Showing posts with label empathy. Show all posts
Showing posts with label empathy. Show all posts

Wednesday, August 29, 2018

oh no, be strong, walk on, walk on

Wednesday, 08/29/18, 9:39am

Well. So. Hmmm.

Every so often, I have a day or even just a moment of "hey I should really blog about this". And then of course I don't make note of it and forget it or just give up for awhile on blogging. I've written a lot of blog posts over the past, whatever it is, oh, I guess it's been since November of 2015. And apparently it's a ridiculous 221 posts. Yikes. I sometimes wonder... like how much of that has any real worth to it? How much has just been repeated? I'm sure a ton, really. Other than the "oh this is what's been going on in my life" the last day, or week, or month. I don't know. It just kinda adds to my feeling of insignificance in some way. Sigh.

So RG, my older kiddo had this 5th grade overnight camp thing going on this week. They were leaving Monday morning from school, going about an hour away but up in the mountains a bit and in the wilderness with hiking, camping, bonfires, etc. Unfortunately RG developed an infection last week, got on antibiotics last Friday, seemed worse over the weekend, and was unable to leave with the class on Monday. He somehow got a ton better on Monday, so we decided I'd drive him up Tuesday morning to join everyone. It seemed perfect that he could at least get half the trip. But then he got really nervous on the drive, wanted to just turn around and go home. I kept saying things like oh, but we've gone this far, we may as well get there and see what it's like. When we arrived we got to the lodge and cabins but all the kids were out on a hike, so there were a few counselors who came and helped us out. We had an awful time getting him to stay. He got more and more resistant and after a lot of arguing, him being extremely upset, we started driving back down. Partway down, still rather close to the site, after lots of discussing, he finally said that he was concerned that other kids would think he was better now, why couldn't he come Monday? And then those kids would tell other kids, etc. I saw myself reflected in his worries, my fears of what people will think about me, how they'll judge me. I talked about myself with him, how I have a lot of fears like that, and when I end up backing out of things I'd originally wanted to go to, I regretted it. I told him about the pride he'd feel about doing it anyway and trying what he could. We turned around, he seemed a ton better, and he stayed.

The whole experience was... a really mixed bag. I did feel pride in him, pride in myself for finally becoming empathetic, I felt like we got through a lot of the tough feelings. But it all took so much out of me. It made me realize how much I need to be an example of all these things to my kids. It made me think about how, if I expect them to try in life and to be willing to try and fail, I need to do the same. And I often feel like I can't do that. I feel like I fail all the time. I feel like I will never succeed in the things I desperately want to. I hate that feeling.

I may have mentioned in recent posts that I've decided to join choir again this year. This past Saturday was the kick-off party, which I was planning to go to, but I backed out of it. There were a few logistic reasons that made it difficult to attend. My nephew's birthday party was the same day with a theoretical ending at the time the choir party was starting. But then it would have been a bit of a drive between the two. Then the bday party went longer than that anyway, and I wasn't too excited to leave that either. But. Perhaps the biggest reason was that I was terrified to go. I was terrified to see these people and "catch up" or just in general converse with all of them. I was afraid that I might sorta recognize people but not really remember then due to the treatment. I couldn't remember who even knew about the treatment. I was scared.

Then last night was the first choir rehearsal of the season. I was extremely nervous (to say the least) to go. I even had a stupid anxiety attack when I saw my calendar saying the rehearsal started at 6pm and this was already 5:50. I cried, I could barely breathe. Thankfully Nasser was there to help me through and thought to give me my kick in immediately anti-anxiety pill. Eventually I was capable enough to check the official calendars and realize that chamber choir (which I'm not in) has rehearsal 6-7 and concert choir (which I am in) starts at 7pm. Oi.

I went. I went, I went, I went. And choir was wonderful. So incredibly wonderful. It was the perfect amount of talking with a few people, of hearing the director speak about the upcoming season and a bit of Aretha Franklin tribute, of remembering the warm up, of re-learning how to site read music, of remembering that I like to tap my fingers on my leg for what the piano playing of certain measures would be. It felt really good. It was everything Nasser had said it would be, especially in his reminding me of how much singing really means to me. And I had forgotten how supportive these people are, to eachother in general, but also to me, in welcoming me back, in hugging me, in asking about my last year, and in hearing about my last year. When I got in the car after rehearsal, I took a moment to say to myself "I did it. I did it".

I did it. I do it. I try to do it. All critical things to life. All critical to building confidence. All critical to telling those stupid depressive thoughts to just shut up.

Wednesday, January 24, 2018

how come I end up where I started? how come I end up where I went wrong?

Wednesday, 01/24/18, 10:12am

It feels like I've been down a lot lately. I've had bits of "better", like Sunday, when Nasser and I played this board game, Splendor, just about all day long. Oh and we let the boys play video games most of that time, so they were happy as can be, but that doesn't rid me of all the horrid guilt feelings of what a terrible mother I am for doing that. Despite how happy it made me. Sigh.

I told Nasser this morning, "Why is it that I feel like I need to cry like 10 times a day????" I had a psychiatrist appointment yesterday morning (this is my psychiatrist I've been with since the beginning, like 8-9ish years ago? not the ECT psychiatrist). I walked in, with Nasser, to his office and he starts asking "so how are things going?" and I couldn't even begin to answer the question without starting to cry. After the appointment, I called up a friend to see if she was available to get together and started to cry in the first sentence or so.

It is like the most frustrating thing in the world, to me, that I've had this incredibly long, extensive mental health journey, trying unbelievably hard to get better, seeing as much progress as we did after starting electro-convulsive therapy last June and feeling so hopeful, and yet, I still feel like such a failure a lot, maybe most, of the time. I still blame myself for not being further along with the getting better process. I still see myself interact with my kids and hate myself for not doing things a million times better. I still look around at the house and blame myself for not being motivated enough to get simple things done, more often, more regularly, more consistently. And I know, some of this stuff is normal, some of this stuff everybody feels. But with me, all this stuff equates, in my head, to things like I shouldn't be here. I shouldn't be alive. I don't deserve to be alive.

I question writing that here in my blog. Because admitting that kind of stuff is dangerous. It can make other people say "well you need to be in the hospital" or "well you shouldn't be in charge of your kids".  Etc, etc, etc. And maybe this won't calm you down about that stuff, but in case it does, we really are handling it. I do recognize in myself when it's those self-blame, not wanting to be alive thoughts that are kinda habit thoughts at this point versus the ones that feel more dangerous. And I still know when to ask for more help. And I am still incredibly honest about all those things with Nasser, my most important support person in my life. And when I do go in for an ECT treatment, which is still rather often, I do fill out the questionnaire beforehand about how I'm doing and I talk with the nurses and my doctor before they put me under. Despite the fact that I'm not just locked away in a hospital, things are fairly regulated and controlled in my life.

Last week, I had treatment on Wednesday (so literally a week ago). And at the time, we decided that we'd wait until next week Monday for my next treatment, so almost 2 weeks. Because for awhile now I've been going once a week, and I've been wanting to spread them out more, probably because I feel like I "should". Now, this week, I'm questioning the judgement to skip this week. But then I'm also questioning whether or not ECT is really helping much anymore. I'm questioning whether or not anything I'm doing is helping.

Ugh, it all just sucks. Depression sucks. Mental illness sucks. Like really really really sucks. And if you don't have it, or don't know firsthand someone who has it, it's almost impossible for you to really understand that. So read my blog and try to empathize and try to understand it. Because understanding mental illness, at least a little bit, makes you a much, much, much better person. Just like how that's true with pretty much everything in life. Understanding something, and having the ability to empathize with what other people suffer in life, makes you so much better. Always.

Short post today, because I can't handle more right now. Right not I gotta attempt a workout (did I mention I'm trying really really hard to get this back into a daily habit thing???), maybe drop off some donation stuff to rid the house of some "too small" items from my children, and see if there's anything else "productive" I can manage. Cuz those things can often be good confidence boosters, and really, I need as much confidence as I can possibly get.

