Letting People In

Here is my latest painting.

I haven't quite decided what to call it, but I am leaning towards "A Green Burial". It is a cross-section of a river and the land beside and underneath it. Your perspective would be that of a person standing in the middle of the river; somehow seeing both below and above the surface of the river; like a plate of glass was stopping the water and the land and you were viewing it as though it were a display in a museum.

I'm not quite done the picture as I want to change a couple things, but I thought I'd share anyways, because it is mostly complete. It is a bit deeper than it looks as I cut some of the bottom off because my name was on it, but that blue running along the bottom is an underground stream and there is probably another 1.5 inches along the bottom. The painting is approximately 24 inches by 36 inches.

That is not really what I wanted to write about today, but sharing this painting with you runs along the same themes of today's post: Those themes being allowing others in, letting people know me, challenging my feelings of inadequacy and my fears of embarrassing myself, and taking chances in order to meet and get to know new people.

First I want to welcome "E" here if she visits my site. I do not generally share my blog site with people I know in the real world (vs. the cyber world), but today I took a chance and gave her this blog's address. I haven't seen her in a long time and it was good to talk with her today. We both share a love of art and writing, and from my brief conversations with her it seems we both struggle with some of the same issues. Anyways, other than my friend "H", and of course on Friday, Dr. X. I have kept this part of my life very private.

I am hoping that sharing myself with others, letting people in, letting people see the real me, will do a few things:

1. It will help me learn to take chances with people. Learn to open up and share, despite being afraid I will be a burden on others, or I will scare others, or frighten, or repel others


2. It will be practice sharing myself with others even if I am unsure how others will react to me. This is like taking a behavioural approach to my intense fears of embarrassing myself.

Up to now this blog was fairly safe from that because of two things: I do not REALLY know the people reading my blog (although I have supportive online acquaintances and friends...and I thank each of you for your support)...so I think if I did become extremely embarrassed about something I said, or did, there is a sense that I have some distance, or I am not as invested in how someone I have never met reacts to me. Also, While I can walk away from my blog if I become devastatingly shy, or embarrassed, or ashamed, I will still see the people who I know personally and have shared the site with.

I guess what I am trying to say is I am practicing being the real me, in the real world...all the good, bad, mad, sad, up, down me there is. I'm taking chances and hoping it will build and strengthen my relationships with the people I know, in spite of being really fearful that I am leaving myself too open and vulnerable.

So, "E" if you came to visit today, welcome. I hope I do not scare you away with my openness. I also hope we can meet for tea or coffee one day soon. I really enjoyed talking with you today.

Opening Up Too Much

I just got back from my therapy session. I have mixed feelings about how it went and how much I opened myself up to Dr. X.

All day yesterday and last night I was so excited about the paintings I had done, so last night I really wanted to share my joy with Dr. X. This morning I awoke with a feeling of shame, or impending doom about my art and sharing it with my pdoc. I wrapped the paintings up and put them in my truck anyways, so I at least had the option to decide once I got to his office.

I've been trying to figure out why I felt ashamed, or feared embarrassment, or was afraid of (hidden) criticism, or had a sense of doom around sharing my pictures, when yesterday I was so really excited and happy to share them with everyone at the studio.

I think one reason is that what he thinks about me matters more to me than what others think about me. This is a strange dynamic. I think partly it has to do with him being a man. Maybe also as a man I project my father onto him. My father would be the only other person from whom I would fear criticism, or a negative reaction.

Dr. X. is probably the exact opposite of my father in terms of personality, temperament and reactions to me, but because he is in a position of power, because I (still) have difficulty trusting the authenticity of his reactions to me, because I sense a big part of his job, and therefore his relationship with me, is to judge me (to judge my wellness, my personality, my pathology, etc.), I feel fearful, that while outwardly he is accepting me, inwardly he just thinks I'm a complete loser. A failure as a human being.

