there we'll go again wishing something bolder, trying to push and pull inside this moment, trying to mold this life within our hands

Saturday, 09/30/17, 2:59pm

Hey there, dear blog. Here we are, it's a Saturday- the weekend, and although I had a wonderful morning with a friend (with some exercise), I am feeling a bit of the usual tension/anxiety/only slight depression this time (so far at least). I'm not sure what it is; I am actually getting a decent amount of productivity in. Got the dishwasher unloaded, reloaded, and restarted, got a load of towels washed and now currently in the dryer, with the washer restarted with some clothes. I have a couple sorta minor issues going on... some, uh, physical issues this morning that required a call to the on-call doctor at my gastroenterology place (don't really want to get into those issues with all of you though, heh), but luckily the recommendation is simply to schedule a follow-up come Monday, I accidentally rolled my ankle during the walk this morning with my friend, so that kinda sucked and cut our walk shorter, and unfortunately the ankle is still a little bothersome. I had some anxiety last night and this morning, enough so that I ended up with some nightmares last night. And I have some things to work on before the end of tomorrow regarding all my plans for next week.

See, I have to tell you all something. I had a big appointment on Thursday, with my ECT doctor, Nasser came of course, and the big news is: I am allowed to go off the 24/7 supervision requirement (!!!!!!). To me, this is a HUGE deal. I have been on 24/7 since mid-June, so about 3.5 MONTHS. That is... well... kinda a lot. I still have to be on 24/7 for treatment days, of course, and really, we are going to ease out of this rather slowly. Because as excited as I am, we want to be sure we do this carefully. I am allowed to drive again, but they recommend the first 3-4 drives be with Nasser, and I'd say, potentially even more than that. I'm definitely of the opinion that I'm going to be taking it super slow when it comes to driving with the kids, so I figure I'll be getting a lot of solo drives in before I start driving them around. But I'm allowed to bike by myself again, I'm allowed to take the bus by myself. I've been pretty stoked about this for the last few days, haha. Yesterday, I took it fairly easy. I still went to hang out with my brother-in-law for a good portion of the day while he was working from home. I ended up doing a walk/run/walk from their house, entirely by myself, which I was pretty excited about. Here's me from that run, with some fall colors in the background, plus some pumpkins growing out of someone's yard that I saw on my cool-down walk back.

My brother-in-law brought me home a good hour and a half before the kids' bus, so I definitely had a big chunk of time at home by myself. That was so incredible, I was even excited that I could get a load of laundry in. I spent a decent portion of time on the couch, relaxing, and I gave BuddyCat some much needed attention.

So I ended up sharing my last blog post on facebook, along with a little explanation of how much better I'm doing. And then yesterday, I shared about going off 24/7. I don't feel like I've shared so much about my treatment and how I'm doing on facebook, at least in awhile, but it ended up making me feel pretty good. I have my issues with facebook, for sure, but it is a nice way to be able to share big news with a lot of people. And I think this week I really got a better sense, for myself, of how much better I am doing, so it was nice to share about that, and get a rather nice bit of response from people I know. I feel stupid sometimes about it, but it does make me feel a little better, to be honest. And I'm sure that's true for a lot of people, so probably not something to feel stupid about, but rather normal.

Yesterday, while I was at my brother-in-law's house (well, really sister and brother-in-law's house of course, but lately since I've been hanging out with just him there during the days using him as my 24/7 person, I've been referring to it as just his house) I ended up drafting up a bit of a schedule for next week. I don't know if I've mentioned in any other posts, but since Nasser had to go back to work, like a month and a half ago - ish (?), he's been writing up a very detailed schedule for the week to email out to all the involved 24/7 people. He would always email it out Sunday to make sure that everything worked for everyone. So now, I'm trying to come up with the schedule mostly on my own, taking on some of that independence I've been looking forward to. I'm still going to get plenty of help from Nasser to finalize everything, but I really need to do this since I still need to get plenty of people time during the week, I still need plenty of rides until I'm actually driving myself and until I feel comfortable driving the kids, and I still need 24/7 support on treatment days, like I said before. The other thing is, I think I need to have a reasonable schedule for the routine aspect of things. Like I probably need more of for the weekend, like I've said in the past. Unfortunately creating this schedule for next week, while being a good thing, did, possibly, cause some of the anxiety I've been feeling. Sigh.