Friday, September 15, 2017

my actions make me beautiful and dignify the flesh. me. I am free. free.

Friday, 09/15/17, 11:26am, 1:26pm

Hey everyone. I'm taking some time today to watch and re-watch some Brené Brown videos. Do you remember me talking about Brené Brown some time ago? Here, here, and here, just to name a few. She is a research professor/author/public speaker who has done a lot of work with vulnerability, courage, shame, and empathy. Her TED talks are worth a watch if you've never seen them: on vulnerability and on shame are the original two, but she's got a lot more stuff out there these days, and honestly I'm a bit behind on everything she's put out there. I still love the empathy cartoon she narrates... it's short, you can handle the less than 3 minutes to watch it...

When I wrote about how to support someone with a mental illness, back in May of this year, the big, big thing I talked about was empathy. Empathy doesn't just apply to supporting someone with a mental illness, or any illness; it applies EVERYWHERE in our lives. It applies to making a connection with anyone you meet, whether it's through work, or school, or in our neighborhoods. Whatever community you're in, empathy is useful. Anyway, watch the cartoon short if you haven't yet. I mean it. Seriously. Do it now.

I wanted to discuss in a little more depth about vulnerability. Brené talks about how "vulnerability – the willingness to be 'all in' even when you know it can mean failing and hurting – is brave." And this is based on her research.

I've felt decently good since reading Brené's book Daring Greatly about how vulnerable I really am by being so open about my depression and anxiety, about sharing some really shameful feeling things from my life, and deciding to ignore the stigma that's out there and sharing anyway. I'm certainly not as good at daring greatly as plenty of other people out there, but something recently made me feel good about it again. Last week, we had Back To School Night at our kiddos' elementary school. In fact it was the same day as an ECT treatment, which made it rather hard for me considering headache and fatigue and the desperate desire to just be in bed, but I really wanted to be there. Partially since we have a brand new school building as of this school year so I really wanted to see it a bit more, but also because every new school year there's new things to learn from the new teachers, etc, and whatever else. Well, the new PTO president for this school year was speaking, and I was there, thinking, "OMYGOSH, I totally know her, but I can't think of where I know her from, because of all these damn memory problems from ECT. Well SHIT." And at some point, in passing, she even acknowledged me and was like "hey Alisa, how are you?" So, when I had a chance to actually talk to her one on one, I immediately started with, "So I have to tell you something. I'm going through this big medical treatment right now, and one of the major side effects is short term memory loss. So I know I know you, but I can't think where from. I am so sorry." She, of course, was totally empathetic and immediately told me about how her kid so and so is the same grade as RG, etc, etc. I have to say it didn't even occur to me that saying all this to her was being vulnerable until Nasser labeled it as such, but really, being honest and open about ECT IS being vulnerable. It's not that easy all the time to do so, but I definitely find that being this way has more benefit than not being this way. I mean, I'm getting a rather large amount of support from family, and friends, and neighbors, and how would that be possible if I were super secretive about it? And being vulnerable isn't super easy. I mean, I don't get a response from anyone, most of the time. I write my blog and very rarely get likes, or +1's, or comments, or anything. And that definitely used to bother me, a lot. I feel like blogging in the last few weeks (as I've gotten myself doing more regularly for literally the past 3 weeks) has been different in that sense. I don't feel like I've cared about the response from my blog nearly as much as I used to, and I expect that the difference is because I'm nowhere near as depressed as I used to be. But I do know that it's easy to dip back into caring a lot about that stuff, and I'm trying to keep myself out of that.

There's this Brené Brown book that I started some time ago, but haven't gotten all that far into, and as it turns out, I'm pretty sure I have to simply re-start it because of the memory problems. Here it is:

Isn't that, um, perfect for what I was just talking about? I think this one is going to have a profound effect on me, but, with the treatment, it's been difficult to get myself to get into this book since it feels so self-helpy and all. But, I have to remind myself: this is Brené Brown, I'm going to love it. AND, it will probably help me A TON. Because usually when I'm feeling depressed, it's because I DON'T feel like I'm enough. It's a pretty shitty feeling.

Here was my "start my day off well" activity while at my sister and brother-in-law's house (since my bro-in-law works from home so he can be my 24/7 person pretty easily many days).

I know, I know, I've shared a picture of this mug before, but I still love it so much. And I have to recommend this book to everyone. It's wonderful, and this author uses amazing animal pictures to tell his stories. So great. So so great. I'll share one page from the book:
Heeheehee.

Not that I was having a blue day, really, at all, but that book and mug just put me in an even better mood, which I could always use, right?

I thought up a lot of things I want to do this weekend and put them as possibilities in my calendar. The intent here is to hopefully avoid some of the depression I've been having on weekends by creating some schedule or routine to the weekend, as that was one thought we had as to why this was happening. But I'm aware that if I don't do these, I may end up with more guilt, and therefore, more depression. That's why I'm trying to set the expectation up that all of these are possibilities. We'll see how well I follow that idea.

My next ECT treatment is on Monday, which makes it 12 days (woohoo!). Making progress, at least slowly. Unfortunately, and I didn't even realize this until this week, Monday is also a day off from school for my kids, BUT we are getting loads of help from lots of different family that day to make it all work. Although, really, even if I didn't have treatment on Monday, I'd still need help with my kids because the 24/7 thing makes it so I can't be in charge of my kids on my own anyway. So oh well.

I'm trying to be as brave and accepting of myself as I can be as I go into this weekend. Well, really I guess I'm trying to come up with as many ideas as I can to not be depressed, but maybe what I should be doing is coming up with ideas for if I DO get depressed. Hmmm. Like maybe put some activities on my calendar for "what to do if you're feeling shitty". FYI, I might just have to type that out here, because I am currently blogging and all, so it's kinda the natural thing to do, right?

For when I get depressed, down, or feel bad in any way:

  • Take a deep breath, or 100
  • Try a downward dog pose, or any other yoga pose (in the safety of my home or with people in a class, but only if I want to)
  • Eat a piece of dark chocolate (because dark chocolate can stimulate neurogenesis you know)
  • Do jumping jacks for 1 minute, then close eyes and breathe deeply for 10 seconds
  • Hug Nasser, RG, and TK
  • Lay in the hammock, with some ice cold water, and maybe a book
  • Read The Blue Day Book
  • Take a short nap, or a long nap, or just lay in bed for a half hour
  • Take a sniff of lemon oil because "lemon oil is calming in nature and therefore helps in removing mental fatigue, exhaustion, dizziness, anxiety, nervousness and nervous tension. It has the ability to refresh the mind by creating a positive mindset and eliminating negative emotions." (that's from here)
  • Watch a favorite movie, like "The Princess Bride" or one of "Lord of the Rings" or "Monty Python and the Holy Grail" or "Ferris Bueller's Day Off" or "Finding Nemo" or "Toy Story" or something else that I can't think of right now
  • Watch a favorite TV show, like "Doctor Who" or "Friends" or "The Magic School Bus" or some nature-y show on Netflix or "The Late Show with Stephen Colbert" or again, something else that I can't think of right now
  • Do whatever the hell I want to do
I'll add to the list when I come up with more, but that's a decent start for now. Hopefully it helps if any of that depression comes up this weekend. Wish me luck, all.

Sunday, May 28, 2017

how to support someone with a mental illness

Sunday, 05/28/17, 10:22am

Oh blog. Dear dear blog. You dear dear readers and loved ones who have stuck with me through, what I believe was the worst of it, and I think I'm close to finally coming out the other side. I love you all for sticking with me, despite my illness causing me to push people away so much. I now understand, after fighting this illness for so long, what it is that helps me the most.

And I can look back on my behavior all these years and I can see my mistakes but I can also see why I made them and what I was looking for.

