increased depression rates among patients with rosacea.30,31 One analysis revealed that 65.1% of patients with rosacea who had a comorbid psychiatric diagnosis also had a diagnosis of depression. This is a much higher proportion than the 29.9% prevalence of depression reported for all psychiatric patient visits. A survey conducted by the National Rosacea Society with more than 400 patients with rosacea revealed that 75% of respondents reported that their rosacea had lowered their self-esteem. In addition, the majority of respondents reported that their rosacea made them feel embarrassed (70%) and frustrated (69%). More than 50% of respondents reported that they felt robbed of pleasure or happiness because of their rosacea."

"Patients with rosacea are affected by emotional and social stigmas, including being viewed as abusers of alcohol or as having poor hygiene. One survey conducted by Kelton Research evaluated patients’ self-perception and the perception of others regarding patients with rosacea. This online “perception survey” contrasted images of women with and without rosacea. More than 1000 members of the general population and 502 women with rosacea completed the online survey between October 29, 2009, and November 9, 2009. Women with rosacea were perceived to be more insecure, not as healthy, not as intelligent, and not as successful as women with clear skin. Overall, respondents with and without rosacea had negative first impressions of women with rosacea."

And below this article is another article cited:

Stakeholder Perspective 
The Psychosocial Impact of Skin Disorders: Time for a Closer Look?

Matthew Mitchell, PharmD, MBA
Manager, Pharmacy Services SelectHealth,
Salt Lake City, UT

"Several studies and patient surveys have zeroed in on the psychological distress, social stigma, and reduced quality of life that are characteristic of patients with rosacea.1-5 Moreover, a small study has documented 16 patients with dermatologic conditions, including acne and rosacea, who committed suicide after presenting to their physician with skin problems, prominently facial skin disorders,6 shedding light on the potential for severe depression that could accompany a chronic skin condition, which nevertheless is often being misperceived as mainly a cosmetic problem.

January 9th 2014

This article in The Independent, all the week back from 1997, heads:

 "Skin diseases drive sufferers to suicide.

It mainly reports about sufferers of skin diseases as acne, psoriasis and scarring, but given the extreme impact rosacea can have on patients (including their every day life, by avoiding endless triggers) and the pain, stress and anxiety it causes, being a progressive disease without proper treatment or cure, it is reasonable to assume that there have been more than the few cases highlighted above in this article, who ended their lives over this. "Doctors have warned that skin disease can be a hidden killer after one treatment centre found that 16 of its past patients had committed suicide. The two doctors who carried out the research into suicides among former patients say that skin disease should be accepted as a cause of suicide, and that rationing of a drug to treat acne may result in some patients who cannot get it killing themselves. Britain's use of isotretinoin, the most effective drug against severe acne, is one of the lowest in the western world, only one-fifth that of France.

Professor Bill Cunliffe, a leading authority on acne, and co-author of a report in the current issue of the British Journal of Dermatology, says that acne and facial scarring can cause deep depression. "Our message is that it causes a lot of psychological and social effects, with low self-esteem, job discrimination, employment problems and interpersonal problems, and that there are people who will take their own lives as a consequence," he says. The report says that research has shown that one in 10 psoriasis sufferers have a deathwish, and adds that there is a considerable risk of suicide in patients with acne. The Leeds research into the deaths of former patients is believed to be the first of its kind. No national figures are available on suicide among dermatology patients, but both suicide rates and the incidence of some types of acne are increasing. It is estimated that about 5 per cent of acne sufferers are severe cases and suitable for isotretinoin, an oral drug which is a vitamin A derivative, marketed as Roaccutane by Roche, and which costs about pounds 500 for a four- to six-month course of treatment."It is extremely effective and can virtually guarantee to get rid of acne after about four to six months with about a 70 per cent likelihood of a long-term cure. It suppresses all the factors that cause acne. It reduces grease, blocked pores, bacteria and inflammation," says Professor Cunliffe, professor of dermatology at Leeds General Infirmary.

The report in the BJD warns of the dangers of the health service not funding drugs for acne and other skin conditions. It says: "Funding problems in regard to provision of this drug could have potentially fatal consequences. Most hospitals have funding problems, producing a rationing of acne care which is clearly undesirable."Acne patients also face discrimination, says the professor: "There are all kinds of discrimination against people with acne. Unemployment, for instance, is 45 per cent higher among people with acne. I have had two young patients this week who have not been to school for six months because of acne. "In our report we emphasized the need for the early use of isotretinoin to control inflammatory acne and lessen the scarring. It is expensive but it is cost-effective in the long term because you only need to treat for a limited length of time."Britain lags behind most of the rest of the world in the use of the drug. In the USA, Canada, Australia and Sweden, for example, usage per head of the population is twice that of the UK. It is estimated that only around 1 per cent of acne sufferers in the UK who consulted their GPs are offered the drug through the NHS, but that three times as many could benefit.Noel Rabouhans, Roche product manager for Roaccutane, says: "Roaccutane is an effective treatment in patients where conventional antibiotic therapy has been unsuccessful, but unlike other acne treatments it cannot be prescribed by a GP, only by a dermatologist. As a result the hospital picks up the bill and it is a prime target for cuts when the NHS is looking for savings."One of the problems is that there is a notion that acne is a trivial complaint, but, as the report shows, that is very much not the case."Acne is precipitated by the male hormone testosterone which encourages the sebaceous glands in the skin to produce increasing amounts of sebum, an oily substance whose job is to lubricate the skin. Over-production of the oil is usually found in people who have acne and it leads to blockage of the hair ducts.In mild forms, the pores scale-up, resulting in blockages, which materialize as the classic blackheads or whiteheads caused by dead skin cells and sebum collecting in a pore.In more severe cases, the pore loses its structure and ruptures, and the bacteria-carrying oil gets into the skin tissue itself, causing the red inflammation typically seen in sufferers with severe forms of acne. A catalogue of deaths that might have been prevented

The report details the cases of the 16 patients who were referred to Professor Cunliffe and a colleague, and who subsequently killed themselves, over the past 20 years. The average age of the acne victims was 20, with the youngest, two teenagers, aged 16 and 17. The deaths included:
-A 31-year-old woman who was desperate for treatment with isotretinoin, but "the drug was not available when she presented because of the budgetary controls in the NHS". She became so depressed that she killed herself.
-A 26-year-old woman who complained of excessive facial hair and thinning of the scalp hair who threatened to kill her doctor, and later killed herself by jumping off a block of flats.
-A 51-year-old unemployed woman suffering with psoriasis who set fire to herself in her own bed.
-A 57-year-old woman who had delusions of parasitosis and who stalked her doctor. She eventually suffocated herself.
-A 71-year-old man who had psoriasis and who threw himself in front of a train.
-n A 23-year-old man with facial scarring from acne who failed to respond to treatment.
-n Six other acne sufferers who killed themselves, all but one using an overdose. They were aged from 16 to 24."

This is a distressing letter a skin disease patient wrote on a forum 

"I have suffered for every second of every minute of every day for over 10 years with a terrible skin condition that has left me permanently disfigured, in terrible physical pain, and emotionally destroyed. I have widespread infections over my entire body skin that peels and flakes off ever square inch of skin that I have. My face is covered with seborrhea and acne and it is full of deep scarring. My hair falls out in clumps, is covered in sebaceous cysts and the most severe dandruff you could ever imagine. I'm 29 years old and I have never been in a relationship. I'm totally humiliated every moment of the day. I look like a dying aids patient. My shoulders, back, chest, arms are covered with infection, boils, scars, scabs, and thick peeling and scabbing skin. [..]

 I have suffered for every second of every minute of every day for over 10 years with a terrible skin condition that has left me permanently disfigured, in terrible physical pain, and emotionally destroyed. 

I have widespread infections over my entire body skin that peels and flakes off ever square inch of skin that I have. My face is covered with seborrhea and acne and it is full of deep scarring. My hair falls out in clumps, is covered in sebacious cysts and the most severe dandruff you could ever imagine. Im 29 years old and I have never been in a relationship. I'm totally humiliated every moment of the day. I look like a dying aids patient. My shoulders, back, chest, arms are covered with infection, boils, scars, scabs, and thick peeling and scabbing skin [..] I'm sick of being in terrible burning and itching pain every moment of the day. I'd rather have no life than to be stuck in a life of constant misery. Nonexistence wasn't too bad before I was born, so I am ready to be eternally non-existent. This life didn't work.Sometimes I think that there is no other choice. Over 10 years spending every moment researching, trying treatments, going to see specialists with borrowed money. Every year goes by and the condition rages on the same as ever.

Holistic healing has failed me.
Alternative medicine has failed me.
Hope has failed me.
Faith has failed me.
Life has failed me."

January 14th 2014

I just read the obituary of a Welsh woman, Frances Medley, 44, in The Guardian, who suffered from MS since 2005 and found the pain, life restrictions (giving up on her academic job for instance) and the outlook on more detrioration too much to bear any longer She wrote a blog about her final decision: Musings of a Contemporary Spinster.

