Thursday, May 29, 2008
My Soul Wants to Trust
Dr. X.: No, I haven't really noticed that.
Me: You have to be kidding. I waffle back and forth between totally and completely trusting you and then thinking you are being disingenuous. It is not you though. You have shown you are completely trustworthy. It is me. I don't trust people.
Dr. X. : I have not seen that.
These are moments that make me go huh?
How can I think this, feel this, KNOW I am like this and no one sees that in me. I told him he would see what I meant if he read my blog, because while I believe he is an incredible doctor and I believe he is knowledgeable and I believe we have the best therapeutic alliance I could ever hope for, I often still feel scared. I sometimes feel suspicious or paranoid or afraid of him and our work together.
Dr. X., "You mean like you are afraid it is too good to be true?" [Our therapeutic alliance, his caring about me, his compassion and trustworthiness etc.]
Exactly! Exactly!
Everything I believe in, everyone I trust hurts me or dies, or disappears. I am afraid that if I believe and trust in him I will be hurt the same way the other important men in my life hurt me. It is like I think he is my Dad; someone I always try to seek approval from, try to make care about me and every time I let my guard down and think I can trust him, I can let him in....every time he dismisses me, or does, or says something that hurts me or that reminds me I am nothing. Every time I try I get sent back to square one. The unpredictability destroys my trust (though you would think by now I would just stop trying...but to me that is not an option)
Maybe it is not that I don't trust, but that I trust too much. A friend at the Art clubhouse and I were talking and he said it was funny how you would think so much depression and mental illness would make me jaded, but I'm not.
Me (To Dr. X.): I know you think I am jaded, because you see me when I am so sad all the time, but really I am not jaded. When I feel well I feel like the world is this perfectly beautiful place. I don't know if it is just me, but I am astounded by all the details in life and in everything on this earth. It almost feels like I have achieved some godly state of being when I feel well...I am ensconced in this world that simply is total beauty and it feels breathtaking to stand amongst such sublime surroundings.
Dr. X.: I do not think you are jaded. I think sometimes when you are really depressed you sometimes struggle against being jaded.
I was glad he said that, because I think, in spite of the hell I go through, when I am on the other side I want so hard to believe. To believe in love, to believe in caring and kindness, to believe I am likable, to believe I will be loved, I am loved and cared for. I want so hard to believe that I do make a difference to some people; that it matters what I do, that one day my purpose will become apparent, or even better I will choose my purpose. I want my life to matter.
Saturday, May 24, 2008
Two Wolves
If you can believe it my best friend did one of me. It was so beautiful. With my permission she "outed" me as a person with a mental illness. Her caption below my photo read: "My Name. Still living. Yeah!" I felt honoured that she chose me as a remarkable woman. Thanks "H".
At the Community Centre there was a poster pinned to the wall with a fable written on it. I do not really subscribe to the pejorative nature of the descriptions of evil in the poster. I am not even certain I believe in "good" or "evil".
I also recognize that Major Depression is the instigator of many of the "evil" symptoms below, but I also think that despite being severely depressed I can push a tiny bit to rid myself of ego and it's soul impairing accoutrements.
Given my propensity to dream about wolves and to cross paths with coyotes the poster captured my eye. This is what it said:
"Two Wolves:
One evening an old Cherokee told his grandson about a battle that goes on inside people. He said, "My son, the battle is between two 'wolves' inside us all.
One is Evil.
It is anger, envy, jealousy, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority and ego.
The other is Good.
It is joy, peace, love, hope, serenity, kindness, benevolence, empathy, generosity, truth, compassion and faith.
The grandson thought about it for a minute and then asked his grandfather,"Which wolf wins?"
The old Cherokee replied, "The one you feed". "
I am so afraid my improved mood and my new found capacity to participate in life will be taken from me; that my mood will disappear into anguish, like it always does. I am trying so hard to feed the "good" wolf, but am terrified that the "evil" wolf gently slips back into my mind unnoticed. I am trying hard to remain vigilant and push forward while I feel well. The thought of returning to the place from whence I came terrifies me.
Friday, May 23, 2008
Am I Overdoing Things?
