RealMental

Liz Spikol posted a very awesome video about depression advice over at her blog yesterday. It makes light of that oh-too-familiar advice that we get from well-meaning people who have no clue what it’s like to be depressed.

If only laughter really were the best medicine. For now, I’m sticking with my Celexa.

I’ve been told to “snap out of it”, to turn up some music and dance around my living room, and to quit taking things so seriously by people who couldn’t understand why I was debilitatingly depressed or anxious.

They meant well, but they had no idea what they were dealing with because they have never experienced it. Their advice only served to make me feel like more of a failure because I was unable to control something they thought was so easy to solve. It made the gulf between me and what was “normal” even wider.

What’s the worst, most ignorant, or most insulting advice you’ve ever gotten from someone in regards to your mental illness?

At the end of September, when the antidepressant I was on made me go wonky, I asked my doctor to refer me to a psychiatrist.

 And then I waited.

 And waited.

 And waited some more.

 Because, while I usually have nothing but praises to sing about the Canadian health care system, when it comes to mental health care, if you don’t have a knife to your throat, you’re shit out of luck. If you want to get in with a psychiatrist for the first time, you have to wait three to six months, no matter how bad you are doing. As long as you’re not actively suicidal or homicidal, you wait.

 I waited five months. By the time my appointment came up, I was feeling fine. My drugs were working and I wondered if I even needed a psychiatrist after all. But, given my family history, I decided to go anyway. It couldn’t hurt, right?

 Wrong. Oh, so very wrong.

 The psychiatrist, whom I shall call Dr. R, came very highly recommended from my family doctor. I had told her, “I want someone who will allow me to be an active participant in my own care, who will listen to me.” She said this woman is fantastic and very compassionate. I adore my family doctor and we get along quite well, so I trusted her opinion.

 My appointment was three weeks after I had major jaw surgery, and only one week after I had my jaw unwired, so I was still on some painkillers and having problems getting enough calories into my body. That didn’t really help my emotional state going into the appointment.

 However, I was determined to have a positive attitude and to be open-minded. Sitting in that waiting room, I tried not to be nervous and instead psyched myself up (hah), telling myself: this is something I’m doing to make my life better and ensure I am going to be healthy long into the future.

 I quickly figured out that this appointment wasn’t what I was hoping it would be, no matter how much positive energy I tried to throw at it. The moment I told Dr. R my family history and the adverse reactions I had to the Effexor and Wellbutrin, she decided I was Bipolar II and tried to fit everything I said into that diagnosis.

 I’m not disputing the diagnosis itself; it’s a fair hypothesis, and one that I have considered myself. However, I have a huge problem with a doctor diagnosing a patient within five minutes and then “accusing” her of all kinds of behaviour that doesn’t exist.

As the “interview” (or interrogation, as it became) went on, the two of us got more and more frustrated, and the conversation grew heated. She was frustrated because I refused to just accept what she was telling me about myself, and I was frustrated because she wasn’t listening to me or considering my explanations for my decisions or behaviours.

 And then it just got plain weird.

 Dr. R: Do you ever spend large amounts of money?

Savia: Sure. I have a house. I’m doing home renovations right now.

Dr. R: How are you paying for that?

Savia: A line of credit.

Dr. R: That’s hypomanic, irresponsible financial behaviour.

Savia: But I’m making an investment in my home, and my house value has quadrupled in the past seven years.

Dr. R: Going into debt for any reason is hypomanic.

Savia: What? But it’s not just any debt. It’s good debt.

Dr. R: There is no such thing as good debt.

Savia: But… [about to explain how her sewer blew up and also how the energy efficient renovations were eligible for a $3,000 government grant, which would pretty much pay for them, not to mention the savings on the monthly energy bills.]

Dr. R: [Cuts me off] The only way it would be acceptable for you to go into debt for home renovations is if you were selling your house and would get the money back right away.

Savia: [looks at her like she’s on smack] I guess we’ll have to agree to disagree on that one.

 Note how she didn’t even ask how much money I make or how much the home renovations cost or any other details that would have explained why I was going into debt for this project? It was all about absolutes. And let me just say, if going into debt for any reason makes a person bipolar, I guess the majority of North Americans have this disorder. Maybe that’s why it’s so hard to get in with a psychiatrist?

