Tuesday, March 7, 2017

you can try the best you can. if you try the best you can, the best you can is good enough

Tuesday, 03/07/17, 9:38pm, 1:43pm

Well, yesterday's post was all hopeful and feeling like I'd had a turning point in getting better. I guess it's only inevitable that this morning, the depression hit hard and I'm just feeling incredibly stupid for having hoped at all.

I hate days like today. Days where I feel so incredibly small, so worthless. Days where I just want to be done. Done with everything- with life, with depression, with anxiety, with being a mom, with responsibility, with expectations. It's really hard to have those thoughts of despair, yet I know I have no option there other than to persist forward. I have to keep trying- for my kids, for my husband, for everyone who loves me, for future me.

It's always difficult to write a really downer post. One full of my real thoughts of despair, in the moment. Maybe it's not something that's the best for me to share about with anyone and everyone, but then I also feel strongly that it's critical to share this stuff. Because what if there's someone else out there who has these feelings too? But they think they're alone because most writers of depression share after the fact. And we're expected to express hope the strongest. I found out yesterday about some guidelines for writing about mental illness from NAMI, the National Alliance on Mental Illness. Now granted this is for when you're representing NAMI, which I don't profess to do. At the bottom, they mention specific words or phrases to avoid. Including, contrary to my personal belief, the word "suffer".

From the site:
Suffer. Although there are times when a person is suffering, we avoid it when it discussing mental health. We opt for more hopeful language that is forward looking. 

I see where they're coming from, but gosh, I've used the word suffer in my blog way more times than I can count. And to me, I think this is incredibly ignorant to try and rub this word out of our vocabulary. In fact, many people DO suffer from mental illness, regularly, just as people suffer from physical illness. Why should we pretend that this isn't a major component of mental illness? By only focusing on the hope, you invalidate what people are suffering. For me, the focus on hope and people constantly telling me to "think positively", "you gotta hope for the future", etc, worsens the self-stigma I put on myself. When I'm not feeling hopeful, I feel guilt and shame over it. Hope doesn't fix mental illness. Sure maybe it can help to change your outlook on life which may improve mood, etc, but hope for me is a double-edged sword. Hope destroys me when I do suffer because 1. How dare I give in to the suffering and not keep hoping? and 2. Here I thought I was doing better/will get better and that hope misled me. It made me think that if I just hope and think positively, this will all go away. But nope, it doesn't.

And the constant proof that things that are supposed to help me, but don't (you know things like medication, and therapy, and TMS), crushes that hope over and over again when I keep not getting better. And it makes me question whether or not I really have a disease. If it can't be fixed by all these things, then what's really going on? Is it just that I'm a screwed up person who fails constantly in life? But then we have concluded that I have "treatment-resistant depression," so my "not a disease" logic shouldn't stand.

My therapist recently noted that I seem to fight my diagnosis. I suppose I do. I question it, I self-stigmatize, and I shame myself over my depression and anxiety. And I can't seem to figure out how to stop doing it. I write about the problems with mental illness stigma, and yet I do it all to myself. What the fuck is wrong with me???

It's the depression. It's the illness. It's the brain disease (another word NAMI doesn't want us to use), but it absolutely is that. And although TMS might not be helping yet, there's still time, and hope, really. And please remember, this treatment will help (or not help) regardless of whether or not I hope. I keep going to treatment, I keep trying; isn't that enough? Sometimes I hope, and other times I despair. That's doesn't make me a failure at life, it simply is a side effect of my illness. I'm telling you all this, also in the hope that saying it over and over again will change my own personal views and stupid stigmas.

I wrote most of the above this morning, and although I still stand by all I said, I am feeling a teeny bit better now. Today's TMS appointment went pretty well; talking with a friend present and the technician makes the appointments go by faster and seemingly, less anxiety-inducing.

I feel less despair now, but I know those thoughts aren't far away. They've been close and intrusive for many months now, and I'm ready for that to improve. Whether it's TMS, or attempting medications again after TMS (because some people do respond better to meds after their brain chemistry changes enough from the treatment), or maybe someday I'll even try ECT, but <shudder>, I don't ever want it to come to that.

But regardless of whether or not TMS works, I've been dealing with all this for like 8 years now. I suppose I have shown that I do persist in the face of these challenges, with every day that I get up in the morning. Even if it feels trivial in comparison to what I view as failures.