I'm not sure if others have this experience in therapy, but I often do despite KNOWING my pdoc is perfect for me and is always caring and thoughtful. I subconsciously re-enact life experience situations in my relationship with him. Yesterday when I was describing Dr, Bennington-Davis' speech I felt this intense feeling that Dr. X. was scrutinizing me/re-traumatizing me; as I became aware of the dynamic it felt like my Dad and how he acts/acted towards me when I found something interesting, or wanted him to find what I was saying valuable. I feel bad because I brought that up with Dr. X; although I expressed that I know it is not him, it is my reaction to him, I still feel bad for feeling that way.
I wasn't very nice of me to tell Dr, X. I was feeling some kind of minor re-traumatization. I didn't mean it that way. Part of what was going on was his proximity to me. He was sitting closer than normal to me and I felt he was too close to me. I found that uncomfortable.
Also, I am almost afraid to say I feel better to him for fear of rejection or loss of support. Maybe that was what it was. I don't know. Whatever it was it was nothing about anything he was doing it was me perceiving in a weird way.
On another note: My husband and I just got in a fight about how much I am doing at the art clubhouse and how I am unable to do anything else, including cook for myself, or him, eat properly, go to the store to buy food, clean the house and my intense fatigue at 4:00/4:30 that causes me to sleep for 2-2.5 hrs.
He says I am doing all the work at the studio because I am seeking approval and that all it will take is one person making a nasty comment to me and my whole world will come crashing down. He is concerned that I am burning out now, and will burnout even more if I volunteer more (I want to apply to teach a teen/young adult group as I though thought it would be good experience).
I see some sense in what he is saying, but I also hear Dr X's voice, "use this energy to push ahead" from last summer when I was a bit too high after coming off Valium. I feel like this is similar in that I need to use the energy I have between morning and 4pm to do things that make me feel good.
Unfortunately, like my husband I do see my health re: bad food, not cooking , not eating etc. is at risk, as is my messy house and undone chores. I feel like I have this very limited energy supply and to waste any of it on something I don't want to do, or don't find intensely pleasing seems like a waste of precious good mood and energy.
I am having a very difficult time finding balance in my life at this time. Dr. X. said the crash at 4pm could be a symptom of Atypical depression, and he has also read literature about MAOI's causing a similar experience. It makes no sense to me that the Prozac is causing this phenomena as it has such a long half-life. Whatever is going on I know I need to do more at home, but I really want to become resilient enough to get back to work. Right now that seems like a more important priority.
Wednesday, May 21, 2008
M.I.A.
Literally! I have been so active...I have been missing IN action. My mood seems to have lifted to the point that on Sunday I would say it was the first day in 6.5 years that I felt "Well" most of the day...not too high, not to low, no anxiety, cheerful, bubbly and vivacious even around strangers, confident in my self image; basically my well self.
I say almost well because the last few days have been like that too, but at about 4pm everyday I am so burnt out I feel sick and have to sleep for 2-2.5 hours. Then after about 1/2 an hour awake I feel a bit refreshed again, but evenings I feel really low key and fatigued.
I have had such an interesting week. I went to a mental health conference on Thursday that was one of the most interesting conference I have ever been to. There were three key speakers:
- Dr. Steve Onken (a social worker from Hawaii)
- Dr. Maggie Bennington-Davis is a psychiatrist and medical director of Cascadia Behavioral Healthcare, Portland, Oregon (USA)
- Amy Long (both a person with a mental illness and a psychiatric nurse)
I won't try to encapsulate their ideas, but I would like to share a few key things I am going to change, either in my beliefs, or my actions as a result of the conference. I made them into "I will" statements. Here I go:
(based on Steve's talk):
1. As I become the ancestor, I will be remembered for my voice, not my silence. This is based on an old Hawaiian saying ("As we become the ancestors, we will be remembered for our voice, not our silence). As of this moment I am "outing" myself as a person with a mental illness. I will not be afraid. My voice is powerful and I am going to use it.
2. I will speak up an challenge any "microagressions" I see in the Mental Health Care community. Microaggressions were described as subtle and not so subtle ways, through words, or social structures and concepts, that mental health staff distance themselves from the shared humanity of people with mental illnesses. An example would be "staff only" signs on washrooms (like we don't want clean washrooms too).