 After that, it quickly went downhill. She snapped her questions at me and cut off my answers. Any time I tried to explain or elaborate on one of my answers, she said, “You’re rationalizing your behaviour.”

Um…no…I’m just trying to give context – the grey answer to a question that she tried to make black and white. Because life isn’t like that – it’s all about the shades of grey.

 At the beginning of the appointment, I was quite succinct in my answers. But then, she would jump in and fire several more at me, obviously looking for more context. So, I started giving more thorough answers. She never smiled and she cut me off a lot, which made me really nervous and uncomfortable. I started talking faster and being less concise. At one point, she stopped, tilted her head, smirked at me and said:

 Dr. R: You’re talking fast and circumventing the question. That’s hypomanic.

Savia: I’m nervous!

Dr. R: [cutting me off] There you go, rationalizing your behaviour again.

 I’ve lost count of how many arguments we got into in that hour and a half. Our personalities clearly do not mesh, and I could tell that she didn’t appreciate me challenging some of the things she was saying or asking questions to help me understand where she was coming from. We both ended the session thoroughly pissed off.

I was so angry and upset, not about the diagnosis (though that did scare me quite a bit, because I don’t want to have this disorder and I don’t want to have to take mood stabilizers, ever), but about the way she treated me. Her cruelty to someone so vulnerable cut very deep.

 I didn’t sleep at all that night, and then I cried for two days straight and fell into a depression. What if she was right, and all of these things that I consider as part of my personality are just a disease? I thought I knew myself really well, but if this is the case, who the hell am I, then?

 I talked to a few friends who’ve known me through all of the ups and downs, and they said the same thing, “You’re always Savia. No matter if you’re depressed or anxious, there’s still something about you that’s always there and doesn’t change.”

 And they were right. I tried to put Dr. R’s harsh words behind me and take the good out of the appointment. A few things that she said did ring true.

 For instance, when I told her that I don’t have hypomanic or manic episodes, she said that for me, hypomania may manifest itself as anxiety. I found that interesting, and it would fit with what’s been happening to me. She also gave me the signs of hypomania and told me to keep a mood chart for the next three months so I would have a record of my patterns.

 Dr. R said that the current drug mix I was on (Celexa and Wellbutrin together, in low doses) could put me at a higher risk for hypomania and that it would be better for me to be on just one of those drugs, or off them entirely and on a mood stabilizer, my reaction to which would serve as a diagnostic tool.

 She also told me to take Omega 3 fatty acids, which she said is the one thing that has been clinically proven to help with depression and mood disorders.

 So, I did take the good advice she had and used it to my advantage. I went off the Wellbutrin at the end of April and found that just being on the Celexa was much better for me. I started taking Omega 3s, along with a daily arsenal of B complex and Vitamin C, and am amazed at what a difference that makes in stabilizing my mood.

And last, but certainly not least, I am keeping a daily mood blog where I quickly jot my mood, appetite, sleep, spending, menstrual cycle, drugs and sexual interest levels. It takes me two minutes a day, but it has made me aware of some of the factors that affect my mood, which gives me the opportunity to deal with things before they get out of hand.

 And the best thing about the mood chart is that the next time I go to a psychiatrist (in six months, if I can get in with someone else, that is), I will have that record to show him/her. And, hopefully, I can avoid any further nastiness.

Because going to the psychiatrist is stressful enough without having to prepare yourself for a knock-down, drag-out fight with the person who is supposed to be helping you.

It’s been a rough spring around our house. But at the same time, it’s been better than each one before it. So I feel like I should be grateful, and I feel guilty for feeling emotionally exhausted all the time, but there you have it. I feel what I feel, and it is what it is.

I belong to some support groups for “significant others” of people with bipolar disorder, and I can tell you from years of observation and experience that, among our ranks, May is a rough, rough month. In a bit of black humor, someone somewhere began referring to this month as “May-NIA,” and that stuck. Even my own spouse, who is faithful and dedicated to his mental wellness, and takes his meds and tries to stick to healthy routines, has periods of “breakthrough” hypomania in the spring. Do what we will, the force of springtime will not be denied. Every year I’m struck with jealousy over other people’s rejoicing in the coming of spring…they’re planning their flowerbeds, washing their windows, de-winterizing their mowers, while I’m monitoring the bank account, trying to keep things quiet, and generally just scattering a fresh layer of eggshells across the floor for us to walk on. I dread spring. And to be honest, I resent having to feel that way.

