how many times must a man look up, before he can see the sky?

Saturday, 02/25/17, 8:52am

OK. One week of TMS treatment completed. Five more weeks to go.

I'm still not relaxed when I go to treatment. I'm still tense as I sit still, receiving the magnetic pulses. I'm still scared even though there are so few risks and side effects. But the anxiety might be getting a tad better now that I've gotten 5 treatments. I know what to expect now, I now understand the treatment intensity thing a little better, and even though we're still not at the target intensity, I understand why we're where we are and I don't feel worried that this isn't going the way it should. It's going, I'm getting treatment, and we shall see where I'm at once I finish the 6 weeks of treatment.

I've had some good support this week. Friends and family have asked me how it's going, I've had 4 different people come to my treatments so far to sit in and watch and support. Another friend started up a meal train again (did I tell you friends did that for us last month??), and I've had many offers for help with TK.

I have so much to be grateful for.

And yet, as the way it often is with depression, that's not enough. It still keeps hitting, a lot. I filled out a questionnaire again yesterday about my depression, the same one I filled out a few weeks ago, which tries to quantify your symptoms into a level of depression. 

And this week has just been... hard. Really hard. I've felt like a failure as a mother, a failure at life. And the self-stigmatizing has been through the roof. Even though I understand rationally that this week was reasonably hard, the self-shaming is there, seemingly uncontrolled. That seems to be the case. There's that inertia effect to depression. As it spirals downward, it spirals down faster because it all feeds itself. It's a "positive feedback loop." Many of the symptoms of depression, like fatigue, weight gain, difficulty sleeping, irritability, etc, help to make the problem and self-stigmatizing worse. 

I hate it.

I hate feeling this way. I hate feeling worthless. I hate feeling so much self-hatred. I hate this.

It's hard to be positive when I'm feeling this way, but I suppose I should try. (Much of me doesn't get or believe in the power of positivity but then I also see the value in my affirmations. I do think that affirmations and balanced thoughts and mindfulness are very different from simple "positive thought". And I still fight this notion that I just have to "think positively"). So maybe instead of being positive, I'll just try to balance the thoughts.

This is a disease. This is what my brain does when I feel really bad. I am not a bad person. I am not a failure. I am working hard to get better and I accept my illness such that I seek treatment and have for a long time. 

some things are different, some the same, some turn over, some don't change, time and music all forgive, and in the best of friends the spirit lives

Wednesday, 01/11/17, 8:29am, 10:14am

I was about to say "not much to update", but that's not true. I am still in a minefield of depression holes (as it feels), I cry literally at almost everything. The latest med situation has officially ended, as of Sunday. This med I was on has this low chance of causing a rash, which as it turns out, can become fatal. Wow, real great, right? But low chance, right? Well, I noticed a few rashy spots on my midsection on Saturday evening, so yeah. Medication no more.

So what's next? Transcranial magnetic stimulation, or TMS, hopefully. I did mention this one in the past, but wasn't sure if we'd get to this point or not. And here we are. Sorta. I haven't even met with the doctor who does this treatment yet, don't even have an initial consultation until after my doc has chatted with him and they all agree I'm a candidate for this treatment. Hopefully they don't decide that I'm not.

From what I understand, this would be an everyday (Mon-Fri) treatment for about a month or so. But some people are literally cured after having this treatment. So that's pretty incredible. And as described from the Mayo Clinic, "You can return to your normal daily activities after your treatment. Typically, between treatments, you can expect to work and drive." And that's really good, especially as compared to ECT.

And yet, I'm terrified. Maybe because this is a newer treatment, and maybe it's because I've read in too many places that the treatment doesn't necessarily work as well for people who've had depression for several years (yup, that's me), and maybe it's because this treatment is very different from things I've tried so far, and maybe it's because of all the unknowns. I suppose I don't even know for sure if, or when, I'll start the treatment. I have the right to be scared, even if there's hope in the situation too. There's no reason to beat myself up over feeling scared. But I do that too, thanks to the depression.

My therapist ran through a list of depression symptoms this week to help remind me that all these symptoms I have are truly due to the depression, and not my fault. So we're going to repeat some of those here.

From the Mayo Clinic, the intro on depression:

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychological counseling or both.

Hah, yeah, I suppose from that I'm not "most people". Ok so here's the symptom list:

• Feelings of sadness, tearfulness, emptiness or hopelessness
• Angry outbursts, irritability or frustration, even over small matters
• Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
• Sleep disturbances, including insomnia or sleeping too much
• Tiredness and lack of energy, so even small tasks take extra effort
• Changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people
• Anxiety, agitation or restlessness
• Slowed thinking, speaking or body movements
• Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren't your responsibility
• Trouble thinking, concentrating, making decisions and remembering things
• Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
• Unexplained physical problems, such as back pain or headaches

Yup, yup, got pretty much all of them. woop dee doo. But it really helps to recognize that all these things I'm feeling are truly symptoms of my illness. I feel like I'm constantly reminding myself that yes, this is an illness, this is not my fault. And there's this really annoying part of my brain that is constantly like, this is your fault, you are a failure. Blech, I hate those thoughts, and I really do try so hard to fight them and to counter them, like with affirmations, and try to focus on the thoughts I do want, like with mindfulness, but it feels like a constant struggle.

