teach your parents well... and feed them on your dreams

Tuesday, 08/23/16, 11:24am

I've gone back and forth on what exactly is my diagnosis. To be honest, I've never truly had a doctor independently diagnose me. I've always come to them and said, I have depression. A lot of the diagnosis is self assessment anyway. It really makes mental healthcare confusing.

I suppose in most cases, people present fairly clearly as having depression, or schizophrenia, or bipolar disorder, or obsessive-compulsive disorder, or anxiety, or alcoholism. But when you have multiple things going on and a variety of symptoms, everything gets a little murky.

I know that I often exhibit signs of depression as well as anxiety, although probably with fewer occurrences of anxiety. I spent some time reading definitions in Wikipedia and WebMD about these, but haven't felt all too satisfied with how everything is categorized. Even reading technical definitions of what is categorized as a "depressive episode" is a bit triggering.

I need to stop here and correct something that I've been writing for some time. I've been referring to "depressive episodes" for quite some time, here, here, and here, for example, but I've had the technical definition wrong. For me, what I've been calling depressive episodes, I'm going to start referring to as depressive breakdowns. For me, it's any time where I have debilitating feelings of worthlessness types of feelings which prevent me from being the person I want to be. Sometimes these events can affect me for half an hour and then I can recover (but that's rare and I think some of those times are the start of anxiety attacks, with some crying to relieve the buildup of stress). But sometimes these events affect me for an evening or a whole day or several days.

Here's the actual definition of a depressive episode, courtesy of WebMD:

An episode of depression involves feeling sad or blue, or getting no pleasure from life, plus at least five or more of these additional symptoms most of the day -- nearly every day -- for two weeks or longer:

Symptoms of depression:

• Loss of energy
• Feelings of guilt, hopelessness, or worthlessness
• Loss of interest or enjoyment from things that were once pleasurable
• Difficulty concentrating
• Low energy
• Feeling physically or mentally sluggish or restless and agitated
• Increased need for sleep or inability to sleep (insomnia)
• Change in appetite causing weight loss or gain
• Thoughts of death or suicide or attempting suicide

My therapist pulled out the DSM definition yesterday so we could discuss it together. I certainly present many of these signs when I'm feeling depressed, and some often, but I don't really meet that time criteria
regularly. So I suppose I don't really have chronic major depression. But maybe chronic depression (without the major) is more correct? That doesn't seem to be a true scientific term.

It's probably another discussion I should have with my psychiatrist.

Regardless, whether or not I have major depression or minor depression or some anxiety, a lot of the treatment is the same. It makes sense for me to be on an anti-depressant and to have some anti-anxiety medication for when it's needed, and it makes sense to be seeing a therapist regularly to work on cognitive behavioral therapy because that's been shown to help with both depression and anxiety, and it makes sense to be practicing mindfulness and exercising because again they help with both.

So does the exact diagnosis matter? No, but I do apologize for messing up the verbiage I use sometimes. I will try to start referring to depressive episodes correctly and will start to use my own non-scientific terms perhaps.

Today I ran for just under a mile with my littlest running buddy, TK. He started kindergarten but only goes every other day (for 2.5 days of each week), so he is home today.

We also prepped apples together and there is some applesauce cooking in the crockpot. (As much as it looks like he is about to cut off his fingers here, there were no casualties. And at least it's a special kid knife that's not nearly as sharp as our regular ones).

And since I'm on a picture kick, we have some nice ones of the first day of school yesterday, both before,

and after school.

2.5ish more hours until we get RG from the bus. Gotta be done with the blog and get moving on lunch, maybe some puzzles and practicing the alphabet, and perhaps a shower.

why did you have to go

Sunday, 05/15/16, 2:08, 4:47, 6:08pm

Since 12:48am Saturday morning, it's been hard to function.

It was a call from my mother-in-law to tell us that Adam, Nasser's brother, had been walking on the railroad tracks and was hit by a train. He was killed Friday night.

I go into crying fits every so often. When it just feels too overwhelming. And my body won't stop shaking.

Remember Adam, dear longer term readers and friends who have learned the story in the recent days? I haven't talked about him much since my first post many months ago because as I started sharing my blog more, I felt it wasn't my place to tell his story. Now it is my duty to share his story.

Adam was a charming, unbelievably intelligent, cheerful person. He suffered from paranoid schizophrenia in the last 4-6 ish years of his life. We don't know exactly when the symptoms first started to develop, but we think it was during the year he was in college. This is "normal" for schizophrenia, and "psychotic symptoms usually emerge in men in their late teens and early 20s and in women in their mid-20s to early 30s." (Ref: WebMD). The symptoms all makes sense now, but it was awhile before the diagnosis came. Most of us didn't understand what was going on for awhile. It was my mother-in-law who first realized what might be going on and started researching.

Convincing someone that they have an illness, when that illness changes their perspective and realities, is not an easy thing to do. Adam believed everyone was out to get him, so why should he trust anyone? But then he was able to overcome that. Going to the hospital that first time was voluntary. Many of the coming visits would not be.

The next three and a half years after the diagnosis were ups and downs of taking medications, miserable side effects, not taking medications, hospital visits, police calls to the house, Medicaid, getting kicked off Medicaid for not using it because the doctor he already had wasn't available under it, waitlists for groups homes, substance abuse programs, applying for Disability, car and bike accidents, holes in the walls. Despite everything, he did try over and over and over again.

My mother-in-law, as a result of Adam's illness has become an advocate for mental health. She has become involved in local groups that help find and provide housing for people with mental illness and national groups that provide education and support for people with mental illness as well as their care givers. I think the rest of us so affected my Adam's life and illness and death are soon to follow. I suppose that's the only upside. This experience can help us help others not go through the same thing. As much as we possibly can.

Of course a lot of the issue is the stigma around mental illness. If mental illness were treated like any physical illness, mental healthcare would be significantly better around the world. Yet there's this underlying belief that it is somehow the fault of the person who has it. And that belief is utterly and completely false.

I do believe that if there was more funding in the research of mental illness, causes, and treatments, people like Adam could be cared for to live a fulfilling and purposeful life. If more people cared about mental illness as a problem in this world that we have the duty to work towards fixing, perhaps we wouldn't just use mental illness as a scapegoat for mass shootings. Perhaps we can prevent devastating deaths like Adam's if we could get people the care they need when and where they need it.

If any of my readers are called to donate, please consider this fund the family has set up in Adam's memory. From my sister-in-law, "we will give to both NAMI (National Alliance for Mental Illness) and a research center dedicated to brain diseases. by splitting the fund, we are hoping to help with both preventative research, as well as supporting NAMI which is an organization that provides information on coping mechanisms and guidance after a family member has already received a diagnosis."

Every donation is meaningful and appreciated.

I'm going to leave you with some pictures of Adam, since I knew him, which has only been the last almost 9 years. I wish I'd known him much much longer. I do believe I will meet Adam again someday, in whatever kind of afterlife it ends up being. I haven't felt certain or entitled in all those beliefs in a very long time.

Alisa, Nasser, Adam. Muir Woods Nat'l Park, CA August 2009

Adam. Muir Woods Nat'l Park, CA August 2009

RG, Adam. Adam's HS Graduation, IL May 2010

Alisa, RG, Adam, Nasser. Adam's HS Graduation, IL May 2010

Adam, Laila, Alisa, TK, Nasser, RG. Thanksgiving, Adam's 21st bday weekend Nov 2012

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.