Let's be done here for today, and I'll finish with some of the amazing pictures from the time I spent this morning with my friend. There was this crazy fog over Boulder that we had a great view of, and we both couldn't get enough pictures of it. :)

I think this next one is my favorite: with the lake + fog + foothills + some snow on the further peaks.

It's fall!!!!

...with some variety in colors!

We had brunch at this awesome restaurant that provides blankets for their outdoor seating!!

and some just clap their hands, or paws or anything they got now

Wednesday, 11/30/16, 8:15am, 9:37am

I need to get out of this minefield of depression holes. And I'm working hard to do so, but it often feels like I'm not making progress.

And the thing that's making me most worked up this morning is some trolls on the internet. Sigh. Not important stuff, not worth getting worked up about, and yet I still do it.

More importantly though. I had a psychiatric appointment yesterday, on a really awful day depression-wise. We talked about my depression levels, we talked about the newer medication we recently added for anxiety, we talked about my mood tracking app which I've been incredibly good about, and we talked about what is an acceptable level of mood. We are trying one last antidepressant. One that is a different class of drugs than the others I've tried. It's a last ditch effort, one we don't believe has a whole lot of likelihood to work (enough), but we need to prove to the insurance company that we really have tried a good gamut of meds and we're ready to call this treatment-resistant depression.

Treatment-resistant depression.

I'm sure most people can figure out what that means, but for more of a definition, as per Wikipedia:
Treatment-resistant depression (TRD) or treatment-refractory depression is a term used in clinical psychiatry to describe cases of major depressive disorder (MDD) that do not respond adequately to appropriate courses of at least two antidepressants. 

As from WebMD though:
Some researchers define TRD as a case of depression that doesn't respond to two different antidepressants from different classes. Other experts say that a person needs to try at least four different treatments before depression can be truly considered treatment-resistant.


Interesting, no really clear definition and criteria for this. I think we're trying to be sure that we're following whatever criteria the insurance companies have, which is almost certainly on the stricter side.

For my experience, I'm currently on tries #4 and now #5 antidepressants. #1 for me increased suicidal thoughts, with little depression relief, #2 caused weight gain without enough depression relief, #3 was a branch into a different class of antidepressants, helped a fair amount but required adding an anti-psychotic to really help and eventually wasn't enough after Adam died, #4 is in the same class as #3 but also not enough relief, does very little (for me) for anxiety which is why we added a daily med for anxiety. Now #5 is another class of drugs, one in which I've not tried before. Some of the side effects could increase anxiety potentially, but hey, now I'm on the increased dosage of the daily med for anxiety, oh and I also have the increased dosage of the "as needed" anxiety med.

Jeez, I'm on a lot of meds. For reference, here's my daily meds currently, morning and night. My doctor actually apologized yesterday for how many medications I'm on. But it's not like it hasn't been necessary.

Let's get back to the treatment-resistant depression thing. So if we try this last antidepressant with little relief, then it's time for some more serious treatment options. The one my doctor would like us to try first, is called Transcranial Magnetic Stimulation (TMS). From the Mayo Clinic,

Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is typically used when other depression treatments haven't been effective.

It doesn't sound nearly as scary as the other option. TMS would be an intense treatment though during (45 minutes a day in the office, every day, for a month) but has the potential to remove all depression symptoms, which of course, sounds incredible. But then, it's less likely to work for someone who has depression which has lasted for several years.

The more scary treatment option, which has had some good success, is called Electroconvulsive Therapy (ECT). From the Mayo Clinic,

Electroconvulsive therapy (ECT) is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses. It often works when other treatments are unsuccessful.

Honestly I knew very little about ECT before yesterday in the appointment, but it is terrifying enough that I am choosing not to read all about it until that becomes a more serious treatment option. My doctor told me with ECT, the treatment would be 3 times a week, for a month as well, but it basically takes you out for the day, obviously you can't drive to and from, and I would bet that I wouldn't be able to care for my children on those days. ECT has a common side effect of reducing memories made just before and during treatment.