I feel amazing. If I didn't know any better I'd wonder if I was manic, but I know that's not it. I can recognize the emotions in myself and I can better label them now. We also think this latest antidepressant might just be starting to kick in.

I should explain. There's so much to explain though. I have to do it right, because this may still be a hard post for all of you to read.

Let's start with a couple things. What I have to say, I think I know a lot about and I want to tell you why I think that and why I think I have the authority to talk about it. You know I have depression and anxiety, right? You may assume some things about my depression and anxiety, and the best thing I can do is share about it and hope that you understand more and assume less. And you may know that I'm an engineer, so you can probably assume that I have a fairly logical and analytical brain, which may or may not give you assumptions about me. I have seen, firsthand, my whole life, how my emotional side and logical side have been in conflict. And I think I finally know how to resolve them.

What I have to talk about is empathy, something I've touched on in this blog, but something I didn't fully understand until now. Many things have led to this "epiphany" I keep talking about. I've been feeling frustrated by my illness and I feel like a burden to everyone around me but part of the reason I feel that way is I see myself rejecting their help as I get worse and worse and I feel awful about that because I want to accept their help but it doesn't feel helpful to me, for some reason I can't figure out. It's been really really hard, but as I understand empathy more, in this last week of epiphanies, I can better empathize that the people helping me have also been scared to death by my illness and my rejection of their help. They see me deteriorating and they don't know what to do about it.

So, quickly let's have a little bit of history. I grew up not understanding mental illness. When I started feeling suicidal when I was about 12 or 13, I had no idea what to do with those feelings. I knew that I shouldn't have these feelings, they certainly felt scary and wrong to me, but I was terrified to tell anyone because I didn't know how they would treat me, because to me, this was me, not an illness. So I didn't tell people. For a really long time. I figured out, enough, how to reject those feelings and be happy and choose to be happy and pretend like all that stuff had never happened. I was happy in high school and college because I chose to be happy and when I was met with people who were depressed at that time, I couldn't understand what they were going through, and I, along with everyone else, couldn't help them either.

Then after having kids, those awful, scary feelings came back. I couldn't seem to choose to be happy anymore, but I kept trying to. I was like, ok, I'll get the minimal help I need and continue to choose to be happy. And I kinda did that, somewhat well, or at least it appeared that way to everyone else. The people who saw me depressed knew I wasn't all the way better, but I was functioning, enough.

My therapist has mentioned several times that I don't seem to accept my illness. All the scary thoughts I have about myself and the reason I usually go down that hole even further is because of this ridiculous belief in me that this is all my fault. And, as it turns out, it's been reiterated to me over and over and over again by the stigma that's out there.

Let's talk more about stigma real quick. I believe that it is something that is so pervasive, even with the improvements in mental health advocacy over the years. It's something that doesn't actually seem to get better because as mental healthcare improves, we also set higher expectations on the patients to "get themselves better". And that's such a ridiculously weird expectation. We see people who are so far gone with their mental illness, and we can't empathize with that situation because we haven't lived their life. We don't actually know what that person has tried and we don't actually understand why they've chosen the care they have.

The reason I call this stigma is we don't treat people with a physical illness the same way. We don't argue with cancer patients about the care they've been getting, usually, if they are seeing the experts. But then experts in mental illness aren't perceived as experts because mental health has to do with human behavior so why do people need experts for that? And suddenly, everybody feels like they need to help but of course most people aren't qualified to do so.

Let's try some empathy on real quick. In the last few days or so, I've been applying it everywhere, I've been practicing it more, and I'm finding it's getting easier and easier to do it as I see how it works. So take for example the young teenager, struggling with bullying and suicidal thoughts. They don't know who to turn to, because despite everyone loving them, very few people are empathizing. Because as this person struggles with these thoughts, they become more and more irritable and they seem to push others away more and more. If they don't understand, like really understand, not just logically, that there is help out there and people are willing to give it, they will turn to suicide. Absolutely.

We keep using this language to describe suicide as "committing" or "choosing to die" or whatever. It turns out, that language blames that person every time. They were "selfish", etc. We refuse to humanize and empathize with what that person was going through to lead them to that act, because it's so scary that someone would hurt us that way by leaving us.

Death by cancer is forgivable. Death by suicide is not.

Because yes, suicide isn't an "option", I'm not trying to claim that it is. It's just, we have to find the right language instead of demonizing the person with the illness.

If I tell you that I'm feeling suicidal, you feel scared. Am I right? You feel like it's all on you to fix this and you don't know the right way to do it. So you do what you know best, you remind the person you love them, and you offer some way to help, by either offering to help when they're willing to take you up on it and/or offering advice. But in the case of mental illness and suicide, etc, we rarely offer empathy, because yes, it is so scary and it's almost impossible to empathize with something that is so foreign and so scary.

I find that the best help I get is when that person offers empathy, first and foremost. Before and throughout any piece of advice they have to offer.

My therapist offers things for me to do and to practice in my life, but she is trained and knows to always give empathy first. I talk about how hard my life is, and she says, "wow, that sounds tough. it sounds like you've been struggling with these thoughts for a long time." And I still don't necessarily respond super well to her advice, because usually it's something I need to change about my life. And of course that's hard. But I respond better to her than I do to someone who doesn't offer empathy.

I started sharing about my mental illness at a point in my illness where it probably wasn't quite what I needed. I didn't know that what I needed and craved was empathy. But after taking data on all the help I've received since sharing openly, I've now seen that empathy is the common thread to helpful help.

I don't think that empathy is the key to eradicating mental illness or something. I do think that empathy is the key to eradicating stigma though, and I think that's going to be my message to the world from now on. If you can empathize with these crazy illogical thoughts that are floating through my head because I have this illness that you can't just fix by telling me the right thing to try, then you can start to offer empathy and give me exactly what I need when I need it the most.

My biggest fear like I mentioned is that I can't get better, either because I won't or because I won't accept help or because I haven't found the right treatment yet. I've been looking for other people to tell me that's not true, but of course they can't tell me that because they're almost too scared to talk around me. I've been looking for other people to remind me that this is an illness, it's not my fault, but then as I refuse to empathize with how hard their situation is in supporting me, I'm not invoking the empathy I want people to show me.

The best thing to say to someone with a horrible mental illness is this:
"I am so so sorry that your illness makes you feel that way. That sounds awful and scary. I wish I could help. Please tell me if there's anything I can do to make it better and I will try to do that thing. In the meantime, I will accept you for who you are and accept that you're trying your hardest to reject these feelings and thoughts."

And the best thing for someone with a horrible mental illness to say to people supporting them is this:
"I am so so sorry that my illness makes you feel helpless and scared for me and I know that you want to help so much. And I know you love me. Please know that when I reject your help, I'm not rejecting you. I am trying so hard and I will continue to try and tell you when I need help and get the help I really need."

I love you all. Really I do. I don't want to hurt anyone by what I have to say and I'm not trying to blame others for suicide or whatever. That's not my message. My message is simply this: try to implement empathy in your life, with your spouse and children, with your parents and your siblings and extended family, with your friends and neighbors and acquaintances, and most especially, with people you find disagreement with. If you try empathy, you can usually start to understand where someone else is coming from. And that is an amazingly powerful tool.

I don't expect I've said everything I wanted to say in this short super long blog post. And I don't expect to get this all figured out real quick because what I want to do is an impossible task. I want every person in this world to put empathy first and foremost in every situation they encounter, but that's not going to happen. It's not how our human brains are wired. When we see a scary situation, we have the "fight or flight" response, and it's really really hard to stop that. I've been working on stopping that, every time I get depressed or anxious, and I haven't been very successful so far. I think, I hope, it's going to get easier, as I get better and better at empathy and asking others for what I need. I think, maybe, I'm getting there.