(based on Maggie's talk):
Her talk about how the brain changes in response to trauma and later "re-traumatization" was fascinating. I will try to capture the essence of her talk...please remember I may get some of the details wrong as I am no neuroscientist oir psychiatrist, but this is what I think I "heard":
She spoke of three areas of the brain that "manage" experiences. The amygdala, which is like a primitive responder to sensory information. It chooses, without benefit of rational thought, whether to Fight, Flight, or Freeze (FFF). Most regular daily sensory encounters go through the amygdala and then into the hippocampus, which acts as a filing system, and then your prefrontal cortex gets the information and decides what to do with the information.
When we encounter a traumatic experience, or traumatic sensory input, we skip the hippocampus/prefrontal cortex experience and go directly into FFF mode("Hypervigilance, Action, not thought, Cognitive diminishment, increased aggression, loss of impulse control, speechless terror") Bloom 2001.
The next time we encounter something similar, or the same traumatic sensory input, we become "re-traumatized". Over time it might happen than seemingly subtle "re-traumatization, can cause huge FFF responses( "traumatic Re-enactment, Chronic aggression, Dissociation, Chronic hyperarousal which interferes with cognitive clarity {and} loss of (or failure to develop)affect modulation" Bloom 2001.
Part of the problem seems to be that the more we are re-traumatized, the more our hippocampus and prefrontal lobes diminish in size, so not only are we on myper alert mode because our amygdala is working overtime, we are slowly losing the capacity to add reason to our reaction in these situations.
She was not talking about PTSD, but of other kinds of trauma. My personal trauma that I kept thinking of as she talked was about the way my Dad could be when I was growing up, and sometimes even now. He was extremely dismissive of anything I ever did. I wanted so badly for him to like me and to be proud of me, but he always pushed me away. He also had the capacity to become enraged out of the blue. He became extraordinarily intimidating and scary to a little girl (he was a policeman and he KNEW exactly how to scare the crap out of people to make them do what he wanted), he also sometimes became violent towards me in these rages.
To this day, any experience I have with anyone in a position of power or authority is coloured by my childhood experience. It takes very little to make me cry or cower, or feel abandoned or dismissed or rejected.
This is what I was conceptualizing as "re-traumatizations: A man coming towards me quickly and me fleeing in terror, A boss saying something negative about me and me being flooded with memories and tears, just like my Dad is standing over me berating me, A person stabbing their finger in the air and I am back as a little girl with my dad stabbing my chest with his finger, pushing me backwards, scaring the hell out of me.
Maggie suggested when these re-traumatizations occur that we try to use "cognitive wedges" to eventually retrain the brain's capacity to be "re-traumatized". Eventually if we are able to do this enough, the hipocammpus and prefrontal areas of the brain will begin to grow again. Those areas will become more in control of what used to be FFF reactions to external "re-trauma"
3. I will practice using cognitive wedges whenever I encounter a situation that feels like it is a re-traumatizing situation. A cognitive wedge requires that when the re-traumatization sequence begins we IMMEDIATELY start doing some task, any task, that requires you to use the cognitive areas of your brain. Examples she gave me was go into the washroom and try brushing your teeth with your wrong hand, or try reading some difficult passage, or write with your wrong hand...anything that takes the brain away from the amygdala reaction and to a prefrontal reaction.
4. I will be careful that as an instructor I do not do anything that may re- traumatize someone. In order to not re-traumatize myself if/when I make a mistake I will forgive myself and ensure the the mistake leads to a change for the next time a similar situation happens.
(Based on Amy Longs Talk):
5. I will remember that if I am alive, I am coping. I never got this before. I remember Dr. Shock replied " I am glad to see you are coping!) to one of my posts I wrote when I was really feeling close to the edge. I didn't understand what he meant. I do now. Thanks.
6. I will never ever use the word "recovery". I will instead say I am "developing my resiliency". Whenever I here the word "recovery to do with mental health I feel like I am failing, because I never seem to recover. If I do feel better I always seem to crash shortly thereafter. I feel like I am not doing what everyone else does when I fail to recover. I think developing my resiliency, so I am able to fight the depression better each time it shows its grotesque self to me is a better description of how I am working towards feeling better over time. I may never recover from this battle, but I can always add more solid layers of resiliency to my suit of armour
Anyways...it was all very stimulating and interesting. I learned a great deal at this conference. The really cool thing was that after each speaker they had a panel of three people (different people for each panel member) responding to the speakers speech. Each panel included a mental health care professional, a person with a mental illness, and a family member of a person with a mental illness. I learned as much from them as I did from the speakers. Whoever organized the event did a great job.
