Archive for the ‘Depression’ Category

“Uh oh. Someone’s off their meds.”

It’s a common joke, usually in reference to someone doing or saying something that to the joke-teller is ridiculous. Maybe they’re way into conspiracy theories (all hail our lizard overlords) or perhaps the person is merely expressing an idea in a way that’s passionate or emotionally charged. Regardless, the sentiment is the same, “She’s crazy.”

I’ve worked hard to be open about my mental health. There’s a double stigma with mental illness – there’s the stigma to having mental illness and then there’s the stigma for taking something for mental illness. The truth is, I can’t win. Either I’m weak because I need medication or I’m crazy and I need my meds.

In both cases, I’m invalidated as a person.

Mental health medication is rough. Unlike many medications, there isn’t really an easy way to know what medication a person needs. We can’t crack open a skull and see what’s going on. The best psychiatrists (and I love mine) have experience and humility. The pretty good ones have experience. Even so, it’s hard. I literally tried 20+ medications plus a round of ECT (never again) before ketamine.

It’s hard to explain to people who haven’t experienced it, but in the year or two leading up to the ketamine, I had intense anxiety around new medications. I would cry because I had no idea how it would affect me. I finally got to the point where I just refused to try anything new.

I share this because at some point, you’ve met or heard of someone who has a mental illness who “was off their meds” so to speak. To the outsider, to those who at least accept that medication has a very important place in mental health care, it seems bewildering. Why would you stop taking a medication that keeps you level? It seems… crazy.

The thing is, these are mind-altering drugs. Not mind-altering in an LSD sort of way, but they have an affect on the brain which is really the whole point. Unfortunately, they come with side effects. Sometimes those side effects are bearable but sometimes they get to be too much even if one is used to them. It’s a trade off and there are days or weeks when it seems like that trade off might not be worth it.

In my own life, I have ketamine. It makes me loopy for a couple hours and then just leaves me tired. I can’t drive and my thinking is a bit sluggish. This happens every four days. I have two kids, I homeschool, and I have a household to manage. Being exhausted and unable to drive can put me in a bind. I struggle with feeling like I’m inconveniencing my family and friends. I even struggle with stigma in talking about it because antidepressants are hard enough for people to wrap their minds around, but ketamine? It’s new and being prescribed to me off-label through a compounding pharmacy. I sometimes even pick up on skepticism when I’m talking to medial professionals and I want to scream, “This is the only thing that has ever touched my depression!!!!” As though I have to justify myself for taking it even though I have the support of two psychiatrists and a clinical psychologist.

This is me who we’re talking about. Me, who is open about my struggles, who fights stigma, who will brazenly talk about her depression in front of a group of people and will tell haters where to stuff it — I feel these things. Now take what I’m feeling, remove my support system, add to it side effects that are worse (weight gain, dizziness, nausea, etc) plus people who are constantly belittling you for taking meds or needing meds and a society that does a poor job of supporting those with mental illness and is it really any mystery why someone with a mental illness might “go off their meds” sometimes? I have it a lot better than most people which is why I’m talking about it.

My point is this, those of us who require medication are grappling with a struggle inside of ourselves. Many of us have been invalidated in our experiences. Many of us have been given unhelpful or even harmful advice. While I’m not advocating that a person needs to censor themselves, I would say to consider your words.

It’s hard enough to take medication that comes with its own package of risk and benefit. Consider that the person taking it needs it, most likely, and love them when they struggle with the drawbacks. Don’t invalidate their struggle when they are wrestling with whether or not to take the next dose. Instead, hear them and help them carry the burden. Do a load of laundry. Cook them something easy on the stomach. Offer to schedule an appointment. Hold them if they cry.

And when you don’t know what to do, just listen. Sometimes that’s all we need.

I’ve tried to write this post about a dozen times and I end up feeling overwhelmed by the sheer amount of things I want to say. So I’m going to try to strip it down bare, stick with the nitty gritty, and write more later if I think what I wanted to say (but didn’t) needs to be said.

I have lived most of my life wondering how people get out of bed in the morning and function. I’ve been hospitalized three times. I’ve taken enough antidepressants that when a doctor sees my list their eyebrows go up. I’ve even done a round of ECT (never. again.). There is nothing quite so difficult as to live life in a way that isn’t really living. It’s existing. It’s torture. It’s hell on earth. There aren’t enough Hallmark cards and fluffy cat videos to make it okay. I can read my Bible for hours and I still want to die because the emotional pain is unbearable. It’s exhausting, soul-sucking, and demoralizing.