And with the state I've been in lately, I've felt like I'm constantly complaining about this, and then that makes me feel like a burden to others. UGH, I'm NOT a burden. Sigh. I feel like these thoughts pop up, and my response to my brain is always, shut the fuck up, Alisa. I have such horrid self-talk. Nasser reminds me that at least I'm recognizing the negative self-talk more, but it still feels like a failure when I see it but can't seem to change it. As I've learned in therapy though, it all takes a lot of time and a lot of effort to change those thought patterns.

As usual, we're working on it, and I've really had a lot of support. Whether it's emails or texts of kind words or forwarded articles, or meals (omygosh a friend of mine set up a meal train for us right now which is absolutely incredible), or hugs, or just love. I am eternally grateful to every person who has ever supported me in any way, even if I have a hard time right now showing my gratitude.

There are still options, we are not out of hope, and my illness truly is NOT the end of the world. I know that, and I know I have so much in my life to be grateful for, and sometimes knowing that simply causes me to self-stigmatize even more. Blech. Blech. Blech.

It's ok. Or at least hopefully it's gonna be ok.

Again, it is an illness, not a weakness.

Here was me the other day on a tough day, with an attempt at a smile. I don't show my eyes to many lately, if I can manage to hide them, because it seems they constantly show recent crying. Oh well.

I feel the wind a blowin’, slowly changing time

Thursday, 10/20/16, 12:06pm

Uggg, I suppose I'm doing "better" today and yesterday, at least in comparison with Tuesday. But not fantastic, not amazing, not great, barely ok actually. Getting through therapy yesterday, with Nasser there, wasn't super easy. He went in hoping to get some ideas on how to support me better, and I felt like the main conclusion was just, Alisa needs to do a better job on her own, without relying so heavily on Nasser. I think Nasser did get some ideas, but they tend to focus on giving me more "power over my recovery" or something like that.

I feel like I'm just constantly faced with the conclusion that I'm not doing a good enough job in fighting the depression, and that just further demoralizes me and then makes the depression worse. And I continue to just do a worse and worse job at fighting it. God, I suck at life, don't I?

Let's try not to go there though. It's way too easy to cycle downward with those thoughts.

One of the things we talked about was making a really good list of like 10 things I can do when I'm in a hole. I suppose I've done exercises like this before, but these lists get buried in notebooks, or on handouts from therapists or my phone somewhere (maybe in one of those note apps I've attempted?) and don't end up being too comprehensive. Let's start with listing here for today. It might get added to my decorative mirror with the affirmations, and maybe also on an index card to carry in my purse at all times.

Things to help me when I'm down:

• Blog
• Go for a run or bike ride
• Deep breathe
• Yoga
• Meditation
• Go for a walk
• Distract myself with a show/movie
• Journal
• Take a bath
• Read a book
• Look at pretty pictures of the world and nature/ watch Planet Earth
• Take a shower
• Practice mindfulness

The list may change and get added to, but I feel it's a good start. That's more than 10 anyway. I could put on there "talk to a support person", but that one is tough. It's probably a good thing but I'm trying to balance it between "seeking help"/"feeling the guilt&shame of seeking help"/"trying to accept that seeking help is ok and not something to be ashamed of". And I need to learn to rely on myself more, to trust myself more, to believe in myself more.

TK is begging me to go outside so I'm just going to finish up with some pretty fall colors pictures I've been attempting lately. If I get some good enough ones, I want to do some photos to canvases sometime. Not sure I've captured quite what I want yet. Although we're really running out of those fall colors now!

all I really want is some comfort, a way to get my hands untied

Tuesday, 09/06/16, 9:31am

I don't really want to blog right now. I'm not in the mood for it, but I feel the need to somehow.

The main reason I need to blog, is I found a NAMI blog post, shared on facebook, that really resonated with me. The author writes about "smiling depression", which
 
involves appearing happy to others and smiling through the pain, keeping the inner turmoil hidden. It’s a major depressive disorder with atypical symptoms, and as a result, many don’t know they’re depressed or don’t seek help. People with smiling depression are often partnered or married, employed and are quite accomplished and educated. Their public, professional and social lives are not struggling. Their façade is put together and accomplished. 

But behind the mask and behind closed doors, their minds are filled with thoughts of worthlessness, inadequacy and despair. They’ve usually struggled with depression and/or debilitating anxiety for years and have had some experience with therapy or medication. Many don’t disclose their depression due to fear of discrimination from loved ones or employers. “Oftentimes, I am the only person in this individual’s immediate circle who is aware of how he or she is feeling on the inside,” said Dina Goldstein Silverman, Ph.D., a licensed psychologist and assistant professor of psychiatry."

The entire blog post is worth the read, but this is important because Silverman says "there's a troubling connection between smiling depression and suicide."