...aqua
Friday, May 16, 2008
Selling My Art Work
One of the speakers, an American psychiatrist (who spoke about how the brain physically changes when introduced to trauma and how to untrain the brain when trauma is reintroduced) (soooo interesting), wanted to buy one of my paintings...the "Unravelled" painting. I didn't sell it, because I can't part with it yet, but she gave me her card in case I change my mind...I feel really honoured that she wants to buy it. This makes me feel like I am headed in the right direction and towards the right destination.
I have a guest this weekend, but will tell you more about the conference in a few days. It was so interesting and I had so many epiphanies during it that I would like to share.
Happy Victoria Day Long Weekend for all you People of the Commonwealth Nations,
...aqua
Wednesday, May 14, 2008
A Switched Flipped Yesterday and...
"I flipped a switch and my mood lifted"I take responsibility for lifting my mood...and Dr. X. if you are reading this sit down:
I joined a guitar class and seriously played my guitar for the first time in years!
And guess what...it made me feel so good. The experience was mostly extremely pleasurable. And then...we played again this morning! And guess what else...though I woke up today exhausted, the music and the inspiration of other's music, and the safe camaraderie in the drop in session this a.m. was again soul enhancing.
Dr. X. will understand how hard this was for me. Years ago, when I was in my early twenties, I hung out with a large group of people. Before and during part of second year University I was dating one of them. Music was my life.
From the time I was young I played ukulele(no lie), the guitar and drums. I listened to all the music I could get my hands on. In my late teens and early twenties I went to see live bands every week, all the time. This was when the grunge movement beginning and was getting big on the Westcoast and I was enthralled by the energy of the music.
A couple girlfriends and I started a band. We had a practice space and practised all the time. It was so fun to sing and make music. Then I started university.
I became overwhelmed by the academics, partly because I was having to work to support myself, partly because I was trying to keep up with my friends outside university and partly because I hadn't been in school for a while and really was not prepared for how much pressure there was. I slipped into an extremely severe depression. As I became depressed my boyfriend cheated on me (on purpose) knowing I would dump him. He told me I was too depressed to be around.
This did two things. It set me into an even more severe depression and it made me lose contact with all my friends. All my friends were mutual friends with him. So along with the relationship ending, all , but one of my friendships ended, our band ended and I stopped going to listen to bands. I also put down my guitar. It was too painful a reminder of so much loss. I became even more depressed and sought help, which helped with the depression, but never helped me pick up my guitar and play again. I literally didn't play it again for years.
Dr. X has tried to get me to play, because he knows music creates a sense of joy in me. I made a couple weak attempts to try, but it just brought back too many sad feelings.
In the impromptu lessons yesterday (that we planned at the Art Clubhouse on Monday) I almost cried numerous times when I was playing. I have so many feelings of loss and abandonment tied up in my guitar. I was terrified I would be so bad and I would embarrass myself. I did embarrass myself, because almost twenty years away from an instrument does not a good guitar player make, but I survived the embarrassment. Dr. X. has tried to help me so many times to allow myself to be embarrassed and live through it. He has advised me to take a behavioural approach to my embarrasment. The more I let myself get through those moments, hopefully the more I will learn to feel less embarrassed.
While I played my guitar in the lesson I almost cried from fear, shame, and embarrassment, but I kept trying and I received so much encouragement. A group of us are planning to meet for lessons and jam session every week.
I am so glad I took that step to force myself to try to play again, despite all my fears and all the bad memories attached to that guitar. It felt like yesterday and today were an attempt to create good memories with the guitar. That is a huge step in the right direction. I can tell it helped me, because my mood lifted during the first guitar session continued to lift today despite being exhausted this morning. After I started playing the guitar at the studio it was like I woke up. I began to joyfully make up lyrics and sing out loud and strong along to the blues riffs we are learning. I love music.
Sunday, May 11, 2008
Invisible
Yesterday I had intense urges to end it all. I have the means as I have hoarded all my leftover meds and still have all my dogs phenobarbital and heart medication. Despite those intense feelings I managed to stop myself from acting. It is not good for me to be alone when I feel like that. I came so close to taking all those pills and just ending it all.
