Monthly Archives: October 2010

Relationships…or More “High School in My Head”

Everyone easily says don’t worry about what other people think, but that is so not easy for a depressed person. We just obsess over what we say or don’t say or should have said and what other people think about it. How we relate to others is a big part of our illness and a big part of how people understand or don’t understand what we are dealing with…which is why I love the Facebook category for “relationship” because my all-encompassing response is, “It’s Complicated.”

Let’s just say therapy was reeeealy rough this week talking about my intimate relationships. Not doing so hot at picking them was the conclusion. Guess because I don’t really choose, I just fall into them. That is all I want to say on that subject for now, because it’s pretty raw, and I’m still working through a lot of details, eeek.

I want to focus more on friendships, coworkers, family relationships. Absolutely loaded subject for people everywhere, not just us chronically melancholy types. Work can always be a minefield. Especially when you are the newbie. Just trying to figure out the culture of the organization, and where you fit in is a big enough challenge…don’t want to make a major gaffe by saying something inappropriate. I think it’s easy enough to avoid edgy jokes and surfing questionable websites during your introductory period, but what about speaking up in meetings, preparing reports or giving feedback? Generally I feel like when hired, they like me for my intelligence and experience, and value my opinion. So it’s hard to temper that with saying just the most “politically correct” thing, or avoiding being in any way controversial or questioning the status quo. Then, what can you say without worrying about having to process it through the “what will they think about this?” filter. By the time you do all that in your head, the moment to join the conversation has passed and the group has moved on to something else. There you sit, worrying what they think about your lack of response! Arrgh. When you do say something, it winds up being an unfiltered blurt, and either people don’t respond and just continue talking, or the room goes quiet like you just had a Tourette’s moment. Oh boy, that sucks.

 Eight hours a day you need to have your guard up, so you don’t screw up by saying something stupid and have people talking about you. Just what you need, is a little paranoia that people are talking about you and are looking to get you to go with the generalized anxiety about work! Always good to build some friendships at work if possible, so you have a sounding board to let you know when you are having a mental meltdown. Just be sure that they are people you trust and who understand and accept your illness. It would be presumptuous to just put it all out there and hope for the best. Feel people out before you give your whole self exposure.

Friendships are so very important in managing Depression. Again, it’s that support system that let’s you know what is good thinking and what is abnormal and when you need to do something about it. When you feel all alone, Depression becomes worse. Not a good place to be. Ever. Sometimes you do reach out, and people just aren’t available, being busy with other obligations. You don’t want to whine and be needy, it’s so unbecoming. That’s when it’s good to have family to lean on as well.

Oh family. Love them, but they can make you miserable at the same time. I think I count on my sister the most. She understands my illness the most, sort of walked a “mile in my moccasins” you might say, but a totally different road. There is a six-year age difference between us, so for  several years, we didn’t have much in common. But we both grew up, and we became the closest of friends. It’s a relationship I count on when things are rough and when times are good. I know she will be there for me. And I know I can say just about anything without worrying that she is going to judge me. And there are no head games. Matter of fact, we can commiserate about the head games others play, and try to figure out how to make our way in this big bad world.

This post has turned out way too long, but I think it’s so important to understand how crucial relationships are, and how depressed people struggle to initiate and maintain them. It’s never easy for us, but if we trust you, be assured that it will be a deep and lasting relationship. Unless you betray us. That’s a different post.

Melancholy Weather

My sorrow, when she’s here with me, thinks these dark days of autumn rain are beautiful as days can be; she loves the bare, the withered tree; she walks the sodden pasture lane. —-Robert Frost

Sometimes the weather can seriously affect the mood. I find changes in barometric pressure, such as when storm fronts are moving in, can trigger sinus and migraine headaches. That in itself is enough to bring on a negative attitude and decreased coping. Some people  respond to seasonal changes and suffer due to lack of natural sunlight (Seasonal Affective Disorder, or SAD). They become depressed during the darker months of fall and winter. Strange as it may seem, my problem has always been the opposite…my major depressive episodes have always occurred during late spring and summer. Can’t blame it on lack of sunshine, that’s for sure.

Of course, I don’t think I could tolerate living somewhere like the Pacific Northwest which has less sunny days than we have here in Ohio. I also would not survive closer to the North Pole with the limited hours of daylight throughout the winter. Might be nice to see the northern lights, but no way am I going to live that far north.

Multiple cloudy/rainy days strung together do get me down though. It goes beyond the rain being a healthful cleansing, nourishing thing, to being a washed out, soggy mess. Too much of anything is not good. Just makes me feel sleepy, unmotivated, and wanting to cocoon all day in bed. Even people who don’t appear to have a problem with Depression seem to get down when we have a long stretch of gloomy, rainy weather. Everyone gets irritable and cranky.