Monday, May 22, 2017

I believe that dreams are sacred. take my darkest fears and play them like a lullaby, like a reason why, like a play of my obsessions, make me understand the lesson, so I'll find myself, so I won't be lost again.

Monday, 05/22/17, 1:49pm, 3:28pm, 4:56pm, 6:20pm

Hello blog.

It's been so long since I've blogged and I've written so infrequently this year, that I feel lost in trying to find a way to write again.

It's been a really tough year. A tough many years. I thought it might be beneficial, for me, as well as you, any readers out there who've stuck with me, to do some recapping today.

I had a primary care appointment today with a doctor who only met me once, last fall, although she'd been assigned as my primary care doctor for several years prior to that. My primary care went to shit, probably at the point of going to college, if I really look back on it. I never had a regular doctor, and when I did have issues, women's stuff, prenatal care when it came time to it, tearing my meniscus and having surgery, and then later, psychiatric care, I always went to the specialist. I mean it always made sense to have my ob-gyn care done through an ob-gyn office. And then I wanted to be seeing a psychiatrist when it because obvious that I had depression and needed more help. I established a primary care physician several years ago after seeing a practice several times for colds/etc.

Anyway. She kinda scolded me today, as she did last fall, for not having primary care. And I'm now at a point that I have 3 psychiatrists at a time, we're reading my lab results ourselves because everything's been ordered by a different doctor, I have a therapist, a sleep specialist, now primary care, and you throw depression and anxiety into the whole mix, and suddenly it's too much. I can see why people stop seeing doctors and stop going to therapy and stop taking their meds and say, fuck it, I need to just figure this out on my own. The primary care doctor told me to consider reducing my sugar intake because I told her I haven't been good about that lately. Well yeah, it's no surprise that I'm eating more sweets, I've been fucking depressed for many years now, with little relief, great, here I am, making it worse with the choices I made, that my depression leads me to. (Sorry for the outburst. I'm frustrated).

Our mental healthcare system really isn't great. It's tough to get the care you need, in a reasonable amount of time, even with "good" health insurance. I can't imagine how tough it is with further road blocks.

So as many of you know, I was somewhat stable on a set of medications for some time before my brother-in-law, my husband's brother, Adam passed away last year, Friday, May 13, after being hit by a train. This was after several years of battling paranoid schizophrenia. Understandably, it was awful. The depression that hit me after his death, the loss of his battle with his mental illness, shook me to my core. In the fall of last year, it became apparent that the meds I was on weren't going to cut it. I tried several more in the fall and was finally diagnosed as "treatment resistant" in January. Over the course of 8 years I've tried at least 6 antidepressants, 1 anti-anxiety medication, 1 antipsychotic, and at least 3 off label drugs including ketamine. I've done years of therapy and continue to do it, I've tried vitamin supplements and yoga and mindfulness and CBT and diet/exercise and workbooks, I did TMS, we've continuously ruled out medical things and we're still working on the sleep thing. As it turns out the at home sleep study was inconclusive but gave reason to do an in lab study which of course can't be scheduled until July. Great.

And now, we're getting ready to start ECT. If you don't click the link, I'll give a brief explanation here, but I also do suggest reading what I linked. I'm planning to start ECT, or electro-convulsive therapy, on Monday, June 19. I'll be having treatments 3 days a week (Monday/Wednesday/Friday) during the acute phase of the treatment, which can last anywhere from 2 to 5 or 6 weeks. During the acute phase, plus two additional weeks after, I'll need 24/7 supervision. So, Nasser is planning on taking a leave of absence from work for much of the summer, and the kids will be in camps during the weeks. The procedure is done under general anesthesia, and they'll be passing electrical currents through my brain, which induce a brief seizure. The biggest and likeliest side effect is on short term memory. We don't know how bad it will be, but that's the main reason for the 24/7 supervision, and plus I can't drive. Oh and some memories made in the weeks or months prior to starting treatment could also be lost.

Oi. It's a lot.

I'm scared of ECT, but almost less scared of the procedure part of it than I was with TMS, strangely. I'm more scared that ECT won't work for me, because I know how that disappointment felt after TMS didn't really work, and ketamine didn't work, and I'm just so sick of things not working. But I'm hoping, at least a little.

We have this big trip planned. We're going to Alaska, by way of Seattle and Vancouver, then cruise with stops in Ketchikan, Juneau, and Skagway, then cruising through Fjords to Whittier, AK. Then we head to Denali, by way of Anchorage to get rental cars, and we'll do the 6.5 hour bus tour thing in Denali, staying at a nearby bed and breakfast. Did I mention we're doing this whole trip with like all my immediate family? My parents, my siblings and their families, and our little family. There's 16 of us, with 5 rooms on the cruise and at the bed and breakfast. I'm excited about this trip, and I'm terrified. I'm nervous about being around a lot of people a lot of the time. I've been avoiding people for some time, and maybe if you were one to judge you'd say that my behavior is contributing to the problem, but I can assure you, the depression came first. And besides, the depression actually is an effing disease, people, let's not stigmatize it more.

It's hard to share openly about my depression and anxiety. Especially because I've found little relief from many treatments. I don't usually offer hope, much, anymore, and sharing takes so much out of me lately. Sharing in person, whether it's with friends, or neighbors, or family, or my therapist, or another doctor, takes so so much out of me. And not everyone reacts or says the things I wish they'd say. I wish the world just had more empathy, less sympathy and pity, less judgement, more of good old fashioned putting-yourself-in-someone-else's-shoes. We're working on it as a family more, at least trying to.

So, I guess that's all I really wanted to share about right now. I'm hoping to get into the habit of blogging more, again, as I've been hoping for many months now, but we'll see. Hopefully I can at least get a few posts about ECT in, maybe one about Alaska before the treatment starts.

Tuesday, January 3, 2017

I've paid my dues time after time. I've done my sentence but committed no crime.

Tuesday, 01/03/17, 11:12am

Remember how I was changing meds "one last time"? It didn't really help, at all from what we could tell. And as of almost 2 weeks ago, I'm on one more "one last time" med. It's a really slow ramp up to full dosage so... it just feels like it's going to take that much longer to kick in. That is, if it does kick in. Ugh, I am so pessimistic about everything lately, but I need to keep an open mind about this one. It's not even an antidepressant, so technically now I'm on no antidepressants at all. But this newest med I'm on has shown benefit for depression when nothing else has worked, so maybe I'm a good candidate after all.

I'm getting really exhausted with trying new meds. Obviously I get some benefit from them all, since they seem to kick in a little and remove some of the overwhelming crush of depression that is constantly present while we're waiting for meds to work. Because yeah, this has kinda been a "crushing" depression the last week and a half since stopping the antidepressants. I've been crying at the drop of a hat and at each kindness I've received from loving friends and family. A dear friend brought over dinner last night, which was amazing. The whole "cooking dinner" thing has been a big failure challenge of mine the last half year or so.

It's been so frustrating that I feel like I want to get better, but maybe I'm not motivated to do things for myself that may help. Mindfulness, exercise, showering, blogging, even brushing teeth, have felt overwhelmingly impossible, and everytime I want to do one of those things, but fail, it's this overwhelming crush of "it's all my fault." For a long time, this stupid effing depression, has felt like "it's all my fault." I don't understand why, rationally, I completely understand that this is truly an illness and I don't have control over it (maybe I have tools that help, like from therapy, but that's almost nothing like "control"), and yet I still self-stigmatize. Ugh, and I hate myself for it. Why do I always have to find reasons to hate myself????

Why? Why? Why? Because it's a fucking illness, and these things (self stigmatizing, self shaming, self loathing) are all symptoms. Sigh. UGH. BLECH.

Have I made it clear enough how much I hate the depression?

This should have been a positive post. A post looking forward to 2017 and things that may help and things I intend to work on this year. And I'm having trouble finding anything positive to say.

Ok.