What stopped me? My family. The thought of my husband having to find me dead was too much responsibility for me to place on his shoulders, so I lay down on the bed and clung to the covers and waited for him to come home. He didn't notice I was unwell, like he never notices I need help. It is like I am invisible to him. That really hurts me.
I feel like that a lot; like I am invisible. It is Mother's day and I really miss my Mom. I never felt invisible with her. Even on Mother's Day she would send me a "Happy Aunty's Day" card. She was so thoughtful that way. Without my Mom, without a job, without kids, without the energy to maintain my household even to minimal standards, without the energy to return calls and e-mails, to meet with friends and keep friendships going, without the energy to be a good wife...I have made myself invisible in this world.
Thursday, May 08, 2008
I SHOULD Have Stayed in Bed...
I see no real change in my perceptions taking place. A friend told me about an exercise she was doing, whereby you think of all the things you do now and then repeat the exercise with all the things you would do if you knew you only had had 2 years to live, or what if you had only two weeks, or even less...2 days. When she explained the exercise to me it sounded so much like the type of existential exercise I find so very powerful.
I sat down and tried to put down on paper how my life would change if I had a pre-determined, set time to live. The first thing I thought of was I would call my sisters and express to them how much I love them, the same with my nieces. However, I already do this on a very regular basis, so nothing would really change there. My next thought was that I would feel intense relief knowing life would soon be over. I decided, for me, nothing would change.
I would continue to wait to die, just like always. Dr. X. said maybe we are all waiting to die, but in between we can do things in our life to make the waiting less difficult. I know what he was trying to say...we all die, but we all can impact the time in between, even if in small ways.
I'm sitting there looking at him thinking..."what the hell do you know about waiting to die? You have an interesting job, that you are good at and well compensated for. You have kids to live for and love, you have the energy to ride your bike and to play the piano and to enjoy living."
I know that sounds harsh...but I just felt an intense disconnect between my situation and his. His is the situation I worked so hard to get into and failed so miserably at. I may not have been able to be a Dr., but I had the skills and knowledge to do something with my life that mattered, something I loved: then my lifelong anxiety kept increasing and it and my depression just took me down. Maybe I should be grateful that now I am only "waiting" and not "willing, or making plans on how to make myself die.
That is what I feel Prozac has done for me; changed my wanting to kill myself into, wanting to die. Something I have felt for so many years I have a hard time remembering any extended period where I did not feel like I wanted to die. Is it worth it?
I've been listening to some of my old cds and my whole headspace sort of reminds me of that Smiths song "That Joke Isn't Funny Anymore" :
"Park the car at the side of the road
You should know
Time's tide will smother you
And I will too
When you laugh about people who feel so
Very lonely
Their only desire is to die
Well, I'm afraid
It doesn't make me smile
I wish I could laugh
But that joke isn't funny anymore
It's too close to home
And it's too near the bone
It's too close to home
And it's too near the bone
More than you'll ever know ...
...[refrain]
...It was dark as I drove the point home
And on cold leather seats
Well, it suddenly struck me
I just might die with a smile on my
Face after all
Knowing when I was going to die would be like putting a smile on my face. Life seems to be the big joke I'm not finding funny anymore. Well, really, I haven't found the joke funny for a long time.
Then, after my pdoc appointment, in case I needed another reason for staying in bed, I was the lucky recipient of a $196.00 speeding ticket; all because my road rage kicked in when the twit in the LEFT (passing lane in Canada) lane was dawdling at 40kms/hr in both the passing lane and a lane that was 50 km zone, and crossing the centre line between the two lanes.
I decided the person was going to cause an accident and I needed to get out of the way, so I saw a break in traffic on the right side, slid in and hit the accelerator to pass the idiot's car quickly. I guess a little too quickly, because as soon as my overdrive kicked in an "insane" policeman stepped out right in front of me on the highway...he's lucky I was paying attention as he was pretty close to me when he stepped out...anyways, to make a long story short it ended in him giving me a ticket with a huge fine and me saying "thank you"...can you believe that???
Who's the insane one? Oh yeah that would be ME!!!!...I bet he walked away laughing at me saying thank you for his ticket writing skills...Oy! I should have stayed in bed.