Seems we are all in physical need of sunshine as well. Many people as of late seem to be testing low on levels of Vitamin D, which the body manufactures when exposed to sunlight. It’s also available in some foods, but there has been an increased need for supplementation. Research is pointing toward an association between low Vitamin D levels and Depression according to the Vitamin D Council’s website. Can’t hurt to get it checked out with your physician to make sure you are getting enough, apparently my levels were very low, and I take supplements.

Since I can’t change the weather, I just have to continue to work on the alternatives to improve my mental health. Of course it takes more than sunshine and Vitamin D, but every little bit helps.

Psychotherapy Hurts

Courage doesn’t always roar. Sometimes courage is the little voice at the end of the day that says I’ll try again tomorrow. —-Mary Anne Radmacher

Treatment for depression takes time. Medication takes time to kick in, and it doesn’t work all the time or for everyone. Sometimes it stops working. Therapy takes lots of time. Not just the time in each session, but the time you spend mulling over what you discussed with the therapist, the insights you gained, the history you reviewed and the patterns you identified together.

Right now, I’m feeling somewhat anxious, thinking about our recent discussions about my failed marriage and my relationship choices. I am so grateful that, for all the misery and emotional pain I have suffered over the years, I can appreciate the one good thing that came of all that; my son. What plagues me at this point is, how did I manage to pick a partner who could treat me (and our child) so poorly and be so mean-spirited? And can I put the trauma of the past 15 years behind me once and for all? This is the part where I need the courage to keep getting up to face each day anew. This week therapy was a little deeper than I anticipated. We aren’t just doing cognitive-behavioral therapy, we are getting deep into the past and doing some analysis. I’m not sure I like it all that well as I gush tears and mucus, but I think all the mining the depths of my psyche is a necessary purge for me to move forward in a healthy way.

Health…that is something so many assume is a given in life. Until you don’t have it. Until it vanishes abruptly, or you lose it to a slow, chronic, physical or mental illness. Then you realize it is a precious and valuable thing. And a commodity with a price tag attached. How much can you afford? Is it fair to place a limit on any treatment, including mental illness? Should copays be as high as seeing a specialist? My point is, studies have shown psychotherapy as effective as medication in the treatment of Depression, yet on a weekly basis it obviously costs  more. Are people getting all the help they need? Are we doing all we can to improve the mental health of at least some of those people so they are less likely to become chronically ill? Yeah, those are rhetorical questions.

Psychotherapy hurts financially too. This will likely be yet another year I can itemize medical expenses. For those who have never itemized for tax purposes, you can claim medical expenses above 7.5% of your income. That’s a ton of money to spend on medical care. But without my health, what do I have? (rhetorical again!) Only those who have no health issues and who know no one with health problems could claim that health care reform is not needed. (That’s my political and professional statement as a nurse for the day).

Today I send up a prayer for anyone in need of mental health care. May you find some solace and healing for your emotional pain. God bless. 

 

Making Plans…

We must be willing to get rid of the life we’ve planned so as to have the life that is waiting for us. —-Margaret Mead

Wow, that sounds so much easier than it actually is. I had great plans before Depression took me down. I was young, married, anticipating a great career and family life. Depression sabataged it all. My first therapist felt I had undiagnosed Post-Partum Depression, but my son was already two when I finally got help. I definitely wasn’t self-destructive for two years, but I could imagine that it crept up on me slowly, perhaps waxing and waning. However I remained pretty darn functional. I worked full time, got my son to and from daycare, took care of the household and all that good stuff. I had to, my spouse at the time was a little preoccupied with his career. Apparently too preoccupied to notice I was in trouble.

Big trouble by the time I finally got help. I never needed to be hospitalized, but the thoughts floating in my head were just horrible. I would have very disturbing, violent nightmares, about thunder and lightning, airplane crashes, car crashes, and death. Thought about suicide as well. It is difficult to admit that, but the brain in that state has you all twisted inside and you just want to escape the awful, relentless thoughts that plague you day and night. I never considered acting on it, because I had too many responsibilities to take care of…talk about carrying the weight of the world! What a distorted way of thinking!

Thankfully, I found a good therapist and psychiatrist, got on medication and started getting better. There was a lot of work to do though. Trying to get back to “me.” How did I get lost in all this? Where did the essence of me go? These seem like deep philosophical questions, but when you are depressed, you not only feel negative, but empty, hollow, cavernous. Like what makes you “you” is missing in action. You find that you are just going through the motions. Without e-motion.

Back to plans. Things don’t always work out because of Depression and how it impacts relationships, families and work. I can say for myself I have had disappointments and challenges in all these areas due to my chronic illness. It sure hasn’t made life any easier. I’m still working on letting go of the life I had planned. I still at times resent that things didn’t work out the way they were supposed to; I’m in my third major episode of Depression/round of therapy and still working through some issues. And still looking for the life awaiting me.