I know it probably seems like I've been bashing NAMI for the guidelines they've posted, but really I do understand the reasoning behind it, and I know they want to be careful that they aren't triggering people with what they share, and there's a fine line between helping and triggering when it comes to mental illness. And NAMI does so much to support individuals with mental illness and their families, they serve to educate and advocate, and they mostly do a great job doing so. I do feel that some of the choices they made about the latest guidelines aren't considering some of the greater harm they might be doing towards those of us who do suffer, on a regular basis.

Monday, March 6, 2017

I'm on a roll this time, I feel my luck could change... we are standing on the edge

Monday, 03/06/17, 3:04pm, 4:41pm

So. Since I wrote last Tuesday, things have seemed to take a little turn for the better. I spoke with the technician on Wednesday about her comments Tuesday; she actually clarified and corrected several things, pulling out a clinical study to reference in the process. It was good. I spoke again with the doctor on Thursday about some of the long term efficacy stuff, and I do feel a bit better and more hopeful again overall.

The other thing that happened last Wednesday was we re-checked my motor threshold. Do you remember how I had that appointment before starting treatment? The one where they found the spot on my head, and intensity required, to twitch my right thumb? Well, the technician re-checked it before treatment on Wednesday, and it was slightly different than it had been. Slightly different location, and lower intensity. Apparently this isn't that strange to get a different motor threshold than the first time, since the brain, after receiving some TMS treatment, can become more easily stimulated, more responsive.

Well, so after we had this new motor threshold, we tried out the new location based on the new spot, and WOW. That first time had essentially no facial twitching whatsoever, which was a first. I could talk through treatment. Plus, the lower intensity for motor threshold equates to a lower treatment intensity as well. Now since then, we've increased the intensity to get closer to target and had to make minor adjustments, but in general, it's been going so much better. I think that's relieved a lot of my anxiety around the treatment, but it's made a bit difference in my overall mood.

This post is going to be short, because I'm starting to feel enough of the mom guilt that I'm blogging right now, after my kids have come home from school. Before I go, a few recent photos are worth sharing.

Last Friday, after school, I was well enough to play a game of Carcassonne with the boys.


And Nasser has been doing so much with the kids while I haven't been doing so great. Including, directing a volcano experiment (involving papier-mâché), and supervising snap circuits.



Tuesday, February 28, 2017

there, through the broken branches, go, the ravens of unresting thought; flying, crying, to and fro, cruel claw and hungry throat...

Tuesday, 02/28/17, 2:52pm, 4:02pm

I'm feeling especially down today. It's weird to even say that, because it feels like that's just been the last week/months/years of my life, but somehow today's even worse.

The TMS appointment didn't help. I mean I was doing pretty badly, emotionally speaking (both anxiety and depression hit pretty hard this morning), enough so that TK and I took the bus and a friend chauffeured us around the rest of the day. Man, I have some awesome friends. Speaking of which, another friend has made it to several of my appointments so far, in support, and she talked us into swimming after the treatment yesterday. I really need to get back into a good exercise routine, since I know it helps me, but TMS is almost about as much as I can handle right now.

So the TMS appointment today. The technician today was a different one than I've been seeing. They have two and normally I'll see them both each week- 2 days with one, 3 with the other. But last week the technician from today was out and today was my first treatment appointment with her. Although I'd already met her at the motor threshold appointment before treatment started.

Anyway, this technician said some strange things during the appointment today. First she seemed annoyed that I had brought a friend. Then, maintenance treatments came up in the conversation so my friend and I were asking about whether or not it's common for people to do maintenance with TMS (sounds like typically 2 days of treatment a month). The technician said something like "I'll be honest with you, a lot of people end up with maintenance treatments. And often those that go into remission, relapse or have a minor episode after a year. And most (many?) people end up on antidepressants again."

Now. It was likely not the technician's place to tell me all this negative news. And I don't know what's true now. When I search studies of the long-term efficacy of TMS, I'm finding good results, but most of what I'm seeing doesn't look past a year. So she could be right. But then why wouldn't the doctor have mentioned this in the first place? The technician shouldn't be acting like she knows all the long-term efficacy anyway, without basing any of this off studies. And what the hell really, telling me how this treatment doesn't really work for most people isn't the right thing to do why you're administering the treatment to me.