Wednesday, May 07, 2008
Fatigue and Isolation and Anxiety
It is strange, I do not want to see, or contact anyone; I am not picking up the phone, or returning calls and I hide behind call display and feel dread at the thought of having to call people back. On the other hand if I push myself out of the house to go to the studio, it is like I get energy from other people. The problem is when the contact is finished I feel even more exhausted than before. It is as though I vicariously absorb all the energy from people around me, but when I touch the door to leave it is really apparent that I have pushed myself to hard to be up and energetic FOR other people. After the interaction I feel even more sickly fatigued.
Today I am forced out of the house as I have committed to volunteer at the studio this afternoon. I know in my role I am expected to be welcoming, available and helpful. All I really want is to stay home, or go there and hide out in my own little world.
Tomorrow is the beginning of the next set of drawing classes I volunteer to teach at the studio. I feel dread about tomorrow. I am really afraid I will not be what people need me to be. I think part of that is because I have no formal art training. I feel like a fraud; someone who got this amazing volunteer position, but really is not qualified to teach what I teach. I am always afraid someone in my class will call me on that and then everyone will make fun of me and than I will die of embarrassment from the ridicule.
Monday, May 05, 2008
Happy Birthday Mom. I Miss You.
It is my Mom's birthday today. She would have been 68; a young and vibrant 68. I miss her so much it is unbearable some days. Myself and my two sisters all agree that it would be impossible to have had a better Mom. I cannot fathom why someone like her would be taken away from us like she was. Happy Birthday Mom. I love you more than you can even imagine.
Here is an excerpt from the eulogy I wrote for her:
"...Along with her great life of adventure, mom managed to bring up three daughters. It is impossible to explain the love that existed between Mom and her three girls. She was the most incredible and inspiring, caring and compassionate, patient and loving mom anyone could hope for. All of us adored her and will continue to do so. There was not a time when she wouldn't help us if we needed it.
She was always there to lend a hand, listen to us, offer us sage advice, and give us hugs, kisses and show us love whenever we needed it. In return the 3 of us learned to how to love. Well versed in caring for another we returned her love to her. When her 4 grandchildren were born the love in our family expanded even more. Mom adored her Granddaughters [S,J,A,and J]. Sadly her grandson [H] passed away at birth, but Mom took care of him both in her prayers and by bringing him to all our family functions. She so strongly believed it was important that he be a part of our family that she sewed him a beautiful bag, placed his ashes in it and ensured he was with us on all our family's special occasions.
As a testament to her love for her children and grandchildren she has literally hundreds, maybe thousands, of pictures showing the experiences she had with us and the little girls. Her children
and grandchildren returned those experiences with love, affection and adventures of their own. When we asked the granddaughters[2,4,4 and 6 at the time] what they loved about grandma they responded gleefully:
- she was very nice to us,
- she took us to movies (and left 10 minutes in if we got scared, or bored),
- she always let us buy a toy,
- we had sleepovers in the camper,
- she told us stories,
- she made us feel happy and gave us lots of hugs, kisses and
snuggles. - She took us for walks with Bert
- and last, but not least..."she made us feel special"
That was Mom's legacy. Her ability to make everyone she met feel special.
People told us this time and time again. She always saw the good in people. If we are to learn anything from Mom's life it is to understand that we all have the capacity for goodness within us. That treating people well, no matter what the circumstances are increases the likelihood of that
person treating someone else well. She believed in practising and showing kindness, compassion and caring, thoughtfulness, patience and love towards others, even when, and especially when, it was difficult to do. Mom showed us that love begets love. That was her lesson to all of us.
Let us carry what we have learned from Mom into the future and let her lesson of love live forever. We love you Mom"
Sunday, May 04, 2008
4000th visitor "My Psychiatrist Won't Give Me Counselling..."
I thought I'd address the question Visitor 4000 googled to get to my blog because I found it especially poignant given how much support I receive from my psychiatrist. It saddens me that people are being left to fend for themselves when they think they need more support.
Visitor # 4000 googled: "my psychiatris[t] wont give me counselling i need more than 20 sessions".
My question is...and this is a big one...Does this EVER happen? I have met so many people in the last 10 years or so with depression and honestly, I cannot think of a single one whose illness was that easily treated.
I don't believe depression is simply a biological illness. There are so many factors involved in why someone becomes depressed and why one person gets better while another struggles. 15 years ago I would have told you all I needed was 5 or six therapy sessions when I was depressed and I got my life back and became well...but DID I BECOME WELL?