Her friend Gilly Adams wrote her obituary and mentioned: "The formidable reputation that she developed made her much in demand when she subsequently embarked on a freelance arts career. She worked as a consultant, mediator and facilitator, and rescued a number of arts organisations from disaster through her wisdom and hard work. There are many artists, dancers, theatre practitioners, writers and others who owe Fran a huge debt for her generous and unstinting support. Eight years ago, Fran was diagnosed with multiple sclerosis and, while she continued to work, her life gradually became unbearable to her, because of the loss of freedom and independence. Fran had an alter ego, the Sophisticated Spinster, who featured in her blog, Victorious Endeavours. The Spinster displayed a keen sense of the absurdity of daily life. She kept her illness at a distance by christening it Cruella and transforming some of Cruella's worst antics into wry and funny blogposts, albeit with a bleak undertone. It was important to Fran for people to understand the crucial distinction she made between suicide and ending her life at a moment and in the manner of her own choosing. She made a 10-minute film, An Explanatory Statement, which was shown at her wake, and also left a final blogpost, under the heading A Sophisticated Sign Off.

In this last blog entry, Frances wrote for instance:

"Well dear readers the Spinster has decided to call it a day; Cruella has simply exhausted me emotionally and physically. The prospect of further rapid deterioration was both terrifying and not one I wanted to entertain. The Spinster decided to end her life in a manner and at a time of my choosing; I am very clear that, whilst the law might say otherwise, I AM NOT COMMITTING SUICIDE. It has been just over 8 years since the Spinster was given the unwelcome gift of a chronic incurable degenerative disease; one that would destroy my life slowly at first and then in leaps and bounds. In just over 10 years this Spinster went from being a higher rate tax payer responsible for running a public body – (as an aside I believe I was the youngest woman to do this at the age of 30) – to a position last year where I didn’t earn enough to pay tax. The loss of my independence both financially and physically has been extremely difficult for me. Without the financial support of my immediate family I would have had to seek the support of the State; whilst of course I was entitled to resort to this I found the prospect humiliating.  Pride is a terrible thing; a real burden at times of need. The Spinster fortunately peaked early on life and so I don’t leave with rafts of regrets or things I wish I’d done. Happy with my lot is perhaps an exaggeration but had the Spinster persisted my ability to do things would have been daily reduced; my potential it seems has been fulfilled.

Some studies about rosacea and mental illness on Truthly.
Patients with rosacea had a higher rate of depression and anxiety, especially men, based on a correlational study. .
Long term lithium use was associated with a significantly decreased risk of rosacea, based on a correlational study. Independently, people diagnosed with schizophrenia were less likely to have rosacea..

June 15th 2014

I read an article of the online version of Rolling Stone magazine two days ago, where a singer called Lana del Rey said in an interview that she has been dealing with a mystery illness the past year and that at times (often) she wished she was dead. I usually don't respond to user comments below such stuff but this one was different I guess. I felt this was a typical, stereotypical view and response of so many people out there on depression and illness. Slacking people mentioning it off as attention seekers, whiners, sad cases and ungrateful spoiled types. So many of such responses, backed up by so many normal looking readers, and those trying to hammer some sense or morals into them are dismissed as sad cases too of course :) With too much time on their hands. Anyway, here is an abstract of the discussion. I know many rosacea people who encounter this same prejudice and vindication about their own illness and depression, and although people never say it to my face, I know that some family members and acquaintances of mine have low opinion of me too, because I let my face 'dictate my life'. It usually seem the types of people judging others, who either had flawless lives themselves, are blessed with a very sunny character and absence of any illnesses, or those who previously had a hard time but managed to overcome whatever hurdle they faced and now want to push their attitude and approach onto others.On the other hand, I know it might also be a tongue in cheek effort, to ridicule the article and life itself a little bit with seemingly shocking comments. If they had been funny, I guess it would even be bearable, but the selection below sounded rather serious for some reason.

Below the article, an on the comment section on facebook, people really went all loose.
The interesting thing is that I copied that public facebook post and all its comments straight to this blog. Only once some vile commentators found themselves back on this blog, did some email me to ask to take their comments down. Sure sure.. I did, but not without saying that public comments like the disgusting ones some of them put online, can circulate for a long long time if they aren't careful

By Kory Grow
June 12, 2014 6:50 PM ET

Lana Del Rey wants to die so badly, she wishes she was already dead, or so she told British newspaper The Guardian. When the subjects of Kurt Cobain and Amy Winehouse came up during her interview, and the newspaper connected the two by their deaths, Del Rey – whose breakthrough album was titled Born to Die, she proclaimed her death wish. "I don't want to have to keep doing this, but I am," she told the paper. And by "this," she said she meant "everything." "That's just how I feel," she said. "If it wasn't that way, then I wouldn't say it. I would be scared if I knew [death] was coming, but. . . " The rest of the sentence did not make it into print. [..] These pallid revelations comes shortly after Del Rey revealed to Fader that she had been suffering what she called a "medical anomaly that doctors couldn't figure out" in early 2013. "That's a big part of my life," she said. "I just feel really sick a lot of the time and can't figure out why."

From the original interview:

"I wish I was dead already," Lana Del Rey says, catching me off guard. She has been talking about the heroes she and her boyfriend share – Amy Winehouse and Kurt Cobain among them – when I point out that what links them is death and ask if she sees an early death as glamorous. "I don't know. Ummm, yeah." And then the death wish. Don't say that, I say instinctively. "But I do." You don't! "I do! I don't want to have to keep doing this. But I am." Do what? Make music? "Everything. That's just how I feel. If it wasn't that way, then I wouldn't say it. I would be scared if I knew [death] was coming, but …" [..] We're in New Orleans, a city not known for peace and quiet. A couple of blocks from Lana Del Rey's hotel lies Bourbon Street, the scene of drunken rampages from morning till night. Head in the opposite direction and you can expect to be assaulted by the vibrant brass of the French Quarter's street jazz musicians. Even inside Del Rey's elegant suite there is carnage: suitcases half-exploded; bags of corn chips strewn across the floor. Even her laptop has been doused in tomato ketchup, temporarily thwarting our attempts to hear songs from her new album Ultraviolence. "Ewww," she says, baffled as to how a condiment could have found its way inside the power socket. And yet when we move outside to sit on her balcony, the scene is transformed into complete calm. "This place is magical," she says, sparking up the first of many cigarettes. So serene is the setting, in fact, that it takes me by surprise when Del Rey begins to tell me how unhappy she is: that she doesn't enjoy being a pop star, that she feels constantly targeted by critics, that she doesn't want to be alive at all. "Family members will come on the road with me and say: 'Wow, your life is just like a movie!'" she says at one point. "And I'm like: 'Yeah, a really fucked-up movie.'" Throughout our hour-long conversation she keeps returning to dark themes. Telling her story – a remarkable one that involves homelessness, biker gangs and being caught in the eye of a media hurricane – also involves working out why a songwriter who has sold more than 7m copies of her last album, Born To Die seems so disillusioned with life.

These are some of the comments people felt free to post in response, mostly below the facebook version of this article by Rolling Stone (and this negative dribble made up the majority of feed back unfortunately):

"Stephanie: What a fucking idiot. Maybe she should take a trip to a hospice and speak to people who are actually dying, and then she'll learn to appreciate the simple gift of life. Or step in front of a bus. Makes no difference to me."

"Joanne: What an idiot! She's an attention whore. I seriously hope kids and teens realize that she is NOT someone to emulate!"

"Stephanie: Sooo..why is she still alive?. I mean surely if the desire is that overpowering she couldve arrange it..pay some someone to kill her or even commit suicide..this is just a charade.. now she is annoying.."

"Dana: What a dumb bitch too say something like this."

"Ryan:  Crazy bitch!!! Hahaha, just do it!"

"Kelly: She's disgusting .... There's people , young and old who are fighting for their lives due to an illness or accident ,,, and this Bitch wants to die ??? Do us a favor ... Quit your whining and just do it."

"Taylor: She's an untalented spoiled rich kid. She's not mentally ill. She SHOULD kill herself for making fun of real issues."  

"Stacy: How fckn stupid. I can't believe how much space is wasted on this shit. You want to die? Go away and do it quietly you stupid bitch, why do I have to read about it?"

"Sagan: If she wishes she was dead she should blow get brains out."

(In response: "Fiona: You're disgusting, and clearly know nothing about living with serious illness and depression. Absolutely vulgar to suggest anyone blow their brains out. Go spend some time with the chronically ill and get over yourself.")

"Libby: Someone give this ungrateful woman a grip of heroin n a needle."

"Deb: Stop talking about it and just fuck off and die already. Can you say "I wanna be the center of attention ALL OF THE FUCKING TIME" (in a bitchy, whiney voice, of course)? Hmm?"