Thinking and Depression

Ever been told just to “think positive” or “positive thoughts lead to positive feelings?” It would be great if it worked. But, you can’t think yourself out of Diabetes or Asthma, so it’s kind of insulting to be told to “think” your way out of Depression. Not possible. No way, no how. Nice try. How’s that for negative?!?

Not that a depressed person is able to concentrate all that well. At my worst, I’m lucky I can think my way through a grocery list. And putting a whole meal together is a major accomplishment. Please don’t ask me to make any decisions, big or small. I’ll be absolutely paralyzed. As in, I used to be indecisive, but now I’m not sure.

So, it’s not just about feeling bad and sad, but so many other synapses that have gone awry too. You can’t even be the judge of how well you are thinking either. Then the stigma of mental illness inhibits you from talking to anyone about how your thinking may be coming across in interactions with others. So you tend to withdraw, keeping to yourself as a means of protection and also to avoid saying anything negative that might offend someone.

Current treatment in therapy focuses on realistic thinking instead of positive thinking. Realistic thinking isn’t sugar-coated, and is simply fact/reality based. Being realistic decreases the potential risk of failure and disappointment. Positive thinking may set unrealistic expectations or goals that remain out of reach and reinforce negative outcomes. This suits me soooo much better than trying so hard to be something I’m not. I can’t force myself to feel a certain way, I don’t think anyone is capable of that. I just don’t believe in “fake it til you make it” as a philosophy of care for Depression. Now I just have to deal with the reality that drags me down to the dark places, so I can stay on the surface, and enjoy the sun with everyone else.

STIGMA and Mental Health Problems

I found these statistics disheartening, but again, I find hope that people (even our government!) want to do something to change it! What can you do to facilitate change?

Campaign For Mental Health Recovery Campaign Sponsor: U.S. Department of Health and Human Services

Substance Abuse and Mental Health Services Administration (SAMHSA) Volunteer Advertising Agency: Grey Worldwide

CAMPAIGN OBJECTIVE:

Encourage, educate and inspire 18-25 year olds to step up and support friends they know are experiencing a mental health problem.

BACKGROUND:

Mental illnesses (depression, anxiety, bipolar disorder, schizophrenia, etc.) are widespread and often misunderstood. According to SAMHSA in 2005 there were an estimated 24.6 million adults aged 18 or older who experienced serious psychological distress (SPD), which is highly correlated with serious mental illness. Among 18-25 year olds, the prevalence of SPD is high (18.6 % for 18-25, vs. 11.3% for all adults 18+) yet this age group shows the lowest rate of help-seeking behaviors. Additionally, those with mental health conditions in this segment have a high potential to minimize future disability and pursue recovery if social acceptance is broadened and they receive the right support and services early on.

Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.

CAMPAIGN DESCRIPTION:

The opportunity for recovery is more likely in a society of acceptance, and this campaign looks to men and woman 18-25 years old to serve as the mental health vanguard, motivating a societal change towards social acceptance and decreasing the negative attitudes that surround mental illness. The PSA campaign is designed to encourage this group to step up and support their friends who are living with a mental illness by demonstrating the roles they can play in their friend’s recovery.

The campaign includes television, radio, outdoor, print, and interactive elements. Viewers and listeners are encouraged to continue to support their friends who are living with a mental illness and visit the campaign website to learn more about mental health and what they can do to support their friend’s recovery.

TARGET AUDIENCE:

18-25 year old friends of people living with a mental illness.

RESEARCH:

• Only about one-quarter of young adults between the ages of 18-24 believe that a person with mental illness can eventually recover.

• Only 42 percent of Americans believe that a person with mental illness can be as successful at work as others.

• Only a little more than one-half (54%) of young adults who know someone with a mental illness believe that treatment can help people with mental illnesses lead normal lives.

• Despite the fact that an overwhelming majority of Americans believe that people with mental illnesses are not to blame for their conditions (85%), only about one in four (26%) agree that people are generally caring and sympathetic toward individuals with mental illnesses.

HealthStyles Survey 2006 (Porter Novelli)

Learn more about fighting stigma at www.nami.org

We have to support and educate our young people and eliminate stigma…they need to feel they have options other than being self-destructive!

Little Thoughts from Therese of Lisieux

From St. Therese of Lisieux’s “Little Way”

If I thought of my life as stretching out before me with suffering, rejection, routine and so on, with death at the end of it all, I would never have the courage to go on.

But I can go on for one day at a time.

Today I can do a small act of love.

Today I can put another person first.

Today I can go to prayer no matter how I feel.

Today I can live patiently with my faults, seeing myself imperfect despite my best efforts.

There’s a reward promised to those who fight bravely, and I’m glad to say I have it already. The reward is freedom to love, freedom to serve, freedom to be who I am in peace and joy, without always wondering what others are thinking of me.

Although not particularly fond of organized religion, this nun’s words touch my spirit, and give me hope. May we each find our center, where the peace and joy make life meaningful.

Amen.