In the beginning of our journey with this illness, post-diagnosis, I lived in a state of wary watchfulness. In the first year, there was a significant relapse, so after that I was pretty much in constant readiness, watching for that sign that would indicate that everything was about to go south again. If he was 5 minutes late, or didn’t answer his cell phone one time, I just knew that “it was happening again;” that he’d disappeared, he’d “run,” and that, since that was the line I drew in the sand when we decided to stick this thing out together, that our marriage would, consequently, be over. I literally went through this entire thought process on a regular basis. It was a long, long time before I could make myself continue to breathe normally in the face of even a small unknown. But I learned, as time went on, how to focus on myself, to trust myself, and to breathe.

As more time went by with no full-blown episodes, something odd happened. I did manage to stop living mentally perched on the precipice of disaster. I remembered who I was before I ever tangled with bipolar disorder. I realized that I’m smart (enough), capable (enough), and tough (enough) to handle whatever it could throw at me. And with that knowledge, I relaxed. A lot. But I didn’t anticipate what came next–what has been happening for the last couple of years.

My husband has expressed to me, often, the irony of managing a mental illness well–that is, that since he stays on top of his medication regimen, sees his doctor regularly, performs well at a regular job, etc., that people tend to “forget” that he has bipolar disorder. Then, when there is an episode of breakthrough depression or hypomania, the reaction is one of disappointment, like, “I thought you had this thing beat.” No one understands that it’s an ongoing, daily battle, and that there is no magic pill that’s going to work all the time. We “tweak” his med cocktail once or twice a year, at the very minimum.

I have caught myself falling victim to this same phenomenon, in a way, and I’m not sure it’s any better than the way I used to live. Instead of being constantly on edge, expecting things to fall apart any second, I now let even a couple of weeks of good times lull me into near-total complacency, so that, when there is a bump in the road, as there most assuredly always will be, I’m left gobsmacked, the rug pulled entirely out from under my happy little world. Every time this happens, I feel so stupid, because, of course, I knew better. But it is so altogether soul-wearying to live in that watchtower, that sometimes I just desperately want to come down for a while. To stay up there, watching, watching, watching, is to admit defeat, in a way…but more than that, that sort of life is really no life to have. It’s not just emotionally tiring; I can feel it chipping away at my physical health, with all sorts of symptoms I never knew before I met bipolar disorder, like anxiety, panic, depression, irritable bowel, nausea…this disease that I don’t even have is shortening my life.

But the alternative–life without my husband? No, that’s no life for me, either. Somewhere, somehow, there must be a way to find balance. I wish this post were more about answers.

It has been so long since I have written anything really mental.  My life has been caught with mostly good things.  Good things.  Some travelling, spontaneous purchase of a new house, won a trip to China to go to the Olympics, went to NYC for the first time, stayed with a fabulous hostess and the most terrific time.  I did see a Surgeon who wanted to Surgeonate my knee.  I scheduled and then cancelled.  It didn’t feel right.  All the Good Things were and are overwhelming me.  Change is overwhelming me.  I changed from Paxil for my anxiety, which I didn’t believe was doing anything to Effexor, which I think is doing something, but we are tweaking the dose.  If you read my regular blog, you would also know that I had weight loss surgery in December, just before Christmas.  More change.  Rules.  Rules are meant to be broken and CONTROLLED when people tell you what to eat, even though I am almost 40 years old. How to exacerbate an eating disorder: give someone rigid rules about what to eat and when and how much and then a list of vitamins and activity or your expensive paid for out of pocket operation will be for naught.  I got it done to gain health, and the losing of the weight surprises me a bit.  My clothes fit differently, but I feel the same about myself.  My skin is drooping, sagging, my boobs, oh dear, my boobs. 

I am still on the lamictal for mood stabilization, and the effexor, but still taking a fair amount of klonapin to keep my shit together most days.  Still taking diabetic meds, except have pretty much stopped my injectible insulin altogether.  My sugars were so low after the surgery and I honestly haven’t been monitoring them.  I am 3 months late getting blood work.  Ok, I lie, I am 4 months late.  I am not monitoring my blood glucose levels.  I am shit at self care right now.