"Ashton: Attention whores. Cant handle reality."

"Ryan Seville: Clearly she is a fucking wrong un no one cares about your problems so Man up or shut up"

"Stefanie: If she wanted to be dead already she would be !!!! She's a whiney bitch.."

"Karlo: It makes me angry how she so openly and unshamefully glamorizes young death and addictions and depression just to emphasize on her "sad" persona. I have no sympathy for people who get the opportunity to live a dream and still complain. If she hates being a singer so much, just stop? I love her music but this threw me off really bad. Disgusting message to pass on to the media knowing it would be made public."

"Ken: fook off and die then"

"Sophia: Our world is about to get destroyed by terrorists and we're worried about this girls depression. You know how many kids our depressed in our country?? Nobody cares about them! Why not tell this young beautiful talented woman to start steering positiveness so she can influence our children today and raise awareness in an area that she can influence (younger generation) so that our America stops deteriorating. In turn, her power will lead to a stronger America and trust me, that'll put a smile on her face. She would save herself, our children and the start of saving our country. Public figures are very influential, we need them just as much they need us. Sorry, I know she has problems but so do I and so does the rest of the world... Only difference is she has the ability to make a difference!"            

"Damon: What a spoiled little turd. People would kill to be in her shoes. Stop being so self centered!"
And more summarized: "Coincidentally, most people who hear her music feel the same way"
"So basically, her PR team decided she should manufacture a darker persona, as it would be more beneficial to her overall image. Got it."
"If she kills herself because of internet cynics, she's too weak of a human being and doesn't deserve to be here in the first place."
"So, by any means, do us all a favor already."
"Singer reveals dark thoughts? Hahahaha! More like desperate for attention. Just check out some her song titles on her new, boring album: "Fu@ked My Way Up to the Top", "Florida Kilos", "Brooklyn Baby". Yup, desperate for attention!"
"Hurry up then! And I will not illegally-download your posthumous recordings either!"
"To be honest RS, its pretty dangerous to put something like this out there for a younger audience and equally an older audience to read because it may encourage self destructive behavior because some people who are in a dark place look up to people like this. I don't know if its her trying to do the 'pop noir' persona or what but its a really negative thing to put out there. A rich musician wanting to die, how cliche."
"Use your money to take some prozac, have some therapy and cheer the f*ck up then. Make happy music. Then you will be happy. Simple. Problem solved."
"If it's because of a chronic pain issue from her "medical anomaly" I can sort of see it...if not, and it's spoiled dark rock start attitude, all I can say is..... awwwwwww weep weep weep....a depressed music star just off yourself already then! Try being a freaking person working in a cubical or a waitress if you want to off yourself."
"If a person really wants to commit suicide, they don't go around telling everyone about it, sadly, they just do it"
"All I get from this is a woman utterly desperate to be seen as a dark romantic heroine, aligning herself with far more accomplished artists who really did have a dark side. She is an insufferable phony with a fake name and fake lips. Flash in the pan who is trying to seem like more. I don't buy any of it."

"Jenna:Wow: This is what an overly privileged childhood does, she can only see herself there's no one else. 100% narcissist"

"Adam: So just freaking kill yourself you whiney c word.
Carmine: I would hope if a loved one approached you saying the same type of things you wouldn't tell them to "just go freaking kill yourself" as well.
Adam: Well there Carmine, somehow I don't presuppose my loved one would be so terribly unfortunate as Ms. Del Ray, to be having a financially successful artistic career. (at such a young age nonetheless!) If my loved one were having similar "problems" as our heroine, I'd tell her to STFU and go volunteer your time in a third world country, or if that's too much an investment on your "woe is me" moan time, then at the local pet shelter. F sake.... Yes, such deep, deep pity I have for this attention seeking windbag.
    Carmine:  So you don't understand what actual medical depression is, which answered my question. Thanks
      Adam: Right, because when you completed your research on my family's medical history, you didn't find any of that. You're very welcome Carmine.
    Carmine: Your posts on the topic are very giving on your knowledge of how it works."

"Lou: Nice marketing angle

Simone: Her friend passed away. Read the whole story sweetheart.

" Justin:  So put a gun in ur mouth. Please."

 "Tina: Sad maybe she should go to a children's cancer ward , and watch these children fight for every breath to try and stay ALIVE!! Then she may appreciate her health and life!!!!!" 

Luckily there were some people speaking up against this rude, offensive ignorant stuff.  

I usually don't respond to internet discussions, but couldn't help myself here as I was just stunned that so many people, often under their own facebook account, would feel free to write such things, telling her to kill herself, that she is an attention seeking whore, that she is a failure as there are people dying of cancer and so on. It hit home I guess but mostly, it made me think of the many reports of teenagers in the USA (yes this is all USA, and mostly Americans responding to this Rolling Stone feature) committing suicide over bullying. Everybody cries wolf then but here these same adults for the great majority write the most spiteful, offensive stuff on a public internet page, under their own identity and people seem totally used to this or ok with this? Anyway, within no time you end up in all sorts of petty discussions with people I found, and you see your own responses plastered all over the discussion. I guess you hope some people feel they maybe indeed said rude things and think twice. And as I wrote; as soon as these tough kids realized their names were on a blog, they went whining and crying to get it removed again. Ugh I hate society and mankind some days. There is just such a stigma on depression, wished people were less 'mean girls' and less offensive about other people's suffering, but that seems to just be the harsh times we live in, and most would probably not say the things they shout online to your face anyway (I hope at least). 

Here are some of the comments of people who also didn't agree with this shit:

"To wish someone's death...my god what kind of monster are you? But you know the sayin be afraid of what you wish for others because maybe that's will happen to you"
"I hope someone close to you gets to go through a deep depression and you help push them over the cliff."

"Tiffany: People are sick telling her to just kill herself. It's artists like her that give us these amazing and beautiful songs. It's sad that's she is or seems so sad, but it works in her music. I love her."

"cruel people who have never met her yet can hate on her harshly. wow just wow."

"I really hate seeing people's reactions to this. It's all oh then just kill yourself. Do you people have no decency? Jeez, people aren't depressed because they want to be. They are depressed because something that happens in their life's or something else makes them that way. It must be hard feeling that all you want to do is die, but jeez lay off even if she's a celebrity, she's not perfect. Nobody is and she doesn't deserve hurtful comments from assholes on this post. I hope Lana Del Rey can find help, and get better because she's really beautiful and she deserves the best from life, like everybody else."

"Some people are just constantly sad, usually there's no way to get rid of it. Lana is a good example, i think that art, as singing is good way to cope with it. She probably wishes she was dead for years already, it doesn't really mean anything, but it's a state of mind. I understand her pretty well ;)"

"Nothing like a good ol' Internet comment section to get the negativity flowing!"

"All of you negative commenters, you should be ashamed of yourselves. The singer is saying she wants to be dead and you are all calling her an attention seeker? You do not know Lana and you do NOT know that. She could be very serious, for all we know, and the last thing she needs is all this negativity. A lot of people like her and look up to her, plus she sings very well, so you can't call her talentless. You also shouldn't be saying that she doesn't have any reason to be depressed because she's rich - Yeah, maybe she is, but that doesn't exclude anyone from depression. Suicide and depression are not jokes - I don't care if you dislike her or think she's not talented and all that other trash, but you should not be taking this as a joke, not at all. We need to praying for her and hoping that she feels better soon because all humans are worth something - Even Lana. I hope you realize that suicide isn't an option, Lana and don't listen to the haters! I don't know every one of your songs, but I still like you and think that you are an amazing person worthy of having a good life! I'm praying for you! :)"

"Dion: This world is a heartless c*nt. I don't blame her, and I often feel the same way."

 "Amy: Some of these comments on here are outright pathetic and demeaning at best. Sad to see such cruel words on here. Incredible ignorance really. Educate yourselves people on mental illness. Stop passing judgment on a person you don't even know."

"Dianna: She is just being vocal and brutally honest about the way she feels. Its exhausting
to live each day as if its a bowl cherries. But to some people it isn't. When you suffer from severe depression nothing really makes you happy. Sometimes it can't be explained. Some of us can tough it out. And the there are some like Lana that its getting too rough to handle and the dark hole keeps getting deeper. I hope she gets help for whatever is ailing her physically and mentally."

"Penny: I have no idea who this woman is but what is up with all the ignorant and cruel comments? The internet has really made me realise how horrible people can be."

"Sonja: i had a friend many years ago, beautiful I was jealous of her! when I heard she wanted to commit suicide.. it pissed me off? I thought it was attention seeking.. a month later she committed suicide.... I couldn't believe it? she had everything.. money looks and her life looked like it was panned out? at the time I thought what a stupid cow? after her death :(( its haunted me 4 - 20 yrs wishing I loved her differently.."

"Tina: She's a fucking moron. I'm sure all of the people fighting for one more day would appreciate a perfectly healthy person taking life for granted. What an asshole.
Amelia: Depression is an illness as much as a broken leg. Ignorance towards mental illness just increases the stigma because idiots like you make comments about something you don't understand. I think you're the asshole here.