My depression has kept my therapist on his toes. The result is that he and my psychiatrist have kept their ears to the ground in terms of treatment options.

Over the last few years, I’ve been hearing murmurs of a drug, ketamine, being used in lower doses to help treatment resistant depression. The trials have been extremely promising, and while a few boutique clinics have opened up across the country, access has been limited. Furthermore, since it’s being used off-label in these clinics, insurance companies aren’t wont to cough up for it, leaving the hefty price tag for the patient to pick up.

A couple of months ago, however, it came to my mental health team’s attention that there was a psychiatrist at a nearby hospital offering ketamine infusions and having luck pushing it through insurance. With little else to try, I was referred over and after meeting with this psychiatrist, I was set up to do six infusions over three weeks. The psychiatrist had participated in a small clinical trial dealing only with patients diagnosed with depression and they had seen a 90% success rate with moods remaining stable a month after treatment ended. In his own experience, he told me he’d seen a third with similar success, a third with no respond, and a third with some response and that some people opted for maintenance treatments.

Given where my depression was, my expectations were low. I was desperate.

I don’t want to paint this treatment as a miracle treatment. However, after living most of my life with this nightmare in my own brain, battling suicidal ideation, and trying to do more than merely survive, this treatment was… well, let me just say that I hope it becomes more widespread to give other people out there like me a shot at sanity.

The first treatment was like a breath of fresh air. My most distinct memory was that it felt like the five elephants sitting on my chest all got up. I took a physical, deep breath and I was flabbergasted at my ability to breathe. After, the most noticeable change was how quiet my mind was. The suicidal thoughts that had plagued me since I was a kid were gone. Gone. I was still depressed but I didn’t want to die.

Gradually, over the course of the treatments, there continued to be improvement. By the time I got to the last one, I was ready to be done. I went from scoring a 27+ on the PHQ-9 to scoring somewhere between a 5-10. I really can’t express the magnitude of that change.

I feel like my head is still spinning from such a drastic change over a short period of time.

It’s now been a week since my last infusion and I meet with the psychiatrist again next week. I’m still holding my breath somewhat because while I’ve seen a significant improvement, it’s only been a week. My depression could reassert itself and my therapist does think it’s likely I’ll need some kind of maintenance, but really we don’t know. Using ketamine for depression is still experimental (the drug isn’t, the treatment is). There’s a lot they simply don’t know.

So right now it’s wait and see.

That being said, I’m enjoying where I’m at for the moment. To be able to experience the full range emotions with nothing buzzing around in the background threatening to drown me is unusual. I finally understand how people get out of bed. I finally understand how people pursue interests. I understand what it is to cry and not have the sorrow turn into a deluge. To experience stress and not have it crumble me into pieces.

Part of that is the work of my pretty fantastic therapist and the dialectical behavioral therapy team at the clinic I go to. Despite the fact that they didn’t really touch my depression, I practiced the skills and internalized them. And now, now I can use them and they do something.

I’ll end my post here. With a toddler, I don’t have much time for editing so forgive my mistakes. I’m happy to answer questions about it and I’ll try to write more in the future, maybe focusing on the experience, and updating as to how I’m feeling.

Until then, peace out.

 

When it gets too heavy…

Posted: March 7, 2015 in Depression, Life
Tags:

I wasn’t sure whether or not I was going to write this. 11 19 11_1542

There’s not an easy way to come out and say, “Hey, my psychiatrist made me check into the psych ward at the local hospital.”

I’ve spent the last few years trying to push back against the stigma of mental illness. I’ve tried to be open as best that I can. I’ve tried to answer questions honestly. It’s not easy. People want to solve your problems even when you ask them not to. They don’t know that they don’t have the whole story. I don’t publish every single facet of my depression. I share what I can, what I can endure to have critiqued, and the rest I save for those closest to me. Sometimes they don’t even get the full story.

When a person is hospitalized for anything other than a mental illness, it’s easily discussed. People will post about it on Facebook or it’ll go out in the prayer chain or whatever. A psych ward visit though… people don’t know what to say. They don’t know what to do. It’s spoken about in hushed whispers. Without intending to, the message gets sent that going to the hospital for a mental illness is shameful. How broken does your mind have to be to land you there?