There is absolutely nothing that Dr. X. has ever done that would lead me to believe he feels like this. He is consistently supportive, kind, caring and warm, but the feeling and fear still lurks in me for some reason. I try really hard to overcome that fear. Today I did bring my paintings in for him to see to with that goal in mind, but as I showed him I had a sinking feeling. I talked with him about it, but I couldn't really express why I was feeling that way. I still am having a hard time explaining it.

On top of sharing my paintings, I also shared my blog address with him. Part of me thinks it would be great if he could read what I blog about, because I seem to be able to be more open and articulate here because I have had a chance to digest how I feel.

The other part of me fears that I have left myself too open on this blog; that I am opening myself up for judgement. Giving him my blog address is in effect challenging that fear; understanding that I have left myself open and vulnerable to judgement, yet pushing myself to do that anyways. Maybe the more I allow that to happen, the more I will be able to overcome those fears.

Ascension

My second painting: "Ascension"

I am so creative right now it feels like the old me has come back. I feel like myself for the first time in 6.5 hellish years. I have a hyperthymic temperment and when well I can do a million things at once, but remain extremely focused on each task. That is how I have felt for 4 glorious days.

In those days I have completed 2 paintings (One yesterday and one the day before), and I have began two others. It is remarkable. I sat down to paint yesterday at 10:30 am and finished at 7:30 p.m. I was so engrossed in what I was doing.

This painting is titled "Ascension". Fitting that I painted it on Easter Sunday. I was thinking of lots of things as I painted it. it is a mixed reference to my increase in mood. The obvious portrayal is a cross, yet the Christ figure is a female. She is descending into the ocean (This is the way I would like to commit suicide).

I called it "Ascension" because of the belief that Christ had to die, before he ascended. (The woman is drowning). Sort of a metaphorical description of how I often see my only hope in suicide. I feel in suicide I will at the very least end my suffering, which is better than life when I suffer. Not that I see myself as a Christ figure. According to the bible his death ended others suffering. Suicide would end only my suffering, not others;>)

While I am not really religious I am very interested in religion and probably obsess over it.

I like the idea of the unknown woman under the shroud, chained and bound by something outside herself. Maybe also a reference to how I find it difficult to know who I am. If you look closely the chains around her neck are clasped with a padlock that repeats the cross in the place where the lock would be.

I know there are errors of perception in the painting, and the colours in the picture do not do it justice. The original has more yellow and blue in it. Despite seeing things I need to change in the painting I love what I did here though. It is approximately12 inches my 36 inches.

High and Full of Creativity

This is only the second painting that I have ever completed. I'm just learning to paint, but I think it turned out pretty well and I feel good about my attempt. For me to even say that I must be feeling better.

Dr. X adjusted my medication yesterday and today I have been feeling so incredible. He increased my Dexedrine to 10mg spansules (time release capsules) twice a day, once at 8am and once at noon. It did wonders for me today.

Before I was taking a 10mg Dexedrine spansule in a.m. and then a 5mg regular release Dexedrine at noon. I was crashing big time at 3pm. I had to sleep for 2-3 hours and had no energy or motivation to make dinner, eat dinner, clean-up. It was awful.

Today I didn't crash like I have been doing. In fact, I painted all day and only noticed it was 7:30pm when I was finished my painting. I even forgot to eat. That is a sure sign I feel better. Whenever my mood goes up I get creative and I stop eating.

This painting is a rendition of a picture I found months ago in the newspaper when the Myanmar riots were going on. I changed the original picture, but used its idea as a reference. I loved the idea of the peaceful resistance vs. the armed guards, the dark vs. the light, the good vs. the evil (and/or the difficulties in deciding what is right/wrong). I am sure the soldiers believe what they are doing is right, as do the Buddhists.

I also thought the picture reminded me of the yin and yang of life. I was also struck by the dichotomous nature of the physical government authorities and authorities of the soul being combined in one picture.

Today I Lost My Best Friend

I took Bert into the vet today and had him put to sleep. His life was quickly becoming one of no quality. I couldn't watch him struggle and suffer anymore. It was the hardest thing to do; to make the decision to euthanize him. I wish I could have gone with him. I loved him so much and I feel lost without him at home.