This is a great response from Carrie: "This quote is for all the ignorance toward mental illness that I am seeing in these comments. Depression is humiliating. It turns intelligent, kind people into zombies who can’t wash a dish or change their socks. It affects the ability to think clearly, to feel anything, to ascribe value to your children, your lifelong passions, your relative good fortune. It scoops out your normal healthy ability to cope with bad days and bad news, and replaces it with an unrecognizable sludge that finds no pleasure, no delight, no point in anything outside of bed. You alienate your friends because you can’t comport yourself socially, you risk your job because you can’t concentrate, you live in moderate squalor because you have no energy to stand up, let alone take out the garbage. You become pathetic and you know it. And you have no capacity to stop the downward plunge. You have no perspective, no emotional reserves, no faith that it will get better. So you feel guilty and ashamed of your inability to deal with life like a regular human, which exacerbates the depression and the isolation.

Depression is humiliating. If you’ve never been depressed, thank your lucky stars and back off the folks who take a pill so they can make eye contact with the grocery store cashier. No one on earth would choose the nightmare of depression over an averagely turbulent normal life. It’s not an incapacity to cope with day to day living in the modern world. It’s an incapacity to function. At all. If you and your loved ones have been spared, every blessing to you. If depression has taken root in you or your loved ones, every blessing to you, too. Depression is humiliating. No one chooses it. No one deserves it. It runs in families, it ruins families. You cannot imagine what it takes to feign normalcy, to show up to work, to make a dentist appointment, to pay bills, to walk your dog, to return library books on time, to keep enough toilet paper on hand, when you are exerting most of your capacity on trying not to kill yourself. Depression is real. Just because you’ve never had it doesn’t make it imaginary. Compassion is also real. And a depressed person may cling desperately to it until they are out of the woods and they may remember your compassion for the rest of their lives as a force greater than their depression. Have a heart. Judge not lest ye be judged."

In this Daily Mail article, a story is told about a woman with severe ongoing pain triggered by a stroke. 

She ended her life when all hope for the funding of a special operation was blocked. I guess that when people are submitted long enough to debilitating pain, this can make seemingly great lives seem unbearable for them at some point. I would always keep going personally, unless you can't take it anymore, but always keep in mind that if there is still outlook on improvement and even a short time of some enjoyment a day, life is worth hanging onto. But this article shows again the destructive powers of chronic pain on any individual. I saw a documentary about a Dutch woman who had developed very extreme ear ringing sounds. She heard screaming high pitched noises in her head and they grew worse and worse. She had severe head aches from them and couldn't tolerate the horrible sounds anymore at some point. When doctors couldn't help her anymore she ended her life. She was also a beautiful woman in her late 40's, with teenage children and in the docu she explained why she would end her life and the viewer heard the type of noise she heard all the time, and to be honest, I had to turn the sound of the television down, it was pretty awful. I really hope that every rosacea patient reading this has other means at hand to control the burning pains and to keep going on and enjoying quality of life. 

If you're reading this, I must be dead'... tragic Dignitas suicide diary that shames the NHS: British woman took her own life after being denied a pioneering operation

Erica Blaza, 51, took her own life in Switzerland last October. She suffered a stroke in October 2011 - and later developed agonizing pains. Mrs Blaza begged Health Secretary Jeremy Hunt for a £45k brain procedure. But she received no reply and was told her condition was not 'exceptional. She tried every other option - then decided to take her own life. A British woman took her own life at the ‘death clinic’ Dignitas after being denied a pioneering operation on the NHS. Despite not suffering from a terminal illness, Erica Blaza, 51, went to the Swiss clinic to die after suffering two years of ‘indescribable agony’ triggered by a stroke. Four months earlier Mrs Blaza had written to Health Secretary Jeremy Hunt pleading with him to fund a £45,000 brain operation. ‘I am losing the will to carry on, the pain is worse and my life is a  living hell spent in bed,’ she wrote. ‘I beg you to help me.’ But she received no reply, and was told by frustrated surgeons that her case was not considered ‘exceptional’ enough for NHS funding. Dozens of other British patients with the condition have been left suicidal since being turned down for the same surgery, and at least one other patient has killed herself. In a diary written before her death, Mrs Blaza reveals how she preferred to die at Dignitas than live on in agony for another few months while her operation was delayed. Having been turned down by the NHS, she was forced to pay to have the operation privately – only for the neurosurgeon who was due to perform the operation to break his wrist, delaying the operation. After trying every other possible medical treatment she told her husband Pete Finch: ‘I’ve had enough’ and travelled to Dignitas, where she took lethal drugs last October.

Assisting a suicide is illegal in Britain. But while in Switzerland the couple from Hoole, near Chester, were contacted by British police who astonishingly advised them to make a video of events. Mr Finch was questioned by police on his return to Britain, and no charges have so far been brought. The Crown Prosecution Service say his case is ‘under consideration’. Mrs Blaza did not blame NHS staff for her situation, but last night, her husband said: ‘If there had been NHS funding for that operation she may still be here today.’

Professor Tipu Aziz at Oxford’s John Radcliffe Hospital pioneered  a treatment which involves inserting electrodes into the brain. But just weeks before Mrs Blaza was due to be treated, NHS funding was abruptly cut. Every day Erica’s pain intensified. Mr Finch said: ‘Every waking moment was agony.’ Prof Aziz said he could only apply for funding for cases when the patient was in exceptional pain. ‘But how can you prove that a patient in pain is any more exceptional than another? It’s a nonsense,’ he said He has had to turn away ‘about 60’ UK patients since then, but continues to treat Irish patients, whose Government funds the procedures. He revealed another woman ‘effectively killed herself... When funding was turned down she turned up her opiates so much that when her gall bladder burst, she didn’t feel it and she died of septicaemia.’ Last night Alistair Thompson, of anti-euthanasia group Care Not Killing, said: ‘This is the first time I’ve heard of a police officer giving advice to make a video. It is very odd that they appear to be issuing advice on how to escape prosecution.’ But assisted suicide campaigner Dr Michael Irwin said: ‘I’m certain nobody has been charged for accompanying someone to Dignitas. There is a relaxed attitude from the police, as long as they are certain that it is an act of compassion.’ NHS England said: ‘Deep brain stimulation is a complicated treatment with potential serious risks and the NHS must only commission treatment where effectiveness is proven. This matter is currently being assessed by leading clinicians.’ A spokesman for the Health Secretary said: ‘Jeremy sends his sincerest condolences to the family in this tragic case.’

In her own searing words, Erica records her dying moments: 'I asked for the drugs that would end more like. "No more pain tonight, love," said Pete. "I love you," I said.' And then she drifted away. My name is Erica Blaza. In December 2011, on holiday  in Spain with my husband Pete, I had  a stroke. I was 49  and had never been seriously ill. After a week in hospital I came home to Chester,  only to have a second stroke.The effects were far more severe. I could not speak, write, dress myself or brush my hair. But I set about re-learning these things: the first word I said was ‘beer’, much to Pete’s amusement. I made slow, steady progress  but about a fortnight after returning home got very bad abdominal pain. Surgeons found  a strangulated hernia, and were able to ‘unpick’ my lower bowel. At the end of the operation my heart stopped and I had to be resuscitated. They discovered I had a rare heart problem called Long QT syndrome, which means it can stop at any time. I was fitted with an implantable cardiac defibrillator – an ICD or I Can’t Die, which restarts the heart. You might be thinking ‘My God, has this woman been unlucky?’ But this was just the start.

In February I returned home, deeply traumatized by it all. One night, after a dreadful panic attack, Pete and our friends took me to Chester hospital where  I was given a shot of the  anti-anxiety drug lorazepam. Thirty minutes later I was Erica again! The transformation was incredible. It was a turning point. With help from a fantastic NHS speech therapist, and from Pete, I started getting my life back. But in late March, out walking, the pain began. It started in the big toe, and by the next day it had spread to my whole right foot. We took it as a good thing, the ‘feeling coming back’. A week later the pain had spread to my entire leg. My excellent  GP diagnosed ‘central post-stroke pain’, or CPSP, and my stroke consultant confirmed it.  There was no cure, he said, but there were things I could try. It could level off or even disappear. It did not, and so began my fight with CPSP. Up to eight per cent of stroke sufferers get this, some mildly, but for some it’s debilitating. By June I was trying so much medication, some approved and some not, but the pain had spread to my entire right side and was much worse. I was referred to Liverpool’s Walton Centre and met specialists in two cutting-edge techniques: transcranial magnetic stimulation and TMS deep brain stimulation, DBS Both options required me to have my ICD removed, as they could make it malfunction. So in March 2013 I had it taken out – even though that meant I could die at any moment. I didn’t mind: the thought of sudden death had become rather appealing. The previous Christmas I’d told Pete I wanted to join Dignitas so  I could go there if nothing worked. Then I could at least end my life peacefully and be free from pain. You see, until this happened  I didn’t realise you can be in absolute agony and nobody can help you. But Pete begged me to try everything first and I agreed to wait until I had tried TMS. Unfortunately, the Walton Centre could not do TMS for me  at that time so I thought there was nothing else to try. The next day I began my application to join Dignitas, knowing their complicated approval process takes months. They want medical records, psychiatric assessments, the lot. You can’t just phone up and ask to top yourself next Tuesday. But then I was referred to Professor Tipu Aziz at the John Radcliffe Hospital in Oxford, who invented a new type of DBS, which has had positive results in 17 of 20 patients. We liked Prof Aziz straight away. He thought  I was a good candidate, telling me ‘I can help you’.