I am scattered and paralyzed.  I wish I could add the adderal back into the cocktail of drugs for the ADD.  My memory is sketchy, I miss appointments, I have to write almost everything down.  I am very jumbly and klutzy and trippy and my word aphasia is bad.  It is a good thing I am not working a full-time job right now.  Self imposed deadlines are killing me.  Deadlines like let’s say, packing.  We are moving into the new house on May 15.  I have done nothing.  The spouse has all sorts of boxes, his office is packed.  I just lie in bed or watch tv or flit away time on the computer.  That reminds me I have an eye appointment sometime in May.  As usual I am trying to keep up the ok, functioning façade that only so many people in my life even buy anymore.  Even when I am feeling jitter anxious and tell people so, my affect falls flat and I wonder if they believe me.  I am having a bad day, like a computer reading it. 

I can’t tell hypomanic from feeling less anxious.  Initially the Effexor made me feel a little hypomanic, but I think that has subsided.  Still seeing psychologist and psychiatrist.  The meds are ultimately what is helping me right now.  I don’t even want to talk about coping mechanisms.  They might make me give up my ostrich like behaviour.  Sleeping, shutting doors, television, senseless errands.  I sit here in my home office and the debris is everywhere.  It has been for months.  I don’t even know where to start.  Last week I lost my wallet and became obsessed with finding it.  Looking in the same places over and over and over again.  I felt I could not do anything but take my kid to playschool and back.  I felt lost and annoyed because I knew I has misplaced it IN the house.  My husband found it 5 days later and the relief I felt was disproportionate to the actual event.  I felt freakish.  I feel freakish and crazy.

I have been having little paranoid moments where I keep needing reassurance that people like me and aren’t going to leave me.  Seriously, do you really like me or are you going to change your mind once you find out the mysterious secret thing that is permanently flawed about me that even I am now aware of.  That is why people leave me, or reject me, or ignore me. 

I have been chastising myself for not writing here.  Reneging on commitments that I made.  I hate breaking promises or not following through.  Or not even starting, finishing.  You know, classic ADD.  I do stupid things all because of my mind?  No, I make choices for certain, but sometimes it doesn’t feel that way. 

feeling lost, and bottomless with no one to catch me.

want to run yet too old now, to think it would do any good.

empty, alone, sad, emotional.

wondering why things happen the way they do.

looking for the break that i believe i am entitled to, even though i know

i am not actually entitled to anything.

don’t want to repeat “sins of the father”,

of being everyone’s support.

old habits are hard to let go of,

holding things in because it is easier that way.

too hard to struggle.

not regretting my age, yet missing my youth to wonder if i would make

different choices.

knowing that all of the choices that led me to where i am

are all a part of a bigger plan.

a plan that i hope my higher self is in charge of.

loving lots of people, feeling emotions very deeply,

wanting to drop in and sprinkle magical fairy dust and then leave.

i question if i was built to be a “staying person” or rather someone

who can only flit here and there with no permanent residence.

i love too deeply, too much, i’m too sensitive, too complicated,

too me.

no one promises that we will be happy, that is a false illusion created by

the likes of walt disney.

i just want peace, serenity, and calm

but not every minute of every day.

perhaps i could store it in the closet on the top shelf and bring it out when

it is most needed.

if only i were not an addict, perhaps that could work.

a higher voice tells me that everything really is ok and not to worry

enjoy each as if it were my last.

that is how my dad tried to live his life, i miss him so much sometimes i

fear i will become invisible with sorrow.

he always knew the right thing to say, or perhaps he is the only one that i

actually “allowed” to say the right thing and be comforted by him.

the trust issues,

of them,

i have many.

my higher self is protecting me from harm

it is important that i experience the emotions

in order to break on through to the

other side.

perhaps i have channeled morrison.

By Michelle

Depression and Generalized Anxiety Disorder is what I have been told for the last 9 years and I believe the Doctors. What does this mean to who I am and what my life is? I do not care what it is called. I have spent many years trying to define it and understand it in black and white. I have found that it is impossible to define as it changes daily.