Berty, I already miss you more than I can express. I hope you understand I helped you go because I cared so much about you.

Love Aqua

How Will I Know?

When my mom died two years ago I adopted her dog, Bert. Really he had been a huge part of our family for 8.5 years and I adored him, so the decision to take him was easy.

He is a boxer. His mom and dad were both white masked fawn boxers, but approximately 25% of boxers are born white or mostly white. According to the AKC and CKC any boxer with more than 1/3 white disqualifies it from the breed standard.

Some say white boxers are not as healthy as other boxers, breeders sometimes will euthanize white puppies. From what I understand there is no science that shows white boxers to be any less healthy than their coloured breed members. There were three white pups in the litter Bert was born into and all of them outlived there fawn coloured litter mates.The white boxers that are not euthanized are sold only if the purchaser agrees to have the dog spayed or neutered so as not to "contaminate" the breed.

I say that last sentence with sarcasm. You could not ask for a better dog. Bert has the most incredible disposition, is the best dog I have ever owned, Despite his size, all 102 lbs of him, he is unbelieveably gentle around even the tiniest of kids and the frailest of grandparents. He has a big and funny personality and is an all around joy to be with.

Bert is the last one left in his family. When he was young he was completely white with one black eyebrow until a few years ago when gave him some light brown age spots and turned his black eyebrow white. He is huge for a boxer. He stood at least 5 inches above his brothers. An average boxer weighs 50-70 lbs. Bert weighed in at an average of 95lbs. He was not overweight, just huge.

Since I have had Bert he has become increasingly sick. Within a month of having him he had an attack of pancreatitis. I took him to the vet. They gave him antibiotics. I began giving vet quality, low fat, easy to digest (very expensive...argh!) food. He became well, but continues to have gastro problems if we stray at all from his regular food and Pepcid AC regime.

He is almost 11 now, which is old for a boxer. Boxers have a very high incidence of cancer and often die around 7 or 8. Last winter I took him for a walk around the farm. He was being his silly self, and was running and spinning and running some more, when suddenly he collapsed. He lay there awake, but unable to move for about 5 minutes. Then he just got up as if nothing happened. The next day it happened again and then suddenly he began collapsing that day anytime he walked more than a few feet.

I took him to a dog heart specialist and they diagnosed him with "Boxer cardiomyopathy". Basically if he exerts himself at all he is at risk of his heart's electrical system just shutting down his heart. He had other heart problems as well, so he was prescribed Sotolol for the cardiomyopathy and Lotensin for blood pressure (I think), and we were told to not allow him to run, or exert himself. (easier said than done when a dog is bred to run)...but we have been very careful and he made a pretty good recovery, still enjoyed life, albeit a bit slowed down.

In between all this he was diagnosed with 4 separate kinds of cancer. He has a small tumour removed from his eye. He has a mass on the top of his head that has stayed pretty much the same size for years. He has lung cancer and another type of cancer that is growing very large (orange sized) lumps on his front leg. I had a couple masses removed, but they have grown back. The other cancers are slow growing and the vet says not painful, but they have definitely slowed him down more. He does have arthritis pain, and for this he takes Metacam, and NSAID for pain.

In November Bert began having seizures. They were awful to watch, but lasted only 2-3 minutes and happened once every three weeks. Then he had three in one day and it began getting really serious. The vet said he was unconscious while they were happening. I wonder though, because it seemed like he was starring helplessly at me while they were happening, begging me to help him. We put him on Phenobarbitol, and he has only had one since then and that was a month and a half ago.

As you can see, I care so much for Bert, and I have done so much for him to make him comfortable, and to help him be a happy dog despite all his illnesses. And he has been a really happy dog most of the time, until recently. He has slowed down so much he is having a hard time walking. All he wants to do is sleep (and eat...he still LOVES to eat, which is a good sign).