Of course there was a problem: the NHS had pretty much stopped funding it. But returning home Pete was elated: his enthusiasm was infectious and I felt more positive than I had for ages. The pain continued to worsen. By July I was on enough tablets  to put me in a drug-induced sleep for 20 hours a day. Life was intolerable. I was desperate for this to end. Whenever I woke up  I was gutted I was still alive. Then Prof Aziz emailed saying NHS funding had been denied. By this time, my Dignitas application had been accepted and I told Pete I wanted to make final arrangements. However, Prof Aziz agreed to do the treatment privately for £45,000. Breaking the news to me, like he’d won the lottery, Pete said: ‘It’s OK love, they are going to do it next month! We have to pay but so what?’ Mum insisted on paying half. Six weeks later I woke to hear Pete shouting ‘NO! NO! NO!’, tears streaming down his face. Prof Aziz had broken his hand and foot and would be off work for at least three months. You couldn’t make it up, I remember thinking, so that was it. I decided it was an omen and the operation would’ve gone badly anyway. There was no way I could carry on for another three months.

It was time, I told Pete, to go to Dignitas. I simply couldn’t endure this life of pain any longer. He didn’t want me to go and pleaded for help with anybody who’d listen. He’s tried so hard for me the past 20 months. I know he really loves me and I love him so very much. We have had almost 24 years together, but now I had to convince him to let me end my life. Then the Walton Centre unexpectedly approved my TMS treatment. Pete was delighted. I was not. I’d had enough. In September, still waiting for the machine, I awoke one night in terrible pain. I begged Pete to let me take an overdose and put a pillow over my face. We were both in tears but he just couldn’t do it. Prof Paul Eldridge at the Walton Centre offered both TMS and conventional DBS, with all the inherent risks. It wasn’t going to happen. It could go wrong, stopping me going to Dignitas, I argued. I was petrified of being stuck here, alive and in agony, for years. If assisted dying was allowed here I’d have tried everything, knowing that my suffering would end one way or the other. So Pete and I struck a deal: I’d try less risky TMS and that was it. If it failed he’d accompan me to Switzerland. After the first session I felt nothing, no pain relief. The next day’s session was the same. I only went to the third session – no effect – on condition I could call Dignitas. The clinic said I could come next week. I didn’t hesitate. Pete booked the flights and hotel and we both burst into tears. We flew to Switzerland. I was in utter agony but the fact the end of my pain was in sight lifted me. A doctor saw me twice in the days beforehand to ensure my intent and explain the procedure, both mandatory under Swiss law. It recognises people have the right to choose to end their lives suffering from an untreatable disease or pain. In the UK vets are allowed to put suffering animals to sleep. How precious have we become when we don’t give ourselves the same basic rights? Feeling guilty about wasting Prof Eldridge’s time, Pete emailed the Walton Centre to let them know we were here and thank them all. At 1am the phone rang. It was Cheshire Police. Walton’s lawyers had told them I had gone to Dignitas. We both spoke to them and they advised Pete that it might be a good idea to make a video. On Saturday they phoned again. I begged them to leave me alone, this was hard enough and the calls made me worried for Pete. On Sunday we reminisced and at night Pete said: ‘We’ve got to have a drink together love, one last time.’ Half a lager was enough. I woke twice
that night in great pain. When Pete woke up in the morning there was nothing more to say and we gave each other a kiss. At 11am Pete wheeled me to Dignitas. I first took a stomach-settling drink. After the minimum half-hour wait I asked for the sodium pentobarbital barbiturate solution to end my life. I knocked it down like a shot of tequila and asked Pete to come and give me a cuddle. ‘No more pain tonight love,’ he said. ‘I love you,’ I said. ‘I love you even more’ he said. ‘No, really, I love you so much...’ [At this point Pete kissed Erica, and she died peacefully in his arms]
So if you’re reading this I must be dead.

This isn’t a rant, and I don’t blame anybody for what happened. Everybody helped me every step of the way. The NHS was fantastic, unbelievable. My GP, exceptional. Sometimes things can’t be fixed. You have to remember, as Pete does, that I am no longer in pain. Love, Erica xxx

To read Erica’s full diary, visit www.mailonline.co.uk/dignitasdiary
She writes for instance in this longer diary entry: "'I didn’t realize... you can be in absolute agony and sometimes there is nothing that can be done to help you'

Mother-of-two jumped to her death from top of car park after suffering years of agonizing pain in her face caused by toothache 

In this Daily Mail article is written: A mother-of-two killed herself by jumping from a multi-storey car park after suffering years of crippling pain in her face believed to have been caused by toothache.Janette Warburton, 58, was in agony and struggled to eat or sleep but her problem was never fully diagnosed, an inquest heard today. On March 29 this year she drove to Blackpool with her husband David to see a dentist because experts believed her pain was caused by a cracked filling.
She then told Mr Warburton she felt too unwell to attend the appointment so he went to the surgery to explain. But while he was away she threw herself from the fifth storey of the car park they were in. Parking warden Craig Walker told her inquest he saw the 58-year-old climbing a barrier and yelled 'come back' but she replied: 'I'm going' and jumped to her death. After her death, her sister Carol Clements, 61, found she had researched how to kill herself online. She said: 'The pain in her face first started around five years ago. She wasn't sure what it was but thought it was maybe because she'd had so many teeth removed'. Mrs Clements said in December last year the pain became unbearable. She said: 'Janette was in Tenerife and she bit down on something hard and it really set the pain off. 'She couldn't eat and she stopped going out because she couldn't cope with the pain.  
'Around that time, she started talking about suicide and we didn't know at the time but she'd been researching it on the internet. 'By the end, she was sleeping just an hour each night and she said she felt like her body was shutting down.  'Janette was loved by everyone and her two children were devoted to her.  'Her friends were just as upset as myself and my three children. There is a huge hole in my life'. Her husband believes his wife had not received the help she needed, and said her condition meant she should not have been discharged from Royal Preston Hospital ten days before her death. Psychiatrist Gillian Strachan said Mrs Warburton had received visits from the Lancashire Care Trust's crisis team, amid concerns about her mental health.
But she cancelled the visits following her discharge from hospital having resisted seeing a psychologist. Dr Strachan said that while Mrs Warburton had been depressed she had denied having any intention of suicide. But two notes written by Mrs Warburton were found at her home, including one talking about not wanting to live any more. Blackpool and Fylde coroner, Alan Wilson, accepted that Mrs Warburton had intended to take her own life and the post-mortem conclusion that she had died from multiple injuries following a fall. He said there was no evidence of any 'gross failing' in her care and that she had not met criteria to be sectioned. Her daughter Shelley Jacobs, who lives in Leicestershire and did not attend the hearing, said afterwards: 'Mum was vibrant, with a real sense of humour. She loved to travel and make cocktails. 'It's tragic that my seven-month old son Sawyer, her first grandchild, will not know his nana'. 

August 24th 2014

Another Daily Mail article with drear and misery. A health visitor with a first class honours degree in nursing was found hanged after she became tormented by her severe skin condition. Hollie McEwen, a dedicated professional, first suffered psoriasis as a 12-month-old but it eased with treatment. However, it later reappeared due to stress and the 28-year-old became so depressed she took her own life at home. Her father Andrew told an inquest: 'Her condition played a large part in what she decided to do. 'She was a beautiful, vibrant young woman who felt she couldn't deal with the condition. She felt this was the only way out.' The Doncaster hearing was told she had suffered from bulimia as a teenager. Her family believed the eating disorder stemmed from her ongoing issues with her skin condition. Her mother Wendy said: 'Her skin condition played a large part in her problems as a teenager and when older I feel this was at the root of all the problems.'