My friend pointed out that maybe she had been having a bad day. The technician probably thought she was being honest and helpful with me. I still don't think it was her place to say what she said, and I will be bringing it up with the doctor, carefully and not angrily, when I meet with him later this week.

Sigh.

I don't know what to think except to try and reject all the external noise. I need to just focus on getting through these treatments, doing what I can to keep myself sane and functioning right now, and doing what I can to feel better.

Saturday, February 25, 2017

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

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

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

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

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

I have so much to be grateful for.

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

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

I hate it.

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

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

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

Tuesday, February 21, 2017

the future's not ours, to see. que sera, sera

Tuesday, 02/21/17, 3:08pm

TMS treatment has officially started. I completed day 2 this morning, and we're not yet to the full intensity of the treatment. Not sure that I'm any more unusual than other patients, but we've still been adjusting the magnet position ever so slightly to try and reduce the twitching in my face. Cuz, you know, that's real fun. Jaw twitches, slight eye twitching (thank goodness that one has been slight- sounds super uncomfortable), cheek and upper lip twitching, and even a weird sensitivity going into a tooth or two. Weird, huh?

So the way it works is I get treatment of 40 magnetic pulses over a period of 4 seconds, and then we wait 26 seconds until the next cycle. Those magnetic pulses translate into a tap at the location on my head. It's tolerable, but not without some pain. Although I should get used to or desensitized to that after some amount of time. But then I've been all worried after today's appointment that we're not at the full intensity yet, and here I am not tolerating the lesser intensity still.

Sigh.

Emotions have been running on a roller-coaster, I mean really for awhile, but especially yesterday and today with the treatment. I can't explain why I find this so scary, when there are so few risks or side effects. But there it is. I've been scared, anxious, depressed, tense, exhausted.

So it's 2 down, 28 to go. That's not so bad, right? Except that it seems every day is going to be intense. Maybe just for a little while, in the beginning. I'll get used to it, I won't be so anxious anymore. And in a couple weeks, if it's working, then I'll be starting to feel better.

I hope.

Monday, February 13, 2017

how many seas must a white dove sail before she sleeps in the sand?

Monday, 02/13/17, 10:07am, 1:11pm

Hello my dear blog. It's been a very long time.

It's been so long I think I've felt especially nervous and unsure about what to come back with. I haven't felt much like blogging in so long, that it's felt that no topic is deserving of blogging.

Well that's just silly. There are plenty of things to blog about, to continue to blog about, when it comes to mental health. A topic that continually evolves, for the world, in our communities, and individually.

The last many weeks have been long. Many of them, many of the days, I've just felt, I don't know, like I'm underwater, in a fog, in a hole. I date my depressive episode here from around Christmas time, when I came off antidepressants completely to try a different bipolar medication (the one that maybe gave me that potentially deadly rash). There've been some ups for sure, plenty of functioning I guess, but a lot of depression, much a deep, dark depression, with a plethora of anxiety to top it all off. It's been really hard, and I think it was too much to share openly on the blog while it was happening. I say "was" because honestly, the last week has been slightly better. One of the difficult side effects of the depressive episode has been the fatigue. Complete, utter fatigue and lack of energy. It's been nearly impossible to stay up past 9pm most nights, or even simply beyond kids going to bed, and we figured out it could have been worsened by one of the leftover medications I'm still on. There are 2, neither of which are antidepressants. One is an anti-psychotic which had been paired with the antidepressants, but we kept me on it since we don't know if I'll be worsened by going off it. The other is an anti-seizure medication which has been shown to help with anxiety. So we weaned me off the anti-seizure med, and suddenly I have more energy. I still don't feel normal by any means, but once in awhile I stay up until 10 or 10:30pm now.

It was good timing to wean off that med since we just had a ski weekend in Crested Butte with family and friends. I certainly needed the extra energy even if it wasn't enough to ski full days, or stay up very late with our friends. The depression still crept in a couple points, as it just does these days, but we kept it at bay, at least until the drive home yesterday.

Here's my best family photo of the weekend. Our attempt at a selfie, minutes after the paid photographer offered to take a photo for us. I did not manage to take a whole lot of photos from the trip.