He's happy to see you when you come home, but he has a really hard time getting up to greet me like he always wanted to, and wants to, so he now waits for me to come greet him. The last few days he has been having some incontinence problems while sleeping. I took him to the vet today for blood tests, but honestly, on the way there I was thinking it really might be better for him if I had him put to sleep. I don't want him to suffer, and I don't want to end up stranded in the middle of the night with no vet and a crisis situation on my hands.

All the way to the vets I cried and I tried to figure out if I want to let him go because I cannot handle all his ailments anymore, both emotionally and financially (I'm spending $500.00-600.00 plus/month on his medications and his special diet and probably another 200.00 for vet bills if I averaged them out over the past two years), or if it is the best thing for him. I only want to do what is best for him. I love him so much.

I also understand that the connection between Bert and I is so intense because for me he is my Mom's representitive. My mom is gone now, but in Bert she lives on. I see so much of her personality in him and he reminds me so much of her. They were inseperable when my Mom was alive. I know part of me is afraid to let Bert go because it means a finality of that connection to my Mom.

He is a representation of my Mom's physical presence on earth. He is a family member, no less so than my husband or I. I believe in euthanasia, both for people and for animals, but only if that decision is what is best for the being. I really want Bert to die with dignity. I don't want to be rushing him to the hospital because he has stopped breathing, or can't move. I want him to go with the ability to feel my love for him as he passes away, but I just could not make that decision today. How will I know when the decision is right for him?

Surging Creativity

Over the past week I have felt my mood and energy lift immensely. This feeling has produced and overwhelmingly intense surge of creative energy. I say overwhelming because the ideas are coming faster than I can even begin the paintings.

I took a class the other day where I learned how to stretch my own canvases for painting. Yesterday I went out and spent a small fortune on the tools, canvas, stretcher bars a staple gun, a few ready made canvases, more paint (even though I have lots of paint) and anything else at the store I decided I "needed".

I have so many great ideas for paintings, today, before I start a new one, I am going to actually try to finish the one I'm in the middle of (and have been for the last 2 months). I love this feeling. It feels like I am back. The real me is creative and energetic, and passionate and excited about everything around me.

The real me sees intense beauty in all the little things that surround me, the puddle of water being used as a birdbath by a robin returning for spring, the willow tree buds popping up each day turning weeping branches of the tree a beautiful shade of light yellow/green, the crocuses popping through the lawns, the mountain's winter water runoff racing down the river searching for the sea, the bald eagle soaring above the farm, climbing to heights that seem impossible and coming together to mate mid air, falling to the ground faster than Icarus fell as his wings melted in the sun. The eagles manage to part ways before hitting the ground and then soar higher and higher and begin their dance again. It is beautiful.

Despite this beauty, and despite my lift in mood I am thinking a lot about suicide, maybe a better description is having suicidal imagery stuck in my head. These ideas are fixing themselves into my artwork. I do not understand why, when I feel so much better.

Whisperings about the Word that Cannot be Spoken

On Thursday Dr. X. and I decided to add a stimulant to my medication regime and continue of with my lowered dose (600mgs) of Tegretol, 30mgs Prozac and 10-20mgs/day Valium. We added 10-20mgs Dexedrine. He left it up to me to decide how much was helpful. I started at 10mgs and by the next day I felt a lift in mood and I felt much less tired and fatigued.

I actually feel like doing things again. This is a huge change. The 10mgs right now seems like enough, because even at that small amount I am having difficulty sleeping. I feel a bit wired, but last night I slept a bit better, so maybe it was both a withdrawal effect from the Clonidine I have recently stopped and my mind learning to accept a bit more stimulation.

Could this be the magic potion that helps me? I am afraid to even think that thought, let alone write it lest the query magically destroys the effects of the medications; just like when I was a kid and writing the name of the boy I loved, immediately destined the relationship to fail.

You will not hear me whisper those words again. It has been 4 days of feeling pretty good I am going to try to accept each good day as a blessing and try to forget that these days always seem like transitory moments for me.

Coping Strategies for Treatment Resistant Depression (TRD)

In a previous post: Reviewing Treatment Plans for TRD I borrowed a list of 9 treatment guidelines used to help with the management of depression that had been posted earlier on the Dr Shock MD PhD blog.