She had spent a long time writing several letters to loved ones which were found in a bin.
Her father, who saw her the evening before the tragedy said: 'She was a happy, young woman who enjoyed her work and social life but she kept everything very close to herself. We had a good laugh on that last night and there was no indication she was unhappy.' Mrs McEwen said her daughter, who lived in Scawsby, Doncaster, had treatment for psoriasis over the last few years involving hospital stays and steroids after suffering anxiety attacks. Hollie had enjoyed a family holiday in Turkey but was 'down' after being given an anti-depression drug by her GP which failed to lighten her mood.
'She was an intelligent, determined and organised young woman,' she said. 'I told her to keep going with the tablets and give it time.' When told about her daughter's death she said: 'I was in absolute shock. Her death has left a large hole in our family. I still can't understand why this has happened.'
Hollie's brother Andrew told the inquest: 'She was a happy young woman who enjoyed her work and social life. She kept everything very close to herself.' He said there was no indication that she was unhappy the evening before she died. He added: 'As a teenager she was always conscious of her skin condition and it worried her greatly. Hollie's neighbour Elaine Lunn found a note from her on the morning of Friday, May 23 asking her to call the emergency services so Hollie's family would not find her body. She said: 'I believe she had planned it. There was nothing to suggest prior that she was going to do anything like this. I feel totally distraught.' She added: 'She was a very attractive young woman. She was energetic, thoughtful and caring and studied to further her career. She was very bright and intelligent.'

Hollie McEwen, 28, hanged herself just two days after she had sought medical help for her depressionNurse and friend Angelina Deighton, who trained with Hollie at Sheffield Hallam University, said she knew her psoriasis had worried Hollie and she said she was having treatment and counselling. 'She was always the life and soul of our friendship group,' she said. 'She was always bubbly. She had a boyfriend for a few months in 2013 but it fizzled out and she wasn't concerned about it. 'Lately she described being tired, down and just not coping. She had been to her GP for anti-depressants but she didn't think counselling would help her and she tried to help herself.
'I tried time and time again to get her to seek help. She had many friends who thought she would never do anything like this.' Behavioural psychotherapist Jessica Dunn, who had a session with Hollie just two days before she died, said Hollie had started to feel anxious and overwhelmed at having to plan a friend's hen party. 'She was well presented with immaculate hair and make-up,' said Miss Dunn. She had 'dark thoughts' but had no intention of carrying them out. 'She told me "I wouldn't put my family through that".' Hollie had been avoiding her friends and not socialising because her mood was so low. After breaking down in tears in the witness stand Miss Dunn said: 'I had no concern for her safety.' Dr Elena Pamphilon, Hollie's GP for ten years, said she had come in for repeat prescriptions for medication to treat her psoriasis which she managed herself. She attended with depression and anxiety towards the end of 2013 and again this year. 'In May she said she was finding things overwhelming but did not mention any particular trigger.'

The doctor gave her sertraline, an anti-depressant drug, but a fortnight later Hollie's mood had worsened and she went back. 'She may have had to wait longer to see the benefits of the drug,' said Dr Pamphilon. 'There isn't a drug to give more immediate relief.' Assistant Doncaster coroner Fred Curtis said: 'She was a young lady who has achieved well in just about everything she has done.'
Although suffering from psoriasis and bouts of anxiety and depression she was 'happy and active' until her mood began to change towards the end of 2013. 'She had the most loving of families - a family that really cared for her,' said the coroner. 'They were aware of some of the problems but never the full extent thereafter not because of any fault on their part because Hollie did not reveal the full extent of the depression she suffered at times.' She never told her family, doctors or friends about her suicide plans. 'During the spring of 2014 her mood was at all times lower than that recognised by anyone,' said the coroner. 'That's not to criticize her family or health services. It may be down in part to the fact that she cared for so many people she didn't want them to believe she had a very low mood and didn't want to distress them.' He said her death involved planning 'which she kept from everyone.'
Recording a suicide verdict he extended his sympathies to the family and said: 'She had been successful and had a good future ahead of her.'

Ms McEwen, pictured, was the 'life and soul' of her group, her friends saidMs McEwen, pictured, had been prescribed drugs to help combat her depression

November 24th 2014

I read some articles on chronic pain, illness and depression and suicide, as I'm not doing great at the moment rosacea wise. This blog post has good things to say, the intro was very recognizable for me:
"Everyone who lives with a long-term illness thinks about suicide at some time during that illness. My hunch is that these emotions usually come early in the disease, during the first struggles with the reality of chronic illness. The second most common occurrence of those sentiments comes, I think, at times of crisis in the disease, at times of reversals."

October 9th 2014

Some Nietzsche quotes:

The Thought of Death

It gives me a melancholy happiness to live in the midst of this confusion of streets, of necessities, of voices: how much enjoyment, impatience and desire, how much thirsty life and drunkenness of life comes to light here every moment! And yet it will soon be so still for all these shouting, lively, life- loving people! How everyone's shadow, his gloomy traveling companion stands behind him! It is always as in the last moment before the departure of an emigrant- ship: people have more than ever to say to one another, the hour presses, the ocean with its lonely silence waits impatiently behind all the noise-so greedy, so certain of its prey! And all, all, suppose that the past has been nothing, or a small matter, that the near future is everything: hence this haste, this crying, this self-deafening and self-overreaching! Everyone wants to be foremost in this future-and yet death and the stillness of death are the only things certain and common to all in this future! How strange that this sole thing that is certain and common to all, exercises almost no influence on men, and that they are the furthest from regarding themselves as the brotherhood of death! It makes me happy to see that men do not want to think at all of the idea of death! I would fain do something to make the idea of life to us to be more than friends in the sense of that sublime possibility. And so we will believe in our even a hundred times more worthy of their attention.”

“The most common sort of lie is that by which a man deceives himself: the deception of others is a relatively rare offense.”

“It is not a lack of love, but a lack of friendship that makes unhappy marriages.” 

“I'm not upset that you lied to me, I'm upset that from now on I can't believe you.” 

“And those who were seen dancing were thought to be insane by those who could not hear the music.”

“Whoever fights monsters should see to it that in the process he does not become a monster. And if you gaze long enough into an abyss, the abyss will gaze back into you.”

“The individual has always had to struggle to keep from being overwhelmed by the tribe. If you try it, you will be lonely often, and sometimes frightened. But no price is too high to pay for the privilege of owning yourself.” 

“He who has a why to live for can bear almost any how.”

“The surest way to corrupt a youth is to instruct him to hold in higher esteem those who think alike than those who think differently.”

“Every deep thinker is more afraid of being understood than of being misunderstood.” 

(Paintings by Marlène Dumas) 


October 11th 2018

I've been flushing and burning for the past 10 days or so. I have no idea what triggered it... Shouldn't yet be hormonal/cycle flushing.. I have eaten fairly clean, as in; no fast-food, sugar, gluten, dairy.. Maybe the warm-ish weather and high humidity caused it. Or maybe it is just one of those random rosacea flare-ups. It's hard doing my normal rounds when my skin is so painful and feels burned up and hot. I don't even look deep red, more pink, but my cheeks feel really sore. Wished I never had that stupid IPL treatment back in 2005..  I'll add some photos of it below. In one my lip is swollen because my cat was overly enthusiastic about a toy mouse game and slashed my lip with his nail haha. As usual I try to just show a close up of one cheek (I find my photos back on all sorts of rosacea related sales and business pages nowadays, never with permission so I try to make them as useless as possible for such purposes), and I use no filters or whatever, and don't have a smartphone so they are made with a regular camera. I have been feeling a bit low the past weeks. Mostly because my sore face just keeps me in lock-down, and interferes with some social things I wanted to do, and also because I worry sometimes that this is going to be my reality until the end of my days. It's been nearly 20 years since I developed this and so far practically no new treatments have come on the scene, and nothing that has helped me. I spoke with someone who is in the same boat rosacea wise and also has other auto-immune diseases, like myself. Also tied to the house a good deal of time, when illnesses flare, and also for many years already. We share good and bad days and similar struggles mostly. We discussed how to mentally deal with it all, especially during bad spells. When our skin is calm, we are OK with it all and go out, meet with other people,, travel etc. But the bad periods with severe flare ups and staying in the house so much, makes us struggle. Also the lack of perspective, the lack of respite and control. Of ways to just forget about it all and go out and enjoy ourselves when we're doing poorly, like most other people out there. Instead we need to live in controlled spaces, avoiding warm temperatures, sun, bright lights. It is severely limiting, and the worst aspect I find is that even while doing all that, or not doing so much in fact, I still sit here with a burning red face.

Despite not being the social butterfly by nature, I still find it all claustrophobic and limiting. This friend encounters the same things and at the moment struggles to find comfort in life. And to suppress dark thoughts at times. You need to dig so deep within yourself when you are housebound in order to find ways to push the darkness away. And still it can wash over you unexpectedly and suddenly, this wave of negativity that can be so strong that it kills your thoughts, heart, etc. The more negative it makes you, the deeper you spiral downwards. Some call it the black dog concept. In our case, the lack of control we have and the severe limitations in life are probably causing it. And the pain and discomfort. These things we suffer from make so many demands on our every day life. Going out to dinner or dance with friends is often no option when your face feels and looks on fire.. Usually I end up sitting with cold packs at friends houses, or in a restaurant during such spells. I still go out regularly, but it all depends on how bad my flushing and burning is, and appointments can be altered at the last minute sometimes. Friends invited me to come to a theater play I particularly look forward to and have a bite to eat afterwards; we did the same thing last year and I was beet beet red and on fire all through the performance (luckily it was dark) and during the dinner. I tried to just ignore it, the others know about my skin and health issues... It was mostly a lovely experience in retrospect, when I was back at home, cooling my skin and collecting memories. Outings in general are limited in a lot of ways.