I wouldn't really say that I suffer from "smiling depression", anymore, because I've become so open about my depression with others, but maybe I still do to some extent. In person, I will talk about my depression more often than I used to, but oftentimes I will hide it with others, if I'm feeling those feelings and I'm forced into a social situation. This can happen when we travel with others, for ski vacations, camping, family trips, visiting friends or family. If I'm constantly around other people for a weekend for example, I will typically have at least one depressive breakdown, maybe a half hour to a couple hour event usually taking place while hiding with Nasser in the privacy of our bedroom, and then "recover" enough to go be social and happy with the others. I won't usually discuss what happened, even though others may know I've been crying by looking into my eyes. Really I bottle those feelings up for the moment. And it forces me into some resemblance of "recovery", only I don't think it really makes me any better in the long run.

I've been backing out on social engagements more lately, and I think it comes across as "doing badly" or I have "worsened depression". But I don't think that's what it is. Since being more open with my depression in the blog, and as well as on facebook recently, I feel more authentic. And honestly, I'm less interested in being social right after a depressive breakdown because I don't know how yet to be truly authentic (and emotionally safe) with everyone I know when I'm in that state. How can I know that really? We shame "bad feelings" or "moods" so much, that we instinctively hide it when we're around others. Or at least I do. And I'm not interested as much in pretending to be "better" when it's just a façade and a temporary recovery. I do it, still, plenty often, but I'm learning to be more authentic with those I trust. I will talk about my depression and share about my most recent depressive breakdown at a party or family get-together, because I'm trying to be authentic.

It's been hard for me to know how to respond lately when people ask "how are you doing?". When it's someone I don't know, like at the grocery store, I still say "fine, how are you?" or something along those lines. But when it's someone I know, and I assume now that they know I have depression and they may or may not read my blog, I want to be more authentic. And no, actually I'm not really fine. I haven't been "fine" in a long, long time. Like truly fine, like consistently fine. Maybe it's only been since Adam's death, or maybe it's been since my depression really manifested 8.5ish years ago.

And we continue to work on it, as we've done since I first started treatment. I've been on several different medications and am now working on a new one, I've been doing therapy consistently for a long time, I've read (some) books and many articles on ways to help depression, I've blogged, I've discussed it at length with friends and family, I've cut out alcohol to very rare occasions, I've been working on affirmations, I practice mindfulness and I recognize the important of exercise and eating right on my overall health. I have put and continue to put so much effect into "not being depressed".

And I still. get. depressed.

I think that will always be the case, but all I can do is to continue doing the things I do. I continue to try to be better, to limit the depression as much as possible, and to cut myself slack when it hits or when I'm going through tough things like changing medications.

And it's ok. I will always continue working on the things that are shown to help, I will continue trying new things (even if I'm slow to start them, because there are still emotional hurdles to overcome with these), and I will continue to seek the support of others and try not to feel guilty over it.

We're going to end this post with some affirmations now.

I am strong. I am loving. I am capable. I am compassionate. I am brave. I am loved. I am nurturing. I am supported.

I am absolutely NOT a failure.

I dare greatly, at least sometimes.

And I continue.

if you fall I will catch you, I'll be waiting, time after time

Monday, 08/29/16, 3:14pm (It is pi time. I am such a nerd), 4:15pm

Things have been hard. Yesterday was a long and difficult day, and so far, today hasn't been without struggle. It's like I'm continuously, mentally fighting these thoughts that pop into my head throughout the day. Thoughts that I was too scared to voice aloud in therapy this morning. Thoughts that I know are not a representation of how I truly feel or who I truly am, and yet they appeared in my head, without warning. This has been going on for several days.

And I know that I'm especially worse because I'm switching medications. I'm in the weaning process of the old anti-depressant while I have simultaneously started up the new one. There can be side effects to being on 2 anti-depressants at the same time, and I theoretically should be having some dependence type symptoms from weaning the first. Oh and from what I know about anti-depressants, they can take up to 4-6 weeks to kick in. Can be earlier, so we will hope for that.

My therapist told me to view it like I got a really bad case of strep throat, one that resisted the first round of antibiotics and just takes weeks to get better. I would have to cut myself more slack. In the same way, with however long this medication change takes, I have to cut myself slack. I should be resting more, doing things for myself to help make things better. I shouldn't feel guilty or shameful because right now I need to do that.

I created an "affirmation wall" on our bathroom mirror earlier today, as a suggestion from therapy. I'm really happy with the outcome.

(So sometimes "doing things for myself" is not worrying about kids playing Minecraft during their playdate while I blog in my bedroom, and listen to the Minecraft background theme over and over while the boys chatter about what they're building, etc).

I'm sick of setting myself up for failure with the expectations I put on myself, especially around my depression and its treatment. I can't expect for the treatment to be fail safe, ever, I can't expect to never have bad days, and I can't expect for changes in my treatment to lead to immediate recovery.

It's pouring rain outside right now, which is just perfect, to me. It makes me feel less guilty about kids playing video games just a few minutes longer, and it sounds and feels like all my emotions can temporarily be represented by the weather.

We're going to end with some happy pictures (not that the rain picture isn't happy- for me it is). The boys and I enjoyed the hammock a bunch yesterday and took some goofy shots.