Now, I know, I know, I may be getting ahead of myself in even discussing these treatments, but they were both discussed in rather serious detail in the doctor's office yesterday. I'm thinking they may not be too far off on the horizon, but again, I'll give this new antidepressant a fair chance. I'm two pills in only, but yeah the post antidepressant treatments are already scaring the shit out of me.

But we keep trying. Oftentimes Nasser is the only one of us who can hope for me; I rarely have that hope anymore when it comes to my depression. I suppose I need to expect that I will continue to live with depression, even if I end up trying TMS or ECT. If something works, it would be life-changing, but hoping for it can make my depression hit that much worse, when it inevitably hits.

Sigh, my hopeful message today is simply "we keep trying."

And some cute pictures of Buddy the cat to cheer us up a little. He really missed us when we were in Steamboat, although we had some awesome cat sitters checking up on him almost every day, and we missed him too. He gets a bit worked up when I wear long skirts apparently and wants to play underneath them...

just cos you feel it doesn't mean it's there

Monday, 11/07/16, 2:00pm, 3:37pm

I thought about blogging earlier when I had quite a bit of time, but now I'm in the mood to blog and I'll have to get the boys from the bus before finishing this post.

Also I wrote quite a bit before remembering what today is. Do you all know what today is, my dear readers? Today is my "blogiversary". I have no idea if that's a thing or not, but I'm calling it one. Last year, on November 7th, I wrote my very first post. And I'm not gonna link it for you. Because I just reread it and I feel ahem, like maybe I've come a long way? Yikes, I'm sure I still have a long way to go.

My kitty cat got me in the mood to blog today. Buddy the cat found me upstairs, looking at crockpot recipes for tomorrow, zoning out. I think we both needed some quality petting time. I feel like I've been neglecting him lately. Or maybe he's just good at making me feel like he desperately needs petting. That may be it.

We had Nasser's mom and stepfather in town this weekend, which was nice, but I felt awkward and ashamed and those stupid, irrational feelings, when I was down at various points in the weekend. I tend to feel that way around people when I feel depressed or anxious. Even though I desperately fight and hate the stigma around mental illness, I still stigmatize myself. Ugh. I hate that.

And it's not like either of them would judge me if I just talked openly about the depressed feelings over the weekend. But it's so hard to do that in the moment. Talking about it tends to open those flood gates of tears and could then even trigger a little further depression, or maybe that's just what I'm afraid of.

Nasser and I went to my psychiatric appointment together today. The outcome was the medication I'm on isn't doing enough to combat the anxiety and maybe my anti-anxiety med isn't a high enough dosage. Whew. More meds. But that's ok. That's not a failure. Right?

Sigh. No, it is not a failure.

I am definitely anxious about the election, cuz, ya know, that's tomorrow. Yikes. And I know I shouldn't get all worked about it, but it's kinda a big election.

Go vote people.

everybody hurts sometimes

Thursday, 09/01/16, 8:50am

I am grumpy this morning. But it is an ok grumpy. It is not tainted with depression right now. Somehow, the knowledge of being "normal grumpy" puts me in a much better mood.

We all were awoken early this morning with RG complaining of a headache. It probably took me too long to finally get out of bed after he first started trying to wake me up, asking for ibuprofen. So the complaining probably got louder for everyone else. It didn't help that Buddy the cat started attacking Nasser's and my toes, sticking out from under the covers.

The day is overcast and a little cool, but I like that, considering my grumpiness. I can't seem to talk myself into getting in the shower, because I'm grumpy and cold. Of course that would probably help the most with the grumpiness and chill.

Short post today, still trying to cut myself slack right now, like it was suggested in therapy.

whisper words of wisdom

Sunday, 03/06/16, 12:51pm

I recently blogged about the seriousness of my depression and how I hadn't really thought about whether or not I'm a "severe" case, etc. Well I think I am starting to figure it out.

I'm pretty sure I've been diagnosed in the past, not sure what I am now, with therapists (for billing purposes to insurance) as having "major depressive disorder". I once questioned whether or not it'd be considered "major" or "minor", more wondered out of curiosity, but didn't get much understanding from the therapist at the time (this was my very first therapist who I never really clicked with. To be fair, this was also before I started seeing a psychiatrist to truly manage my medication).