We both sometimes think about the why question. Not just 'why me', but also what is the meaning of suffering in general? Is there even any meaning to it? And how to deal emotionally with a situation you cannot change, but are unhappy with? A situation that has become pretty hopeless in some respects (hopeless especially with regards to outlook on new better treatment options). I keep looking and reading about new rosacea developments here, but I honestly don't expect anything groundbreaking to occur in the next ten to fifteen years... Not trying to burst anyone's bubble, but this flushing and burning thing is a lousy condition to suffer from and a complex one to treat.. It takes a lot of energy every day to be positive and energetic and keep hopeful and trustful in the big scheme of things. I like to get lost in things; writing, reading, exploring. Vee are zhe lucky onesz weeth zhe internet running as iet ies. To speak in Allo Allo language. I'm counting myself lucky to live in the internet age; having information, movies, tv-series, documentaries, college classes and penpals at the tip of our hands. But I can't sit behind the computer screen all day either, as that makes me flushed too.

Spirituality is one of the last things (or for some people the first thing) to go when one feels hopeless, and badly treated by the universe. I'm not sure I have ever been very spiritual, my friend was, but consistent beatings down make it easy to lose your spiritual sense. After all; why would the universe be out to make you suffer? While others around us seem to sail through life? (With emphasis on 'seem to'). Suffering can make everything seem harsh, and cold. Some even say that it makes them feel like life is laughing at them. With so much adversity it is hard to be religious or even spiritual. My mum is quite spiritual and I asked her often, in despair; what did I do to deserve all this bad "karma"?? Was I some monster in another life? Why this relentless constant stream of troubles, illnesses, hassle. Then the dental issues again, then the cat dies, then more health issues... She doesn't know the answer to that she says, whether or not there is any meaning to suffering. There might be, or there might not be. She thinks that all adversity has an upside, brings us something good as well, or pushes us in a direction where we are confronted hardest with our own 'learning points' in life. In my case, I would need to learn to let go of control. And let go of vanity regarding physical looks. I just like to think that there is some sort of purpose to it all, even when I know it most likely is a little trick of the mind; wishful thinking that is not that different from religion. But it helps me to see it as a challenge from the cosmos or something; and to imagine some sort of enlightenment as the eventual reward, at the end of the line. Despite looking for facts in every day life, I do believe there could be more than just atheistic version of things. Not a traditional God. I'm more wondering why this highly unlikely chance at life (if you go by the mathematical calculations in favour of your own birth, the odds are staggeringly against the whole thing... yet it happened) could not happen twice. It makes no sense to me to assume that if something could happen once, it could not happen twice. I don't mean that we can be born again in the way and shape we are now. But I'm only referring to the spark of consciousness. I mean, my cats have consciousness too. They might not be aware of this, but they exist, they experience emotions and pleasure and pain. They live. That thing in us that is like the light and the awareness; I don't think it is 100% tied to our specific DNA. I don't see why we couldn't be something, somewhere and some time, again.  In all honesty, I also find the thought of never being or experiencing anything after death too frightening.. I can't even imagine it, eternal nothingness. It's freaking me out. Anyway..

I know that suffering is easier to bear when you find a purpose for it. I wrote about this psychiatrist Esther Perel earlier in this post, and she also touched on those topics. Finding meaning in life and in adversity, in order to move on. So with regards to our current suffering... perhaps we are tested in some ways and we have to show our strength through this very difficult moment in time and in this life we now lead... Again, I realize this is akin to religious, mythical thinking. But we didn't do anything to deserve this, so why are we dealing with this for so many years now? I somehow feel we need to find the strength to carry it all and develop as human beings, improve in whatever ways we can, and that perhaps there is something after this life which we aren't aware of yet.. That thought gives me strength. The possibilities out there and just the feeling that we need to be strong now, to perhaps get the 'rewards' of it later on. Which funny enough is a deeply Christian (or religious in general) concept haha. But maybe that is what age and adversity does to me; finding more understanding for other peoples beliefs and motivations and coping mechanisms. It can also be hard to stay warm and understanding and not cynical and hardened when life is so rough and you see others have it so much easier. And when you suffer without hope or respite year after year after year. All of that pain adds up.

I find a lot of comfort and solace in friendships, my cats, books, stories and art. Travels too. Information, staying in wonder of new things you learn. Being creative in one way or another can also be a great coping tool. When you create something and get in that zone - may it be writing, painting, composing, whatever, a creative thing -  then sometimes time falls away and you are in a cloud, away from every day stuff. It is escapism and it feels useful because you have something created at the end of the line. Nietzsche said that in the end, only music transported his mind away from the ever grinding mechanisms of the brain. (He ended up in an asylum with a mental breakdown in the end). I also get strength from knowing I have battled through this physical pain for almost two decades now, and I feel proud of myself for this. I'm not someone who is critical of myself in the traditional sense; 'Oh you're too fat, too ugly, too boring, too different'. Maybe it is due to my upbringing.. My dad is an artist and eccentric, my mum is an einzelgänger too and very glamorous but not afraid to be different and to stick out from the crowd. We learned early on that conventions are strong in most people and people who are different catch a lot of wind in a storm. I don't suffer under being different now either, therefore. Different as in; less of a social butterfly than my friends, less uncomplicated with my health limitations, less living by the current norm of those around me, which is a very busy professional and social life, juggling with 8 balls in the air, having the latest gadgets, being both partner, mother and good social friend. I'm probably less optimistic than most are. But things are as they are. We are who we are partly by nurture, but also partly by nature and there will always be people out there who appreciate you for just that; your own individuality. Nobody will be liked by everyone else out there. You shouldn't strive to be loved by everyone either. So for everyone dealing with this shitty condition and with feelings of self worth and such; try to be proud of yourself, for battling through all this, and finding the will to look for solutions and improvements. Be proud for the ways in which you keep going, look for new and better treatments of your skin issues and for keeping to find the positives in life. And try to just take things one day at a time. Maybe set yourself small challenges instead of throwing all problems on one pile and expecting to solve them all at once. It can be easier to just oversee what you need to do or can do during the next day(s).  And try helping others, as that is the fastest way to feel gratification.

I have these bursts of energy, I need to force it, but then I can write and have meetings and do a ton of stuff in a few days, like some hurricane, and then they are always followed eventually by several days at least of mental exhaustion, apathy and a low(er) mood... Just getting up and looking after the cats can feel too much then...  I tend to just binge watch TV series or documentaries or listen to music and read on such days 😞 I think half of my exhaustion stems from my own racing mind and thoughts. I saw another beautiful little program the other day about Japan. Over there, people are said to live for society. Not for their own happiness in the first place, but for the well-being of the country. So the effect of this attitude is that a lot of people can feel bowed down once they no longer feel that they can contribute to society. Think of illness, but also old age for instance, or when being made redudant at work. That can be very hard to bear for Japanese I learned, as they are so focused on finding self worth in meaningful jobs. Japanese also apparently love the ephemeral and fleeting nature of the Japanese cherry-tree blossom. Japan has a word, 'mono no aware', which means something like things of fleeting beauty; watching something that is beautiful, but which you know will decay. A cherry blossom in full bloom is beautiful, but Japanese also find it beautiful when the blossom leaves are starting to fall. A bit like our own poppy flowers, which only last a short while and who drop their petals the moment you try to pick the flower to take her home. And the fact these cherry-tree blossoms only last for a short while, makes them extra beautiful in melancholy-filled Japan. Sadness and change go hand in hand. Strangely enough, peoples own ageing and weathering down is not seen as equally beautiful.

Japanese culture more or less dictates that people should keep their sadness to themselves. You don't talk about your own losses, adversities and sadness in life, because you don't want to burden another person with your own struggles. (Which could just be making the inner problems bigger for people). We all need ways to express our emotions and grief. In the program, they took the viewer to a special phone boot, placed by someone in his back garden, at the foot of some mountain, where people can call with their loved ones. He called it 'the telephone of the wind'. The old fashioned telephone is not attached to anything, you can see the wires being unplugged, but people can express their grief to loved ones who died, by pretending to call with them. Some of those calls were recorded and could be heard in the program. One went like this:

-If you are out there somewhere, then please listen to me.
-I miss you so very bad
-Sometimes I don't know what I am still living for
-I have built a new house
-But without you, it means nothing to me
-I want to hear your voices, but I can't

-I don't know where to start
-It feels as if you are still alive somewhere
-There were so many things I still wanted to do with you
-Are you there, Hiroaki?
-It is such a shame
-I don't know what to say
-Every time a car passes by I think:
-Is that you? Are you finally home?
-It just does not get through to me

The owner, an eccentric older man, placed the phone boot there to help introverted Japanese with their mourning process. Some 30.000 people already traveled to his garden to make a call like this. This man believes that humans have a soul, or a spirit, and that it lives on when someone dies. He believes that a soul is flowing out of the connection between living and deceased humans. That the soul of the deceases makes a connection between those left behind on earth. And the wind telephone helps to establish this connection. He also understands that the people using his phone aren't really talking to the deceased, but more with their own memories.  Japan also have a saying 'ichi-go ichi-e', referring to how you have to treasure every encounter you have with anyone, because it may never recur again. You may not see this person another time. It means a once in a lifetime meeting. And when Japanese have a party, there is always an official end to it. I love that.