It's 2017. It's a new year. Who knows what this year might bring? I know I have some vague new years' resolutions, but I am going to keep them private. Sure, I know we're more likely to keep them when we share, but that can also be extremely dangerous for me in the expectations I set for myself, and the self-shaming I do if I am not doing as well on my intentions as I want to (and being a perfectionist, I always want to do things better than is ever reasonable or possible). For now, for this year, we have some big hopes (not really resolutions) regarding my depression and treatment. But if they aren't fulfilled, it is NOT a failure. Just have to get that out there now, before those "what if" thoughts even start.

It's not much but my positive thought today is about hope. Hope for good things this year and always. Hope for love, and for gratitude. Hope for peace and collaboration and empathy in the world.

Tuesday, November 22, 2016

but the fire is so delightful

Tuesday, 11/22/16, 8:50am, 10:12am

I haven't wanted to blog. My last two posts were more political, and I'm sure I probably offended somebody. I still stand by how I felt when I wrote them, and I stand by how I still feel. Regardless of how much I get called "crybaby" or "sore loser" or whatever else. There's been a lot of name calling. If you haven't figured out by now that I have some real, pretty valid concerns about the Trump administration and the hate crimes that have been going on, then I suppose you would name call. The same people that name call are the same people that don't listen to other people are the same people who refuse to tap into that empathy that they are born with.

Because I do think to some extent we are born with empathy. Children typically are empathetic. Babies "sympathy cry" with eachother when they're near another baby that cries. And most children stop to comfort when another person is upset or hurt. I think we can always nurture our empathy further, some need to more than others. And at a certain point in life, many people push their empathy away. We are taught that feelings are bad and we should hide them. Men are expected to be "tough guys" and women are taught that crying in public is weak and in order to make it in the working world, we are forced to hide all emotion. Empathy, on the other hand, forces you to face all the emotions. In order to empathize, we must try to feel what someone else is feeling. We recognize a feeling in others and we admit that yes we have felt this before in this instance or whatever and we allow ourselves to feel some semblance of that emotion again.

Let's do a quick refresher on empathy. You all remember Brené Brown, right? Here again is that empathy cartoon she narrates that's always worth re-watching.

Brené says that you must be vulnerable in order to be empathetic. You must feel a little of what the other person is feeling, and that's not easy. Most people don't want to be upset and avoid it at all costs. So it ends up beings difficult to try and gain support from others when things aren't going your way. You see this on platforms such as facebook. It's those new baby, new job, new house, amazing vacation posts that get the most attention. People generally scroll past the things that bother them or make them uncomfortable or bring up feelings that force them to be vulnerable. And I suppose that's somewhat fair since most people are turning to facebook to get some sort of mindless break from reality. (I'm not dissing those that spend time on facebook, I do it too, a lot). I'm not sure I use facebook the same way as the general population. I have "liked" so many different news organizations, professional athletes, people like Brené Brown and Cheryl Strayed and Glennon Doyle Melton, my favorite senators, comedians, NAMI, etc that I get a lot more out of my facebook experience (I feel) than just catching up on all my friends' lives. Lately I've additionally appreciated the support from politically like-minded people there. Not to go on a tangent about facebook, but there are some good things about it.

We are spending this Thanksgiving week in Steamboat Springs, as a break from life and work and school and commitments and reality. Adam's (Nasser's brother, who as you may recall, passed away in May) birthday falls on Thanksgiving this year, mine two days later, and we are expecting both to be potential triggers. The place we've got is super nice, 2 bdrm, 2 bathroom, great amount of space for us, has a hot tub, and it's super convenient to the free shuttle. We actually did take that shuttle yesterday into town to go to the hot springs pools. There's a climbing wall, coming out of one of the pools, in 10ft deep water, that RG and I attempted, but never accomplished, several times. Nasser, of course, rang the bell at the top on his first try. His extra height is what helped him so much; that's my story at least.

So far though, we haven't done much. We've each done a lot of what we each want to do. There's been a fair amount of video games as well as some house design planning,


TK and I are the only ones to have tried the hot tub so far- it's awesome though, RG and I played Ticket to Ride yesterday,

Nasser and I played Red 7 the day before, the boys have been trying out the Playstation 3 that's in the master bedroom.

We've all been eating and relaxing A LOT.

We have a few more things we may do, although some are dependent on the snow conditions on the mountain (the ski resort is supposed to open officially to the public on Thursday, but we'll see if that happens), we have lots more board games to try (several that Nasser and I enjoy but haven't attempted with the kids yet), more hot springs to potentially check out, and more relaxing to do. I like this trip so far.

Today's view.

Also my children truly are Colorado kids. This is how they dressed for the road trip to get here.

Saturday, June 25, 2016

on board, I'm the captain, so climb aboard. we'll search for tomorrow on every shore

Saturday, 06/26/16, 10:31am

You know, there have been a few terrifying incidents lately involving children and a large animal. In May, a 3 year old boy at a zoo slipped into a gorilla enclosure. The security team shot the gorilla and the boy survived. Then about a week and a half ago, a 2 year old boy was snatched and pulled into the water by an alligator. Although his father fought the alligator, the alligator got away with the child and the boy was devastatingly killed. Just a few days later, a mountain lion attached a boy in his backyard. This time, this mother was able to pry the cat's jaws open and save her son.

Each incident, while awful and terrifying and devastating in many ways, sparked some real controversy on the internet. There's anger and blame being thrown about, especially towards the parents in each of these cases, with little regard for the horror those involved have experienced. I read one of the most viral responses to the blaming, and felt most inclined to share that one. This mother of 4 blogger starts off with:



Parents, I beg of you, stop blaming and shaming other parents.

35 years ago, a mom shopping in a Sears department store went to go look at lamps, and left her six year old with another group of boys, who were all trying out the new Atari game at a kiosk. That boy’s name was Adam Walsh.

30 years ago, an 18 month old toddler playing in her aunt’s backyard fell into a well. Rescuers worked nonstop for 58 hours, finally freeing “Baby Jessica” from the well.

In both cases a tragedy happened, an unforeseen tragic accident took place which left Adam  dead, and a toddler fighting for her life deep underground. But they also has something else in common; they had an entire  country of moms and dads supporting the grieving parents. 

Let me repeat that, EVERYONE SUPPORTED THE RESCUE EFFORTS WITHOUT BLAME. NO BLAME. None. ZERO. 

No questions asked, not one single “Where were the parents?” comment. Just a country of other moms and dads, grandmas and grandpas watching in horror as a set of parents, one of their own, went through the unthinkable. Adam was our son. Jessica was our baby daughter. 

THOSE PARENTS WERE US. 



The rest is worth a read, but keep your tissues nearby for the end. The point is, you don't understand what they've experienced and are experiencing, so stop judging.

Of course, this is readily applicable to all aspects of life. You don't understand what others have experienced, so stop judging. You can attempt to understand, through empathy (oh what's that? I've mentioned that word before? you're right, here, here, and here just to name a few).

Nobody is perfect, everyone makes mistakes. Practice a little empathy and know that you make mistakes too. Again, this is applicable to all aspects of life. Every relationship, every interaction.

I'm not perfect either. I certainly have a lot of trouble empathizing with Donald Trump and understanding why he says such horrible and horrifying things. Speaking of which, also read this sometime. It's Aziz Anzari's essay, "Why Trump Makes Me Scared for My Family". Very very worth the read. And practice empathy as you read it.

A friend passed this article on to me, which highlights a study done by Northwestern University showing that a third of women, 37% actually, experienced depression while pregnant. I'll paste just a little bit.

Their data showed 37 percent said they experienced depression during the nine months of pregnancy, 25 percent pre-pregnancy and 38 percent during the postpartum period.
Everything from infertility to sickness to undergoing an enormous life change — to seeing others' happy belly bump photos on social media while not feeling similarly happy — can be part of a depression equation, women said ia previous report.
The women in the 2015 Chicago Tribune story spoke of depression so serious it meant delaying a second child or even had led to suicidal thoughts.
Despite more awareness around postpartum depression, that time period was least severe, researchers found.