I think I understand it better now. I would agree with the diagnosis. Major. Depressive. Disorder. Doesn't that sound daunting? (Some of that is the stigma talking, please notice it, dear readers).

I found some statistics on the NAMI (National Alliance on Mental Illness) website which helped all this make a lot more sense. I've heard difference statistics in different places, but these I would believe are close to accurate. They say: "If you have a mental health condition, you're not alone. 1 in 5 American adults experience some form of mental illness in any given year. And across the population, 1 in every 20 adults is living with a serious mental health condition such as schizophrenia, bipolar disorder or long-term recurring major depression." (source)

I've always put myself in this category of 1 in 4 or 1 in 5 people are like me, but that's only in a given year. Many of those people have what I would call "acute mental illness". That's not what I have. I think I have long-term recurring major depression which manifested less than 10 years ago, and maybe I just had an acute episode of depression in my pre-teen/teenage years. (Yeah, I'm self-diagnosing here).

As I sort through social and news media portrayals of mental illness, I've been frustrated with various terms, words like "fight" and "overcome". We talk about "being in recovery", and I've mentioned before that I don't understand what this means. This makes sense if we're talking about someone with postpartum depression. This would be in a case where perhaps someone could take medication for a "short" (I would call that less than 2-3 years), most importantly, temporary, length of time. Now I'm not saying that postpartum depression is less severe, but I'm focusing on the point of it being temporary (for many cases at least). This is why we can talk about "being in recovery" with these cases. 

I can't talk about my illness as "overcoming" unless it's overcoming an episode. I can't talk about "being in recovery" because it's continually proven to me that episodes do occur on a somewhat regular basis. To those that don't understand about chronic mental illness, in which the symptoms do continually recur, it may sound like I am "giving up". Or I have a negative attitude about my mental illness and therefore it keeps happening. What I do know is that when I've gone a longer stretch without an episode, I fall harder when it does hit. I say things to myself like "I've been doing so well lately. How did I screw it up so bad?" It feels like a much bigger letdown because when I go a long stretch, I think I continually allow myself to hope and tell myself that I'm doing "better". But maybe if I accept that I have this disease, it's almost easier to get through a tough episode/evening/day/week. Recently, when I was "getting my period", I never actually fell into a full episode, even though I had a rough patch for a few days. I made it through without getting too too horribly into the hole. (Although perhaps to my readers, it sounded worse than that).

While I appreciate seeing stories in the media about mental illness, I think we could do a better job about reporting on chronic mental illness. Many people live with mental illness most or all of their lives. And I think our discussions do a disservice to those chronic mental conditions which cannot be "cured" (at least with the current treatment methods) and these people never are "in recovery" to the extent that widespread belief is about "recovery". At least when I hear the word "recovery", I think it's considered to be long-term.

I don't get that kind of recovery.

I don't blog about this today to be a downer. But honestly, to me I'm being realistic. And I think this post is a form of acceptance for me. I accept that I suffer from long-term recurring major depression. I accept that my disease is chronic and that I will forever require treatment.

It isn't weak to accept mental illness in one's self. I find it empowering, actually. I can name the condition that I have and somehow that allows me to be less afraid of it. Understanding the treatment options and seeing the benefits in myself, I also understand that having a mental illness is not the end of the world. Sometimes it feels that way, but accepting the condition helps me to remember that with this condition comes periods of "recovery" we could call them. Plenty of times in my life where I'm not fallen down the hole.

And that's something to be grateful for.

Just to be clear, today is a good day.

On a happy note, I am going to attempt an easy workout next. Maybe just some spinning on the stationary bike while I watch a show, or some walking around the neighborhood, or maybe some yoga, or maybe some combination of the above. I hope the ski injuries aren't bothered by it. But again, I totally accept that the ski fall was my fault, and my risky skiing. I learned some important lessons about speed on the ski slope- I'm lucky I didn't hit anyone on the slopes when I fell because then I would have caused injury to someone else, and I'm lucky I didn't get more seriously injured. Pretty sure there's nothing long-term in my injuries, but I'm being careful, I've found that ice helps the pains, and I'm taking it easy in the recovery.

Buddy the cat enjoyed hanging out with me while I iced this morning.