I was first diagnosed with situational depression, but I realize depression, the anxiety, has always been there. Looking back to when I was a teen, I can easily see it now. But no one talked about it then.

Now I feel strongly about it. Everyone has something and my something is this. If I am afraid of it, others will be too. If I shy away from it, others will shy away from me. I need to be strong and I need to write (and take meds and see a therapist) to be strong. I need to keep believing that none of this makes me a bad or lesser person. I love the days when I can actually convince myself of this.

The whole decision to have a baby has brought thoughts about this to the foreground again for me. Having a baby is something that I want more than anything (ok so forget about the part when I was so scared I thought I did not want kids) and yet I am scared to death, but I cannot let my fears define me. If we do, it wins and I lose. So I write.

Please don’t get me wrong. I have my bad days, weeks and even longer when the depression just gets me, and yes sometimes it wins. I truly believe that my depression in a chemical imbalance and I believe that for long term depression sufferers that this is at least partly the case for most of us.

I have to believe that somehow I will be able to come off the meds I need to during my pregnancy and be OK. At the moment I am tackling it all with the positive approach – I CAN DO THIS. We’ll see how that goes when I actually have to come off the meds in a month. I have a good team of doctors both medical (OB/GYN, Endocrinologist and Diabetes Nurse Practitioner). I also have a darn good a psychiatrist that I have been with for 7 years. I want to try and be med free for my pregnancy. If it is not meant to be and I need to be on an anti-depressant when I am pregnant, no I will not be happy about it, but I will do it and I will do it as safely as possible. Depression can post its own set of risks to an unborn baby and I don’t want that either.

Through all of this I have questioned myself and who I am more than ever before in my life. Can I add “mother” to the list of who I am? I am Michelle – daughter, wife, educational technology project manager, compassionate, giving, self-sacrificing for those who I believe are worth it. I am a reader and writer, a dog lover and a cancer survivor.

I am also someone who HAS depression and anxiety but those two things are not who I am, they are something I have, just like I have diabetes. Both pose risks to the whole baby thing but what worries me the most is the “after the baby is born part” (if we get that far). I do not want to be one of those mothers who always “is resting”. I fear that I will fall short of being a good mother because the anxiety and depression will get in the way.

But I have to believe. We all have to believe that we can do it – overcome the fear of whatever own “IT” – whatever that “IT” is – it is not us, just a part of us and we have to not let the fear win.

Previously posted here.

That you are more irritable, more angry, every day.

That I am not The Enemy.

That I am here because I choose to be.

That there are so many landmines around currently, I can’t take a step in any direction without setting one off.

That I have made, and continue to make, sacrifices of myself in order to be with you.

That I make these sacrifices because I love you.

That I do not feel like a martyr.

That  following a burst of anger just before bedtime, while you go to sleep with the aid of sedatives and sleeping pills, I am left awake, crying, hurt.

That I don’t have anyone to confide in–not really–partly because I want to protect the way you are perceived by others, and “this” is not “you.”

That I feel very, very alone.

That I temper every single decision I make, no matter how seemingly insignificant, with what possible effect it may have on you.

That I resent not only not being able to look forward to Springtime, but having to dread its coming.

That I feel like I’m being “used up” faster than I should be.

That when I am sick, like I am now, I try to somehow “schedule” my illness and treatments around what I think you can handle.

That I sometimes feel trapped, even though intellectually I know that I’m not.

That I have learned more than you’d believe about detachment.

That I refuse to be manipulated by The Bipolar Beast.

That a great deal of my strength in dealing with these bad times comes from knowing that I am only here by choice, and that the power to stay or leave is all mine.   I can say “I don’t have to take this,” and mean it.

That the fact that, so far, I have chosen to, and have been able to “take this,” does not mean that I always will be able to.

That you do keep getting better.  Even the worst times now are better than the best times “then.”

That I appreciate when you try.

That I understand that it is hard.

That I KNOW it’s not fair.

That I am your single most loyal ally on all of God’s earth.

That if I don’t figure out how to get some of myself back, there won’t be anything left to give to you.

That by the time you could read these words with understanding and empathy, they will no longer be relevant, because you’ll be “yourself” again.

That I’m not sure how long I can hold out waiting for that time to come this year.