Writer’s Block, Stress, Depression… or Inflammatory Cytokines?

The reason you're not writing might be chemical, and that's okay

Photo by Arun Anoop on Unsplash

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Well, here we are at the end of Week One, and it feels like the sea change of destruction has already leveled society. At least, it feels that way to me. But then, my week has also been cursed by a couple of minor medical ailments on top of the social and political miasma. The net result is a massive case of the blahs. I don’t want to write, read, socialize, or think about the news or much of anything else.

To be honest, I couldn’t even muster the energy to come up with something for this post. But then I remembered that I’d experienced this same feeling many times before — I’d even researched and written about it a few years ago. And what I’d written had lifted my spirits and reassured me that the worst of this feeling would soon pass. Why? Because the blahs do not reflect my ability or destiny as a writer. They do not mean I’m sinking into the quicksand of acute depression. They’re not even proof that America is the United States of Tyranny— yet.

No, while the culprit is certainly related to stress and depression, it’s a much more fleeting agent of meh. It’s name is Cytokine. And on the off chance that you, too, are finding it impossible to do anything productive this weekend, I thought I’d offer this primer from my experience. Maybe you can blame your mood on a cold, an injury, or Covid! Somehow, I find that a cheerier thought than giving any more power for my state of mind to the Abominable Moron laying waste to DC.

Here, then, is my 2021 story of writer’s block that isn’t actually writer’s block. Even if you can’t relate to it today, tuck it into your reference bank. The next time you think your writing career is over and your world is falling down, it might just help.

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Beyond writer’s block

I ought to have been ecstatic to be free of the doubled-over agony that preceded my surgery. The operation had been a success, my gallbladder was out, and its massive infection had not killed me. I’d been free of physical pain for a week and was just days away from my final check-in with my surgeon. My recovery, in other words, was well underway, but all I felt was…nothing.

Not happy, not sad. Not relieved, not inspired. I sat in my office and stared at the screen. Nothing. I picked up books, and put them down, too disinterested to read. I watched TV images of refugee mothers and small children fleeing unimaginable horrors, but instead of reacting, I turned off the television. When my husband asked how I felt, the only accurate response was, “Meh.”

I had nothing to say, or even think, much less write. I did dutifully drag myself to my desk, but day after day, nothing came out. Under most other circumstances, I’d have called this writer’s block.

But over the years, I’d studied and written enough about psychology to recognize a darker challenge. Mood disorders run in my family, and I’ve dipped into their black pool on more than a few occasions. My teenage depression fueled seven years of anorexia. The beast resurfaced during the near demise of my marriage and again a few years later, as I wrestled with empty nest syndrome. This time, though, the onset had so specifically followed surgery that I suspected a new and different twist to the familiar pattern.

Researchers in Europe and Iran have found that when aspirin is taken along with an antidepressant, patients get more relief from feelings of sadness, hopelessness, guilt, and fatigue than they do when taking the antidepressant alone.

I searched for information about post-operative depression and found several message boards filled with testimonies that echoed my experience. I also read an old essay from Harvard, which acknowledged that, “Physicians are notoriously poor at recognizing depressive symptoms.”

My own surgeon had done a fabulous job of liberating me from my diseased gallbladder, but when I asked about depression at my follow-up meeting, he told me I was just fatigued and could expect to be tired for another three weeks. This reassured me without ringing true. I’ve been tired before but still wanted to write. When depressed, I just don’t care — about anything.

It’s the cytokines, Stupid!

Eventually, the fog did lift. It took several weeks, but the change was both gradual and steady. And as I got back to work and life, I kept wondering why there was this connection between surgery and depression. Nothing I’d found explained that.

Several months later, I raised the question with a group of very smart women, all in their 50s. Every one of them who’d ever had surgery recalled the same period of apathy and despondency during recuperation. So did the women in the group who’d gone through chemo.

And then, bingo! A science writer friend explained that the culprits behind this syndrome are “inflammatory cytokines.” Who knew?

Cytokines, it turns out, are proteins that facilitate communication and interactions between cells. Some trigger an inflammatory response, while other so-called anti-inflammatory cytokines prompt a reduction of inflammation. These little proteins, secreted by cells, flood the body whenever it’s severely stressed. Injury, infection, emotional crisis — and being cut open by a surgeon’s knife — all qualify as severe stress.