Dr. Shock, having read my post, responded in another post that he saw an important aspect of depression management missing from the list; that is coping with the depression. He suggested , "Some ordinary but useful measures can also help, such as running, light therapy, daily activity scheduling". He then asked if I had anymore ideas.

I have mulled this over for several days. My first thought was that I was unclear on the concept of coping. I remember a post where he commented "glad to see you are coping well" and I thought I was coping very poorly. At the time my understanding of the definition of coping was that in order to cope, one had to have strategies in place that were successful. In my mind, that meant strategies that rid me of my depression.

I looked up the definition of "cope" in two dictionaries last night:

Merriam-Webster Dictionary: "to struggle to overcome problems or difficulties" (this reads like my previous belief about coping....I have to "overcome" in order to be coping).

Webster's New World Dictionary: "1. to fight or contend (with) successfully or on equal terms 2. to deal with problems, troubles, etc."

The Webster's New World Dictionary's 2nd definition is more encompassing and fits with how I cope. This is the "cope" I will write about. These are strategies that I use to survive and that help me continue trying to get better.

I am sure as you read my list you will recognize I have positive ways of coping, and not so positive ways of coping. I will reserve being judgemental about all my ways of coping and allow the reader to decide for themselves what might be in their best self-interest if they want to incorporate some of my coping mechanisms into their lives.

My Coping Strategies: (in no particular order)