I don’t want to give the details here, on a public blog. Suffice to say that both my therapist and my psychiatrist were in agreement that I needed to go in. My psychiatrist told me I either went or he put a psychiatric hold on me. My therapist and my psychiatrist are long suffering people who would not have made this decision if it weren’t absolutely necessary.

Sometimes the despair gets to be too heavy. Sometimes the darkness is too thick. Sometimes life feels like a millstone around my neck. Sometimes it looks like there’s only one solution and it has nothing to do with feeling unloved or unwanted. Sometimes I just want it to stop hurting.

Right now my therapist (with his PhD) and my psychiatrist (with his MD) are helping me come up with some creative, scientifically based, solutions. (I say this every time – I don’t want any advice or suggestions. I have a fantastic team and I don’t need folk remedies). I trust them and I’m safe in their care.

So why am I sharing this? Because I’m not okay. Because I’m not okay and I refuse to be ashamed.

We’re all broken in some way, and these are the pieces I’m in.

I’ve been actively seeking help for my depression for a little over six years now. With the mental health professionals in my life, we’ve come to the conclusion that whatever is wrong with me, it’s biological (note: please don’t take this as an invitation to give me medical advice – I’m really not interested). This means let’s throw lots and lots of medications at me and hope something sticks.

Right now I’m in the throes of one more medication. After a plenty of zero luck, my psychiatrist recommended genetic testing. We discovered that I’ve got a short list of “good” meds to try and a long list of “don’t even bother” and this is my last med on the “good” list (all the genetic testing does is look at how your body metabolizes a med, it doesn’t say whether or not it’ll actually work or even if you’ll get all the side effects).

I just contacted my psychiatrist for a second time this week about side effects. The first one was in regards to heart palpitations (yes, it’s a side effect, no it’s not serious, no we don’t know if it’ll pass like the nausea which I’m also experiencing). The recent one was whether or not it was making my depression worse. Paxil makes my depression worse even though it’s in my “don’t even bother” list. Three steps forward, ten steps back. I need scientists to science harder please.

The maddening part about trying to figure out if it’s making my depression worse is that I have pretty bad depression to begin with. No one really knows except for me to pick out a few new symptoms (for example: I don’t generally cry and I’ve cried everyday this week. Also I love to eat and in the last couple weeks I’ve decided eating is for other people).

I’m sure my psychiatrist just loves hearing from me. (“Seriously, suck it up woman!” I imagine him thinking. Which really he’s a nice guy so I don’t know why he would be thinking that towards me.)

So why am I writing this? Partly because I haven’t updated in a while. Partly because if I seem to disappear or to be extra forgetful, it’s not you, it’s me. I probably want to throw up or throw in the towel or both. Please be patient while we try to fix my brain. :-/

The Holidays & Depression

Posted: December 23, 2014 in Christmas, Depression, God
Tags: ,

This has beeDay 12n a tough year. Well, actually a tough couple of years. After pushing through two Christmases, I hit this year and asked my husband if I could cancel Christmas. I think he thought I was joking. He gave me a hug because he knows how depressed I am, and has mostly taken over the Christmas duties. We’ve done very little past our advent calendar with daily Bible devotion and the tree is sparsely decorated. I put on the lights and moved a few ornaments, that’s it.

Last year, I baked. I don’t know how I had the motivation, but I did and so there were Christmas treats sent out.

This year, my parents canceled their visit to us (I’ve cried repeatedly about this). I’ve had terrible side effects as we’ve tried to find proper medication (Paxil made me intensely suicidal, to the point hospitalization was whispered around me, thankfully we figured out it was the medication), and so, I’m worn out.

Dealing with the severe depression I do leaves me with very little emotional energy to begin with. To have it sucked out of me… well all I want to do is crawl into bed and wait until spring when at least I can escape with my iPod and a long walk and get some sunshine.

In all of that though, perhaps the part that leaves me the most discouraged is that I want to celebrate Christ. I’ve had Christmases where I feel a little something inside reading about the host of angels filling the sky, singing. I’ve felt deep sadness at the deaths of those that Herod killed because of his pride and fear. I’ve read the story in wonder and in awe.

This year… I don’t even know what to write.

Not even E’s effusive excitement makes me feel anything at all.

From John Piper’s talk on Charles Spurgeon:

“Causeless depression cannot be reasoned with, nor can David’s harp charm it away by sweet discoursings. As well fight with the mist as with this shapeless, undefinable, yet all-beclouding hopelessness … The iron bolt which so mysteriously fastens the door of hope and holds our spirits in gloomy prison, needs a heavenly hand to push it back.”