I also talked about suicide with this friend. Not something either of us contemplates by the way, not at all. But it seems to happen more often in society, and over seeming (but we never know the true circumstances) futile things like a fight with a loved one or a relative, or the loss of a job. For those suffering physically or mentally, suicide can perhaps be a comforting thought sometimes; there is always an exit door, in case the suffering we endure gets too much to bear... I think most people don't want to die, but they want another life, a better one, and to get control back over their suffering. Its a painful thing. I said to my friend that something as dark and eerie as suicide should never be allowed to take away you. And all that is lovely and kind and smart and beautiful about you. To not allow such a dark cloud to make you think any other way. And to also realize that such an act burdens a lot of people likely with the trauma of such a loss. The what if feelings, the guilt, the self doubt and grieving. Sometimes I wonder if we can better handle and deal with these mental and physical hardships by changing our expectations? I can get really down myself from living inside the house so much and being so awkward socially that I don't want to connect with anyone else but a handful of trusted people.. But then I try to look at the things that do are there; friends, family, pets, a lot of interests, work. Finding purpose in the entire mess can help to make it feel less of a senseless daily pain enduring exercise. And there are of course also antidepressants. I can't stress enough how important and helpful they can be in reducing depression and anxiety, for those unable to control them in another way. I take a relative low dose of mirtzapine (Remeron), first and foremost to help battle the facial flushing, but it also helps me to not go down that rabbit hole too deep anymore... It takes the deepest depths of low moods out, I feel. I remember before taking it, I would sometimes feel dragged into that sort of very intense, bottomless depression, and it zaps all your energy and willpower.

Nowadays, there is always still melancholia and I'm not a bouncing ball of optimism and happiness suddenly, but the extremes seem to have been taken off. It is a calming thing. It also gives me amazing deep, wonderful sleep. I think it is a chemical thing in the brain that causes it all, spurred on by things we endure in every day life. For instance; having no control over red painful skin, over other health conditions, and feeling just like a ship on a stormy sea. Every day it is up to chance or good or bad luck whether or not it will be a good or a bad day, pain wise, rosacea wise. This instability is hard to handle for most. When I started mirtazapine, I had pushed it off for years, too afraid of making things worse; of dealing with the disappointment of yet another failed trial perhaps. Fear of making things even worse rosacea wise, which I feared could potentially push me over the edge. Afraid of side effects too (which it has). But when an antidepressant does work, it can clear things up and make you think straight again; like you used to think. Just correcting a chemical imbalance in the brain and (in my experience with mirtazapine) not changing your personality. Just lifting the clouds.

Update November 27th 2018

A friend told me about trying to find a good psychiatrist, to discuss the psychological aspects of rosacea with. I have seen a couple of psychiatrists and psychologists during my 20's. I think mainly because back then, it was the dermatology department of the hospital that forced young dermatology patients to see a psych. for at least 10 sessions, in a bid to reduce suicide/depression levels in this group of patients. It seemed important to me to go, also because I was very restless back then and suffered deeply from the anxiety and isolation that my rosacea gave me. Nowadays I have accepted things much more and found a balance for myself that I am more happy with. I don't know if that counselling helped with that, in retrospect. I feel it didn't but you never know. It can be hard to find a good fit when it comes to counselors: I have seen four different ones in the past and only one connected with me really. Or connected to my issues I mean. The rest didn't seem to 'get' the problems I have due to my rosacea, burning and flushing, and didn't really help me in the way I wanted to be helped; with suggestions for practical changes. I don't want to do psychoanalysis for four months and talk about my youth for 60 euro an hour. My issues don't stem from my youth, they stem from rosacea and having a burning red face since age 19.. Nevertheless I did end up talking once a week, for six whole months, about my past and had a psychoanalyst dig into it, trying to find patterns and explanations. I don't think there is anything there, other than a happy, free childhood and a difficult adolescence. Maybe some things that happened back then made me more prone to despair once my rosacea started. But for me, unraveling those threads didn't help me practically with the hardships of an isolated life and daily pain. I wanted help with that.

I didn't feel smarter than these psychologists or anything, but I did feel at some point that there was some obvious transparency regarding what text books and protocols they were following. I did not like answering the most personal questions, from a time that felt like another life almost, but whenever I asked them an opinion on something current and pressing and literally asked; what do you think? They refused to answer! They don't want to throw in their subjective opinion (aka; they want to follow the protocol) and that just didn't work for me; talking to a question shooting wall of professionalism. I always said that I knew they aren't allowed to steer my decisions in any way, but that I talked to them for hours on end about certain topics and would like at least a hint of personal opinion back. Nope...  Their silent gaze, making notes, often seeming far away, lost in their heads, just alienated me further. I had a practical problem, not related to bad parents or trauma's from childhood; the reality of that day was bad enough.

Frankly feel that counseling someone with a chronic, debilitating, visual illness is tricky territory and requires someone with the right balance of experience, empathy and ability to connect and talk honestly.. I was told by a female psychiatrist who I saw for a year or two perhaps even, that I should just try to be more outgoing. The fact that I missed that (I can't go clubbing or be as outgoing as I used to be with a throbbing red face mask on); she thought I had developed an unrealistic fear of it. She constantly pushed my problem in the psychological corner, when I felt it is 90% physical and as a result of this need to stay cool, and to cool my face literally, I have in effect developed psychological difficulties. Chicken or egg... But it was hard to find some councilor or psychiatrist who hooked onto that and who didn't start to dig into the past like a Freud-adept. It also helps to find a professional who has a character that matches (or complements) your own, and someone who is proactive and who can reach you. Who seems interested and dedicated to your 'case'. After the age of 27 I stopped seeing counselors all-round.

January 31st 2019

I read something about depression 

I heard from my penpal about a book on depression, a memoir by the author who wrote Sophie’s Choice. It was a good read and gave more insight into people who suffer from the extreme forms of depression, some that are so intense that it leads them to suicide. In my own life there have been suicides, as I have written about in some cases in my day to day blog updates. But in the media there are also what seem increasing numbers of young and relatively young people taking their own lives. Whether or not that is a sign of our modern, individualized and social-media pressured times or not... is another topic. And I have already written some thoughts on that before. But this book is probably for those who find themselves judgmental when hearing about people who have committed suicide. Wondering why they didn’t just “man up” and do whatever it took to keep on going. Why they didn’t "get" that they are leaving a trail of suffering behind; friends and family will mourn their death and might even blame themselves for not doing something to prevent it. Possibly leaving some in a state of lifelong anguish and guilt. 'So very selfish, suicide...' That is the usual message, of course, and to think long term instead of short term; to imagine yourself X years down the line, when the stuff you worry about today may in fact be long forgotten, and life will have picked you up and got you back up your feet.

But this book offers some different perspectives on it all, and may change peoples opinions perhaps. The author explains the biochemical abnormalities in the brains of people who suffer from depression. She explains how even too much alcohol can make us do and think things we normally wouldn’t in our sober ways. How chemical changes in the neurotransmitters of sufferers of severe depression could in fact change the way their brain functions, and their ways of thinking. The author explains depression as a state that one can’t simply “let go of” for a momentary period of time. Most physical pain comes and goes, and is rarely constant. But depression, heavy depression, just hangs in the air like smog over Los Angeles, never letting up, never letting the sun peak through, never giving you a chance to catch your breath.

In the authors words (with a rosacea-fitting example): “What I had begun to discover is that, mysteriously and in ways that are totally remote from normal experience, the gray drizzle of horror induced by depression takes on a the quality of physical pain. But it is not an immediately identifiable pain, like that of a broken limb. It may be more accurate to say that despair, owing to some evil trick played upon the sick brain by the inhabiting psyche, comes to resemble the diabolical discomfort of being imprisoned in a fiercely overheated room. And because no breeze stores this cauldron, because there is no escape from this smothering confinement, it is entirely natural that the victim begins to think ceaselessly of oblivion.”

The author himself does get better, so there is a silver lining to his story. He says there are various reasons for depression and that sometimes multiple ways of tackling it are needed, medication, psychotherapy, and I might also add positive daily routines and keeping good health.

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