I've wondered in the past whether or not my depression started while pregnant, and now I feel more confident to say that it did. I always felt like something was especially wrong with me because I wish that pregnancy hadn't "made me depressed". I've felt a lot of guilt over that, honestly. This week, since the kids have been in Chicago, I've felt less depressed and felt guilt over that. I start worrying that the kids "made me depressed". Certainly I'm more stressed, but that's not really true. And I wasn't even free of depression without the kids this week anyway. But my thoughts go there, and I feel this incredibly heavy guilt with the primary triggering thought being "I am a terrible mother".

Gotta keep fighting that triggering thought with my "evidence against".

  • I love my children
  • I want what's best for my children
  • I want my children to be happy
  • When I put my children to bed in Chicago Thursday night this week, it made me calm, and relaxed, and happy
  • I've been refusing to clean up their fort on the loft this week because I know they would be sad to see it gone when they come home tomorrow
  • I typed "they come home tomorrow" and a smile came to my face
It helps me to think through the "evidence against" that stupid, triggering thought.

Knowing how common it is for women to experience depression both pre-natal and postpartum, makes me feel less shame around my illness. Did you know that even though I write about my depression and share it openly, I still feel shame and the fear of stigma around my illness? Oh I feel them deeply. And I fight them every single day. Sometimes I fight them by writing and sharing my blog. Sometimes I fight them by posting articles about mental illness on social media. Sometimes I fight them by recovering from a depressive episode. Sometimes I fight them by being a little more open about my depression with my children. Sometimes I fight them by simply getting out of bed in the morning.

Tomorrow is my triathlon. I've decided to do the longer distance, the Olympic. I'm a little terrified of the distances, really each of them. Each one is a push for me. Then it's all together too, so yeah. But I intend to finish, with no injuries and a smile on my face even if it doesn't quite happen until I cross the finish line.

Monday, June 20, 2016

lean on me, when you're not strong, and I'll be your friend

Monday, 06/20/16, 11:33am

Today's post is my 100th post. In about 7.5 months. I can't figure out if that feels like a lot or a little.

I told Nasser I want to make a mini cake for my 100th post. :) Somehow diet friendly.

I feel good about how far I've come in my blog.

The blog is a comfortable place for me to return to day in and day out. There aren't many days where I don't look at my blog or think about it in some way. Whether it's to think, ooo, I should write a blog post about what just happened, or if it's in a depressive episode, using my writing therapy to crawl back out of the hole.
I say crawl, not climb, (although I certainly picture these holes as having gravity) because in those moments, there is nothing that feels strong or heroic. Sometimes I look at my blog to reread old posts, and sometimes a friend sends me a note about my blog.

So far I've felt really good about sharing my blog more widely. I feel so honest and open. I know that this blog holds some of my deepest pains and yet I've chosen to share it with all who would read it. Brené Brown, writes about a "vulnerability hangover". I don't think I've quite gotten there yet but I still have time to royally freak out.

The support thus far has all been positive and caring and heartfelt. It warms my heart and I truly get why Brené says that vulnerability is key to wholehearted living. (If you don't know who Brené is, go to my last post for her empathy cartoon and a link to more on her).

My last post, I think, was the first post where I didn't mention Adam. Long term readers know Adam is Nasser's brother, who was killed last month. I still think about him every day, but I felt guilty that I didn't when writing my last post. And then there's a part of me that realizes that's ok.

Thank you, all you fine readers out there for following my life with depression. We've all come a long way since my first post.

I'll leave you with a lovely shot of the cherries I picked off our tree this morning. Today it's fight the birds day, when they're the ripest they'll be before we lose them to the animals.

And looking up into the tree yesterday morning.


Sunday, June 19, 2016

threatened by shadows at night, and exposed in the light. shine on you crazy diamond.

Saturday, 06/18/16, 11:52pm/ Sunday, 06/19/16, 1:09am (it got late!)

I am not perfect. I am not perfect.

I can never be perfect.

Perfection is an illusion, an idea that doesn't actually exist, at least anywhere on earth. Human beings have yet to find perfection and yet to achieve perfection. I'd be tempted to say that math and science are perfect but then you have things that exist like irrational numbers and genetic mutations.

Some would say God is perfect. God, gods, Allah, whatever you call this being. Could be. But maybe perfection cannot exist, even for a god. I think the God I believe in is perfect. The God I believe in is not jealous, is not hateful, is not spiteful, does not favor one over another, and is pure.

I did a lot today. Audra joined me on my full brick workout this morning. ~20mi biking, much of it along US 36 between Boulder and Denver, along the new bike path,

AND almost 3mi running. Although could you call it running? It was a rather slow pace. But Audra is always kind enough to go at my speed (hah, she thought I was going at her speed when she was pushing the double stroller with two 30-40lb kids?). It felt great to get that much exercise in and feel more confident about this upcoming triathlon.

I also got my hair dyed. I wasn't quite sure what color I was going with when I walked in, but it ended up a red again. There's supposed to be a violet tint, which I can tell in certain lights. PS, I am not naked in these photos. The tank straps are behind all that lovely, gorgeous hair. Hah.

I had some really good friend time (you all remember Nasser and the boys are outta town right? Hence all the me time) this evening with 2 different friends,

and

I shared my blog on facebook.

(It is my personal jab at facebook that I refuse to capitalize their name on my blog. Even though Google tells me it's spelled wrong. I love facebook and I hate facebook. And I suppose I might hate that I love it sometimes too.)

I've been thinking about doing this for a very long time actually. And I finally decided to take the plunge today. I've mostly been avoiding looking on facebook since posting it, but I have checked (and read and commented) a few times.

There are lots of reasons I decided to do it. And in the end it felt like there was more to gain than to lose. I could bare my vulnerability to the world and dare greatly, as Brené Brown puts it (hey readers, remember her?), although the true credit for the phrase goes to Theodore Roosevelt. The part of his speech she quoted in the book, the famous part, I'll paste below, from "Citizenship in a Republic":

"It is not the critic who counts; 
not the man who points out 
how the strong man stumbles, or where the doer of deeds 
could have done them better. 
The credit belongs to the man who is actually in the arena, 
whose face is marred by dust and sweat and blood; 
who strives valiantly; 
who errs, who comes short again and again, 
because there is no effort without error and shortcoming; 
but who does actually strive to do the deeds; 
who knows great enthusiasms, the great devotions; 
who spends himself in a worthy cause; 
who at the best knows in the end the triumph of high achievement, 
and who at the worst, if he fails, at least fails while daring greatly..."

It is excruciatingly hard to be vulnerable. To share your story, share your pain. I do so only behind the safety of my Chromebook.

But I think the more we do so, the more we bring empathy into the world. And just in case I have any new readers who've never seen it, please check out the empathy cartoon below. It is still useful to those of us who have seen it many times. I will watch it with you now.

I think the best way to practice empathy is to share our stories and listen to each other's stories. You can never have the empathy if you don't listen as well. I hope I do so with my friends and loved ones. I try to.

Some people say the key to stopping mass shootings is to enact some gun control, others say we need more God in the world. Still others say we need to crack down on terrorism, while others say we need love. I think a big part of the equation is empathy. If you can empathize with others, you start to value each other more. You value human life more, you value working together more. You value your planet more, and you value your fellow human beings' rights and freedoms more. I think empathy is the key to it all. Here's my equation:

X (empathy) + y (love/morals/values/God) + z (reasonable limits on what weapons go into the power of what people, at all levels of society- civilian up through presidents/dictators) = a safer and happier world with fewer wars and deaths of all kind

Thursday, May 26, 2016

why do you weep? what are these tears upon your face?

Thursday, 05/26/16, 9:59am

Grief is hard.

