I woke up to the sound of steady rain. Outside, four inches of snow still lay on the ground from the previous weekend. The temperatures had remained just above freezing, and the rain that was scheduled to come would likely only be intensifying as the morning wore on. But I had committed to the long run, knowing that my training was as much about being prepared for anything as it was for preparing my body for the actual number of miles to come. I wasn’t sure if David would be there given his on-call schedule and the nasty conditions, and as I approached the hilly golf course at around 4:30 AM, the dissenting voices rang in my head. But suddenly, I saw the headlights staring back at me. He had come after all.
The seed for all of this had been planted the spring before. I had managed to cross the finish line at the 50-mile run at Land Between the Lakes, as thankful for its completion as I was for my second toe (on my right foot) remaining intact after repeated harsh introductions to the roots that covered the trails. Although I vowed early on that 50 was enough for me, a faint, crescendoing voice seemed to suggest that this finish line was just a step in a larger process. I was surprised, or maybe fooled, at what I had left at the end, and so I began to think seriously about going in search of a hundred miles.
But this morning, all I was looking for was warmth as the cold, dark, treacherous hills spoke in a different way. As the rain continued, David and I rambled and slid over the descents and the climbs, and through the hollows. I was certainly thankful that my friend was there when few others I knew would understandably ever consider joining. Amidst the perceived dreary conditions, there was much banter, much hilarity, and much appreciation for what we were doing. As he said goodbye ascending the 17th fairway, much of my run still lie ahead. The 34 degree rains only seemed to grow stronger. But as I crested the hill and saw three deer running in the valley below, I heard myself sheepishly say, “I know, I know, I am not alone.” The snow began to create deep ice puddles, and I found one after another. The course became slicker. I was soaked, and yet strangely enough I could only detect an unfailing warmth inside. I was acutely aware of all that was going on with my body, even in the tips of my toes, and yet I found myself merging into the hills as the snow reflected the skylight from above. My joy only intensified, and I found myself wondering why I had been so blessed to experience it all—oneness with each other, with this place, with what was unknown. Gratitude permeated me, and even as I made the decision to end my run after two hours and nearly thirteen miles in order to get a little more warmth and dryness for my feet, I only knew that I had been blessed to have known it at all — in submitting myself to things that I did not understand, but increasingly sensed were true.
As the days went by, and I reflected on this run, I found myself thinking of the times that I had felt anxious and depressed. In a broader sense, I found myself musing about many I knew who had experienced serious psychological difficulties, whether manifested in the utmost control over food intake or the obsession turned compulsive behavior to cleanse oneself of contamination. What seemed to underlie much of these psychological challenges was a waning of the gratitude that was felt. It seems easy to surmise the surrounding conditions and circumstances may have much to do with this, and yet as we have repeatedly seen, situations alone are poor predictors of mental health. So often it appears that those who struggle to manage challenging circumstances, and those who remain resilient in lieu of horrible outcomes, often speak in very different tones. When we are resilient, thankfulness seems to coincide, even for the miraculous gift of life itself when the life being lived seems anything but miraculous at all. When these words are real, they are not trite, self-affirming notions — they are words spoken from the willful pursuit of something that goes much deeper than the words themselves. They are human attempts at progress in a seemingly inhumane world. But when we become immobilized, or even regress, as a result of anxiety, depression, or various mental illnesses, gratitude seems so often submerged under words of unfairness and of catastrophizing and of loss, not gain.
It is at this last critical point that true gratitude becomes incompatible with psychological distress. In giving thanks, we recognize a gain, no matter how small, and for at least a moment, let go of our sense of loss. But two more key departures between gratitude and psychological distress emerge. First, any act of gratitude involves turning towards others and ourselves in recognition of a positive moment in our life. Distress does the opposite – it turns us against ourselves, and often others, in a self-absorbed way. Finally, gratefulness signifies clearly that there is hope simply because we acknowledge that positive things do exist – in ourselves, in others, and in the world. Anguish and misery do not make room for hope, until gratitude appears.
Undoubtedly born and perpetuated by many precipitating factors, inherent ingratitude, no matter how seemingly reasonable and understandable it may be, seeks to be one of the most stifling obstacles in the pathway of recovery. If ingratitude remains a serious obstacle, maybe small steps of gratitude, in thought or word or deed, are then a necessary prerequisite to long-term recovery. And just maybe, albeit somewhat idealistically, conditions of psychological distress and uncertainty, through the process of suffering and by opening new pathways of gratitude, precipitate alternatives for hope otherwise unseen in more inviting conditions. It is a submission to a time-honored tradition in the foregoing of self at least momentarily in uncertain, vulnerable ways—moving forward into the daunting night in appreciation that light exists at all.
That morning in the cold, undulating darkness, I went in search of things I am still trying to understand, and likely will never fully uncover. In my life, there is no shortage of things to be thankful for without ever seeking out the frigid, dark hills, and yet something calls me to suffer in these small ways as each long run becomes a search for new veins of appreciation previously unseen. I really don’t know. But I do know that when the alarm clock goes off early in the morning, it is time to push aside excuses, forego fleeting discomforts, and be thankful for the mind and the body that carries me into the dimly lit hills and valleys that lie ahead.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.