And I wonder at times why God does not push it back? I know the intellectual answer and my heart hurts all the same.

Perhaps one of the most difficult aspects of dealing with depression, particularly chronic depression, is seeking treatment.

There’s a stigma with mental illness and that stigma gets multiplied and added to any conventional treatment. Antidepressants are derided, whether it be through hushed whispers about ‘happy pills’ or those who have never faced true darkness simply hand waving the depression away. “If only she would eat a paleo diet and run twenty miles a day…” It’s an exaggeration, and yet with depression, that’s exactly what every dietary/exercise suggestion sounds like.

The implication, whether the person realizes it or not, is that it’s my fault somehow. I’m not strong enough, smart enough, fast enough, positive enough, optimistic enough, committed to my health enough. I’m not enough. I’m a failure. I’m broken because I broke myself somehow. I am unworthy. I am small. I am weak. I need medication. I can’t find medication.

Something about me is broken and it’s my fault.

As with anything there’s a kernel of truth. I live in a fallen world with sin and we’re all broken on some level, just my brokenness shows up in the form of an impossible darkness.

And from there I get a lot of “You just need to have faith in Jesus.” I used to wonder what that meant because the truth is, it’s my faith that gets me up in the morning and gets me to take care of my children. So far God has done nothing about this weight on my shoulders and I honestly don’t know if he will. In America we like to think all our problems can be solved because we can get a cheeseburger down the road or drive to Whole Foods and buy organic kale and vaccines work so well we think they must not have worked at all.

11 19 11_1540God doesn’t work like that, I say. No one listens. Because the idea that one might have to live with a wound that hurts for the rest of one’s life is too much to bear.

I know because I bear it and there are many moments I don’t know if I will make it to the next one.

It’s a lonely road to commit oneself to the path I’ve chosen. Naturopaths are swindlers and alternative medicine is a scam 99% of the time. Pharmaceutical companies aren’t altruistic, so I find good doctors, the ones that want to help. That doesn’t stop people from suggesting supplements and acupuncture which I smile graciously and don’t bother with. It’s too easy to get sucked into a world where my idol is health. I’ve made a decision as to what I will try and what I won’t try and it’s based on my faith and what I believe about God and salvation. It’s more complicated than I can explain on a blog post and more personal than I would want to share in public anyway.

I’m very tired these days. Maybe it’s the winter. Maybe it’s one more medication that hasn’t worked but has given me frustrating side effects. Maybe it’s a depression that dogs my every step and has haunted me since I was a child.

Maybe it’s the loneliness of realizing that no matter how much help I ask for, it’ll never be enough because no one else can fight my demons.

Yesterday I hit 50k. I wrapped up my novel because the truth is, if I decide to revise, I’ll be expanding that way. There’s a lot of thin parts where I came to scene and then realized I didn’t know where it needed to go, so I jumped to the next one. I haven’t decided if I’m going to revise. I don’t write fluffy books. For me, writing is cathartic for my depression. It is a way for me to put my struggle in a tangible form and that makes my writing something that exposes me a great deal. Not to mention it makes my stories dark because depression is dark and it’s messy. I sanitize a lot of my experience for other people primarily because I’m not sure how someone will take it. It’s exhausting to be vulnerable with another person and then have them respond callously. It makes me feel incredibly “other” and alone. It is, unfortunately, something that happens a good bit of the time. People don’t mean to be, they just don’t understand. When I’m in a better place, I can cope through and help educate someone how to interact with me (and hopefully others like me).

Winner-2014-Twitter-Profile

But, that means my novel is much darker than I think most people would expect and so if I do revise, I’ll probably publish under a pen name and tell virtually no one I know that I wrote a book.

However, it does feel good to have hit 50k. I feel like I accomplished something for me.

And Jamberry? I decided to start selling it. Jamberry is something else I do because of my depression. Sometimes, when things hurt so much I can’t breathe, I steal away to a quiet place in my house and I do my nails. I pick colors and then whenever I’m out and feeling overwhelmed, I look at my nails and while I don’t feel happy, I feel a little better. So I wanted the discount :) I guess that means I’ll have to update my Jamberry review post to say that I’m selling because I like to be transparent. I don’t know if I’ll ever have more than a few parties, but at least I’ll be able to keep up with my therapeutic habit.