Yesterday I did a lot of normal things. I switched off runs in the morning with my sister, got in a shower, attended RG's presentation on the Smithsonian Museums, ran some errands with TK, talked with another mom after the bus pick up, tried to get our passports taken care of with the whole fam, went to MNO (Mom's Night Out). And yet. The grief was there every step of the way. I grieved while talking about Adam with my sister since I hadn't seen her since before we went to Chicago. I grieved as I thought of Adam on the run, alone with my music and my thoughts. I grieved when I saw RG's teacher and she gave me a few hugs, asked about us, and offered her condolences. I grieved when the cashier at the grocery store asked how I was doing, and after my long pause, and "ok... ay", I felt the need to answer that we had a death in the family. I grieved when I didn't feel like I could go to MNO because I was feeling depressed. I grieved when a friend encouraged me to come, in whatever state. Then I grieved when I had to share a bit of Adam's story with my Uber driver (because driving was out of the question given my state of being and emotion). And I grieved with my fellow mom friends. With each of their hugs and their kind words of support and their listening to me talk about it. I keep needing to talk about it and share my grief with others.

I think grieving so openly yesterday made me seek the safety of home today. And being out there, doing normal stuff, I feel like I can't hide my grief so I share it. It took a lot out of me.

I skipped an exercise class with my sister this morning. Maybe it would have helped in some ways. But being around a lot of people all day again sounded exhausting. The idea of it made me feel anxious. I'll still get my exercise in since Audra is being kind enough to come over and watch TK while I go for a bike ride. But I've got to be around people later today and that's the goal. To make it to and through that. There might be some crying again with the people, hugs and condolences do that to me, and that's ok. I'm not expecting to not have that. But the goal is to get there with just the grief, and none of the anxiety and depression.

Having grief on top of a mental illness, specifically depression, is... I don't know what to call it. Let's just say I don't know how to navigate it yet.

The closest I came to a full-blown episode was Sunday morning in Virginia. It was the morning after the wedding and I didn't get enough sleep which I'm sure didn't set me up well. But I think I'd been keeping myself so busy that the depression hadn't had a chance to catch up with me.

I said something to Nasser, in my lowest point, that I wished it was me who'd been hit by the train. That terrified him because I meant it then. I do feel guilty sometimes for being here when Adam isn't. I feel guilty that I couldn't do more to help him. I should have been able to do more, coming from a place of sharing a stigmatized mental illness. And I know rationally that I couldn't. Oftentimes the worry was of making it worse.

I never shared my blog with him. I will always feel guilty about that because I wonder if it could have helped in any way. Of course it could very well have made things worse.

It doesn't help to think of the "what ifs" but they do come and go.

This morning I feel like it's unfair for me to be functioning so badly. What right do I have to take the grief so hard when I'm not the sister or brother or father or mother and I only knew him for less than 9 years? And I didn't support him as much in his illness while others did so much more?

But then I always felt this closeness in sharing a mental illness, even though everyone was always reminding me that "yeah but they're different". They are and they aren't. I suppose I'm much more high functioning than he was. But my illness does fall into the "chronic" mental illness category of never really being "in recovery". And I know what it's like to feel stigmatized, even if my mental illness is better accepted than his is. I know what it's like to have expectations of yourself that "you should be able to handle this better" without needing help. And I know what it's like to have foreign, extreme thoughts that frighten you to uncontrolled sobs.

Although we will never know exactly what happened on the tracks the night Adam was hit by that train, most of us agree that the mental illness contributed to his death. He wouldn't have been in that place at that time, perhaps if he had his judgement would have been different and he wouldn't have been crossing the tracks. I do blame the illness. I blame the mental healthcare system in our country for failing him.

I hope that someday we have a better scientific understanding of mental illness. I had hoped that day would come in Adam's lifetime but I suppose it wasn't to be. I hope that better treatments come and I hope that the people in our world become more compassionate and more empathetic and more accepting of people with mental illness.

Wednesday, May 4, 2016

don't let yourself go, everybody cries and everybody hurts sometimes

Wednesday, 05/04/16, 9:58am, 12:32pm,

I'm watching my nephew for much of the day today, and yet it's almost easier to attempt to blog when TK has a playmate. We'll see if I can fit it all in. What I have to blog about today has been on my mind for some time and requires some extra thought and planning. It's a topic I don't want to mess up.

What I have to discuss is suicide. It's not on my mind because of anything specific to me, but NPR has done a slew of articles about it recently and it's really caught my attention. They've reported on suicide in the Native Arctic communities in Greenland where the suicide rate is the highest in the world (here's a spoiler: they don't think it's due to the darkness), and they did a followup with questions from listeners and readers here. They talked about suicide rates climbing in the U.S., particularly among female adolescents. PRI reported on the CDC's investigation of a cluster of teen suicides in Palo Alta.

It's hard to read about suicide. I'm not going to deny that. But I think it's great that the media is sparking some conversations about it. It's something that we as a society feel shame to talk about yet it's so important to do so. I strongly feel that the best way to confront the issues of mental illness and suicide and substance abuse is to talk about them and keep working towards ways to improve outcomes (which you can't figure out unless you talk about it), with legislature to follow the best we know based on research. More on that another day. Today I want to start the discussion about suicide.

NPR had one article on "How Do You Help Someone Who Is At Risk Of Suicide?". I thought it was pretty well done. I think I expected more from the title of the article than it gave. But there are some useful things it included which I'll paste below, hmmm, maybe it's most of it. For some background, NPR talked with Dr. Jill Harkavy-Friedman of the American Foundation for Suicide Prevention and Dr. Jitender Sareen of the University of Manitoba, both psychiatrists, about what is known about youth suicide and best practices for preventing suicide. The article follows a question and answer format.

"In Greenland the highest rate of suicide is among young people between ages 15 and 25. How does that compare with the U.S. and worldwide?

Dr. Jitender Sareen: In native communities here in Canada and in the U.S., unfortunately young people have a much higher risk of suicide — often five or six times as high as the general population. Men commit suicide more often than women — that's true almost everywhere. [Although it's unclear why this is, it may be related to access to weapons or greater impulsiveness.] We've also seen instances where multiple young people enter suicide pacts, and there can be a contagion effect especially among youth. The underlying issues that lead to those crises are related to lack of basic things like clean water, housing and jobs. A lot of young people are impoverished and do not see any path to a good future.

Dr. Jill Harkavy-Friedman: It's also important for people to understand that suicide is not native to any culture. It's what happens to people when they're in situations of increased stress. So the high rate of suicide in Greenland, for example, doesn't say anything inherent about the culture. Actually, in the United States and most places, the highest-risk group for suicide are middle-aged [people] and the elderly. Fortunately, teen suicide rates in the U.S. are significantly lower, though teen suicide is still of concern.

Are there specific things a parent or friend should say — or not say — to a young person who they believe is potentially suicidal?
Harkavy-Friedman: If you're worried about somebody, ask. It's a little scary to ask, and you don't start off with, "Are you thinking about suicide?" You want to base your questions on what you've seen and what you notice. Like, "You seem very down lately and you're not with your friends. Is something going on? Are you feeling OK?" or "You look kind of sad. Are you?"

Then the next step is to just listen to what they have to say and try to really hear them, and interact with them so they know you've heard and understood. These are not quick-fix problems, so even though as parents and friends we want to say, "Just snap out of it!" or "It's not that big a deal!" to that person at that time, it is a big deal.

Sareen: In Native communities, one thing we've found is that messages that are based in culture are often more effective, but culturally sensitive communication is complicated. You can't assume that everyone in Native or First Nations has the same Native culture. For example, some Native people may feel cut off from their traditional culture and religion, while others are practicing Christians, and you need to remember that when you talk to them about their problems. This is one challenge for researchers and doctors who want to help in Native communities. Before you can help, you have to build a trusting relationship and understand the place, which can take years.