But yeah, I did the pigtail braid thing...

And this was the view from our condos... a ski in/ski out place. :)



So this Thursday I have my motor threshold appointment for the TMS treatment which starts next Monday, a week from today. This whole process has felt like such a long time coming, and really it kinda has been. But it's here. So motor threshold is interesting. That will be my first experience with the magnet, and they'll be positioning it on my head to find the location where they can twitch my right thumb. That will determine the precise location, some exact number of centimeters forward from that point or something, where they'll be delivering treatment.

Man, it feels surreal to be talking about this treatment as something that's actually going to happen to me. Like it still feels like I'm talking about someone else.

And this treatment has few risks, little to any discomfort, and likely positive outcomes, and yet, I'm awfully scared still. I guess I'm just scared it won't work. That nothing will change, that I won't start feeling better. And I'm still doing the cautious hopefulness thing here, trying not to get carried away, banking on something that may not do anything. But I am hoping. And I'm excited that it's almost here.

I will try to blog more often through treatment. I want to. I want to try and document it to some extent because it may be a somewhat unique perspective out there, but I'm also going to be continuing to take things a little easier. I've been letting go expectations for quite some time now, and it's been helping, but it's still challenging for me to do. I still beat myself up for not cooking dinner very often, for not feeling well enough to do a lot of normal things, for not feeling up to social stuff, for not being a better mom while I feel awful about myself. But everything has taken second place to the depression for awhile now, too long, and I'm looking forward to hopefully feeling a bit better finally.

Tuesday, January 24, 2017

I've looked at clouds from both sides now, from up and down and still somehow, it's cloud's illusions I recall, I really don't know clouds at all

Tuesday, 01/24/17, 1:53pm, 3:52pm

Oh. Wow. Whew.

I've been in a pretty hefty state of anxiety the past several days to a week. I felt literally petrified about this doctor appointment I had this morning.

But ok. That first part is over. Everything moving forward will still be anxiety inducing, I'll still be scared, but I think what I was really scared about was unfounded.

Ok, let me give you some background. As you may know, I've been working towards starting TMS (or transcranial magnetic stimulation). It's been kind of a long process, at least from when my psychiatrist first mentioned it to me, although I suppose that was still only a couple months ago. It's felt long though from when we decided, yes, we're going to try this route, contact that doctor. Then there have been a bunch of insurance discussions because of course the place my doctor recommended is out of network. And release forms so that my doctor and this new doctor can talk. And doctors talking. And scheduling an evaluation appointment, which brings us to today.

Today was my TMS evaluation, and Nasser took me to it because I was so anxious. And it was good. Good to meet the doctor who does this treatment, it was kinda more like an interview for us to go over my history a little, get any questions answered. It put me into a nice hopeful state. But the woman who does scheduling wasn't there when my appointment finished so we planned to talk later in the afternoon.

Well it felt like my world came crashing down again this afternoon after speaking to the scheduler. And it's not that bad. It's just that the earliest treatment start date, based on doing a motor threshold appointment with the magnet the week before (that one is the hard one to schedule since there are several people that need to be there), is Monday, February 20th. So like a month away.

And there's still the possibility they will try to get me in earlier. The doctor had wanted to get me in sooner after talking with me.

I knew this was possible, yet now that it's scheduled, it feels nearly impossible to wait that long. I thought I was preparing for scheduling to be tough, but I guess I'd still held hope that they could start next week or something. Four weeks and two days until that motor threshold appointment, then four days later I'd be starting treatment. I mean you'd think I could handle this.

But. It's still really really hard. It's been really really hard for awhile now. And as it seems it will be really really hard for awhile longer.

And then this is probably the biggest reason I haven't wanted to blog. Much of the time lately I've been depressed, or anxious, or both, and it feels like I'm just complaining about this sucky life I have. And I am grateful for all the good things that I have in my life, I really am. But then depression has a way of removing that gratitude and replacing it with self-doubt, shame, and worthlessness.

I just keep having to remind myself that this is all my illness talking and work to not beat myself up about feeling bad and thereby make it worse.

On a separate note, one of my biggest projects lately, has been coloring and a little bit of drawing. It's been a good distraction. Below is my sketch of "dragon tea party, with some politics arguing"...

And colored in...