1. Having a regularly scheduled therapy session with my psychiatrist to review my treatment plan , my mood and to work through current difficulties and/or celebrate successes.
2. Scheduled responsibilities and commitments. Like the volunteering I do. I am the type of person who absolutely will not break a commitment. This is often a healthy strategy for me as the external pressure gets me to leave the house and do things. However, and this is a big however, it is easy for this strategy to backfire for me because I have difficulty setting boundaries and will continue to keep my end of the deal, even if it is clear I am too ill to continue. I am working on developing better boundaries for myself.
3. Schedule social and cultural activities: Buy the tickets for the symphony, or a play, or a concert. Make arrangements to meet people for lunch, or dinner on set dates. Sometimes I get cajoled into doing this. I almost always don't want to go do these things If I did not have the arrangements in place ahead of time I would stay home. However, I am almost always glad I went and/or participated in the activities I scheduled ahead of time.
4. Setting boundaries. Knowing when to say no and when to commit to tasks, meetings, volunteering etc. (a work in progress)
5. Working: I used this for years to cope. The more depressed I became, the harder I worked. In one way, having a very set, strict schedule helped me maintain some level of consistency in my life. This MDE however, I managed to work for two years while severely depressed and then my work threatened to drown me. This coping strategy became my enemy and I had to leave work to save myself. I know I NEED to work again, even if it means only volunteer work. I do better with more structure, but I need to work somewhere, or at something, that has the flexibility to allow for the ebb and flow of my moods as well as something I feel is meaningful and full of purpose. Also, I worry so much about my long term income security while on disability income. When I work this fear is minimized, although it is still always there. I always worry about being laid off or fired (even though in performance reviews I have consistently been reviewed as a hard working and high performing employee). This fear is an OCD thing for me.
6. Volunteering: This is even better for me than working for money. I get to work so I have a sense that I am being useful. I have set responsibilities and 2 half days where I have committed to showing up, so I have the external pull to get me out of the house. On top of that I am helping others and that makes me feel really good.
7. Having a dog: the responsibility for his care and knowing he needs me has literally saved my life a few times in the past year. Also, when he was well I lost 10 pounds in the first few months I had him because we went for long walks so often. Even now he gets me outside numerous times everyday and we go for short walks, rain or shine. I never thought I was well enough to accept the responsibility of a dog while I was this ill. Now I see I not well enough to NOT have the responsibility.
8. My love for my sisters, my nieces and my husband. I stay alive because I do not want to hurt them
9. Fresh air, long walks: If I can force myself to get out of the house going for a long walk always makes me feel better. I love the outdoors.
10. Sleep: Sometimes as an avoidance strategy...if I sleep I will not kill myself. Also, getting enough sleep and keeping a regular sleep schedule as a strategy to regularize my mood (I have a really hard time staying asleep). This is almost impossible to do, but I do try to wake up and go to bed at the same time every night, regardless of whether I actually slept or not.
11. An S.A.D. Lamp: I sit in front of one for an hour almost everyday. Does it work? I don't think it helps my mood, but I like sitting in front of it to read the paper and I can't see it hurting me.
12. Lay on the couch and cling to life: sometimes, when I begin having obsessive and/or violent suicidal thoughts I curl up into a ball on the couch and just try to wait out, and get through, the thoughts.
13. Drink alcohol: to relieve anxiety, to disappear, to forget. This is a dangerous strategy for me as I tend to use it when I am most depressed and anxious. It calms me, but also brings down my inhibitions making me at greater risk of committing suicide. I am working on losing this coping strategy.
14. Write: In my blog, on my support group's website, in my journal. Writing helps me get all my thoughts out of my head and helps me search for a solution.
15. Sex: Something has happened in the last year and I have given up sex. I am to tired and too depressed. I have to get this gift back again. It used to be, if I was really irritable it was the best time for me to have sex. The physical connection, the energy, the release almost always helped me feel better.
16. Go for regular massages: I have a regular massage therapist that I see. I have seen him for years. I have told him all about my struggles with depression. I have known he has had troubles with depression before, but he recently told me he had a severe psychotic episode years ago and was treated as an inpatient for a very long time. This information really helped normalize me to myself, because he is doing so well now. Knowing this I feel I can be open and honest with him, and that helps me relax more throughout the massage. In a bizarre twist of fate his first name is the same as my pdoc's...so I call him my body "J" and my pdoc my mind "J". Just another funny coincidence. His wife had a baby on my sister's birthday, and my pdoc's wife had a baby on my birthday. I sometimes wonder if these cosmic coincidences indicate I was destined to have a strong relationship with these people.
17. Have my husband hold me tight: Sometimes when I am really irritable I just ask my husband to hold me really, really tight. Something about him squeezing me in a big hug calms me.
18. Pay someone to clean my house: It used to be I was depressed and could not keep up with the housework, but every once in a while I would get a spurt of energy, go crazy and clean it from top to bottom. I would berate myself in between these spurts for how disgusting the mess was. In the past couple years have not had any of those spurts of energy, so my house became even worse and I began berating myself more and more over my inability to manage and keep up. Even though I cannot really afford it, I now have someone come in once every few three weeks and clean my house for me. It has relieved me of my guilt and I have a cleaner house.
19. Drop my laundry off: For the same reasons as the above.
20. Lay in the sun: While I use sunscreen I do not worry about sun damage. The sun makes me feel better. I am more at risk of dying from my mood disorder than I am of getting cancer. Starting in February any time I get a chance I go into the greenhouse, climb up on top of the planting tables and lay down on a mat with my pillow and soak up the sun. It is relaxing. Come later spring I lay in the sun and fall asleep on the back deck.
21. Eat chocolate and carbs: (mashed potatoes, chips, cereal)...all fill some void.
22. Swim or Gym: I have not done either in at least two years. I actually stopped because I did not see my depression getting any better as a result of doing these things daily. I now recognize I was mistaken in the goal of doing each of these. They are not a means to an end. They are themselves the ends. While swimming I feel an intense calmness come over me. It is like a moving meditative exercise. While swimming and working out I feel strong and powerful. This is relief, if only for the time I am doing it. Also, while participating in both I like my body better even after I leave the pool or gym. This must affect my mood in some positive way even if it is not immediately apparent to me.
23. Listen to music: To anyone who loves music this strategy needs no explanation.
24. Get creative and enjoy creative things: draw, paint, creative writing, pottery, read, watch a good movie or an interesting t.v. show. I get lost in these activities IF I can manage to start them. Getting started is the hardest part, but once I begin my spirit becomes entwined in the creative process and all bad thoughts leave my mind.