What if the person you're worried about doesn't want to talk?
Harkavy-Friedman: It's not uncommon, particularly with teens, that they don't want to talk. Or, they don't want to talk to you. If you're the parent, for instance. The key is that there may be somebody they can talk to, and it's not a time to stand on ceremony and say, "You must talk to me because I'm your parent." Find somebody they do feel comfortable talking to, and try to help them engage with that person.

Is it ever dangerous to ask someone about suicidal thoughts?
Harkavy-Friedman: Talking about suicide with someone will not make them suicidal. In fact it will make people feel better more typically, because they're holding [painful feelings] inside, and when you ask them, that's an opportunity to address it and problem-solve and feel better. So you're not going to make someone suicidal if you say, "Are you feeling like you want to kill yourself?" Talking to someone really helps; we have data to show that.

Is there such a thing as talking too much about suicide?
Harkavy-Friedman: It's not so much that a person can talk too much or too little. It's more about talking to someone who can help versus someone who can't. If you're talking to someone who can help you, then it's good. And, unlike maybe even 20 years ago when there was nothing available and no one was talking about teen suicide, now there are lots of tools and interventions available.

Sareen: I would say there is a balance when you're talking to teenagers, especially in very small towns. What we're facing, often, in the small communities is there's almost too much talk about suicide. When a suicide happens, in a larger community you might not hear about it, but in very small communities youth are kind of exposed to suicide and there's a lot of talking about it. It may inadvertently positively reinforce suicidal behavior. An overresponse of the media and overresponse of the community can actually lead to a clustering effect. That's one of the challenging parts of making suicide more publicly discussed ... that youth might see it as a way to escape their difficulties."



I have such a hard time with the last part, that talking about suicide and giving it exposure can "inadvertently positively reinforce suicidal behavior". I can see why that would be but we need to figure out if there are specific ways we can report it that wouldn't do that. I think talking about suicide too much with a higher-profile death, Robin Williams for example, could lead to a clustering unfortunately, but I really don't have anything to back that up other than what my gut says. My gut says that talking about it in a manner that NPR and PRI have been doing lately is the right way to do it. I don't feel like they're glamorizing suicide in any way, and they're presenting the facts, the issues, the statistics. I feel unsatisfied in most of these articles in regards to what's currently being done about these issues. I don't think that's a failure in the articles; I think that's a failure in society. Suicide isn't a high profile "cause" for most people unless they've been personally affected by it. But then there's the added societal stigma that comes with mental illness and suicide, and no one wants to talk about it.

The one unifying theme that I've found in suicide research, it's the idea that suicide is preventable. I also want to recognize that we should be careful when saying that because that can cause shame and guilt in survivors, those who have lost loved ones to suicide. Many things can help prevent suicide though: the support network looking for warning signs is probably number #1, medications, therapy treatment just to name a few. We should be doing all we can to prevent suicide considering how "preventable" it is. 

I've said before that I don't really consider suicide to typically be a "selfish" act, although I know that's a common belief. The reason is, when I've felt "suicidal" (and there are degrees of "suicidal" ranging from thoughts of helplessness and hopelessness to planning and attempting. I've been on various points on the scale in the past, typically much closer to the safer end and I've never attempted.), the "reasons" (however irrational) for my thoughts are that everyone would be better off without me, I'm a horrible person. It's selfish in the sense that it's very centered around the self, but it's not selfish in the sense of "I don't care about anyone else", etc. I don't know who's right when it comes to it, but I think it's important to educate yourself on what suicidal feels for a person, before making judgments on them. It always come back to trying to empathize with others. Putting yourself in their shoes, trying to understand the thoughts and fears and struggles other people have. I'm not going to go on an empathy rant again, I've done that before, But, if you haven't yet seen the Brené Brown cartoon clip on empathy, you should watch it now. Or re-watch it.

I guess my biggest thing about helping someone who may be suicidal, if they're willing to talk to you about it, please just be open and empathetic (NOT sympathetic) in your conversations with them. It is not your job to tell the person that their thoughts and emotions are irrational or that they should "snap out of it" or that it's not a big deal. Those kind of comments can have the opposite effect. Instead you can say things like "that sounds hard" or "I'm sorry you're going through that" or "is there any way I can help?". And please please don't take offense if a friend or loved one doesn't wish to talk with you about it. It takes an incredible amount of vulnerability to open up to someone about this kind of "tough stuff" (although I do think it gets easier with practice), and sometimes the fear that it will hurt more than help can close people off. All you wonderful support people out there, it usually takes a lot of patience, and understanding, and again, empathy.

Saturday, March 19, 2016

can I handle the seasons of my life? oh oh I don't know

Saturday, 03/19/16, 9:17am, 2:21pm

Yesterday, at RG's school, they were holding a special The Leader in Me event. I attended most of it since TK had preschool in the morning. The basic concept here is teaching children to be leaders by embodying the 7 Habits, as penned by Stephen Covey. If you're completely unfamiliar with the 7 Habits, I'd recommend skimming them here.

I was listening to individual presentations in the third grade classrooms. They were presenting on Habit 5: Seek first to understand, then to be understood. It's a good habit, really. Now, most of the presentations were pretty much the same. It seemed like the kids had been giving some guidelines of what to include, but then could expand on specific examples of good and bad ways to show the habit, etc. Basically, it was listen first, understand what the other person is saying, don't be the one to talk about yourself all the time, etc. One girl had an additional insight in her presentation that I thought was really great and really important. She said that if someone is sad or upset, listen to them, don't tell them what to do. This is so great! Sometimes, yes, our friends are looking for a solution when they're bothered by something, but most often, people just need someone to listen.

I'm not sure where my blog falls within this habit. I guess I'm providing a way for others to seek to understand, but not really myself. But this is one habit that I really work hard at. I consider myself a good listener, but I know I could always do better. This is something that's really hard to do when you have differing opinions with the other person. When you get into conversations about politics, religion, parenting, values, it can be really hard to listen first when the person has a strong, differing opinion. But we need to work on that more. One of the third graders also pointed out that he thought we would have fewer wars if we all worked on this habit. How awesome would that be? Just by listening more, and trying to understand others more, and being more empathetic, as I've said in the past, we could improve our world.

The other Habit I want to talk about is actually the first one. Habit 1: Be proactive. I do think that this one is worth following the link and reading up on the background of this habit. The key point in this habit is "taking responsibility for your life." It's not always easy to do. It's easy to blame our grumpiness on other factors: the weather, this person was rude to me today, the kids are being exceptionally tough today, my spouse doesn't appreciate me, etc. We have to understand the difference between our circle of concern and our circle of influence. Do you remember me talking about this once before? When I talked about it before I talked about the circle of control and circle of influence. But sometimes we talk about it in terms of the circle of concern. We have a large circle of concern, but only a small portion of that is within our control. We have to always understand and accept the things we can't control (other people for example). We need to focus on what we have control over (ourselves). It's something I'm still really working on. There are people I know with mental illness who I wish would get all the help they need, but I can't control that. There are people I know who suffer from hurts in the past for whom I wish I could take away their pain, but I can't control that. I can only control me, my reactions to people and things in my life. It would be healthiest if I could stop worrying about my circle of concern, but I'm not sure I can do that either. It's hard.

The 7 Habits is something I'm quite interested in, have learned some through RG's school, but I feel I need to immerse myself more in. It is/was hard to be told, with reference to the first habit, that we have control over ourselves completely. We control our mood, we control our actions, we control our emotions. Sometimes, with the depression, I don't feel like I have that control. It's a tough balance. Knowing that I can change my emotions can sometimes be empowering, but when I don't feel like I can do it, I feel guilt and shame that I'm unable to do it. And of course, that guilt and shame make my depression worse.

I went for a run this morning, with my sister, and we made it a full 10k. Felt awesome and a great start to a busy weekend.