Would I have been in a better situation now if my depression had been taken more seriously when I was having short Major Depressive Episodes. I addressed this before in my post "Early Medical Intervention for Major Depression" . There are no easy answers, but I really believe I needed the support of a psychiatrist, and especially a psychiatrist who works longterm with his or her patients in therapy as well. Twenty therapy visits would not be enough for me, even before this episode.
Why do I believe this??
- I believe Major Depression is complex and has complex triggers...environmental stressors, the person's family history, the individual's history, the individual's coping mechanisms. whether abuse has been involved, whether there are other psychiatric problems like anxiety disorders, or OCD problems, or alcohol or drug abuse problems, whether genetics is a factor, how much, or how little support the depressed person has, whether or not medication, or medications work....the list goes on. No one can convince me that all these things can be addressed in 20 sessions or less.
- What if medications don't work, or work for a while and then stop, or are not optimal and as such are leaving the depressed person at risk of another depressive episode, or more problems in their life due to the side effects, or ineffectiveness of the medication. Long term support is crucial.
- By long term support I mean a psychiatrist you have the opportunity to learn to trust. A psychiatrist who is there for you when it's black and dark and life is not worth living, a supportive psychiatrist who listens and cares and believes they can help you, a psychiatrist who does not falter when mistakes happen, or when the patient gives up hope, or even when the patient feels distrustful of the psychiatrist in spite of the doctor's consistency. My experiences in life have left me scared and scarred and afraid and distrusting of other people. No medication takes those fears away without a combination of therapy. Certainly, 20 therapy sessions cannot eradicate a lifetime of lessons in anxiety, fear, intimidation, helplessness, hopelessness and sadness.
- I know the reason I have survived the last few years is because my psychiatrist offers therapy. Without his continuing support, without there being an understanding that I can see him until I am well, and even after I feel well, I would not have the courage to keep trying.
Dear 4000th visitor...there are psychiatrists who offer therapy. If that
is what you want, or think you need, please listen to yourself and look for a different doctor. You have one life and it is so important to get the care you need to make your life manageable, and, hopefully one day, delightful. I wish you all the luck in the world.
Thursday, May 01, 2008
In My Bubble
Usually this type of feeling is brought on by extreme stress, typically intense social anxiety, or fears that I will embarrass myself or look stupid, or fears I will be rejected. I talked with Dr. X about how I have been feeling in my bubble this past week. I don't really understand what we were talking about in our appointment this morning.
I think he was explaining to me that when I get in that state it would be better for me to just "be" in that state, rather than both be in the state and berate myself for being there.
When I got home I thought of a funny story my sister told me this weekend. It seems when she was in her early 20's she smoked some extreme pot with a friend and some people she didn't know that well. She said she was so high that inside her head she kept repeating "Just say something!,Just say something!, Just say something!", over and over, but nothing would come out of her mouth until suddenly, in a really loud voice she said, "SAY SOMETHING"!
....I laughed so hard when she told me that story, but her description of her inner turmoil while stoned sounds so much like my inner dialogue when I begin to go into my bubble, and when I come out of it. I begin to feel aware of myself slipping away. I suddenly am detached from everything. I can't see, hear, touch, smell anything. I'm gone.
Then just as suddenly I come out of it. I feel so scared and afraid I must look completely bizarre, or that people will have noticed me "gone", but no one has ever said anything. Given other's reactions to my behaviour I can only surmise too much time does has not passed while I was stuck in my bubble.
I have other experiences like this that are so distressing. Not sure why, but it seems to happen in large stores, especially grocery stores. I feel like I've left my body and am hovering above myself. I feel myself getting all clammy, like I'm going to faint, I begin to panic and then I'm gone. This sometimes happens when I am in a stressful group situation, for example with people I do not know that well, or even with people I know well when I am feeling severely depressed and anxious. It is as though I am "outside the circle": a detached third party viewing myself and others from outside myself.
In both types of situations I feel "stuck in the sensation" of not being there. I want to be in the moment, but feel completely disconnected from it. I begin slipping away and there is nothing I can do to stop it from happening. It is an awful feeling; almost as though I am a ghost of a person and existence is surreal, or experienced through a veil or from a distance.
I don't really understand what Dr. X was trying to get me to do, or understand. Was he saying to just let go and give in to slipping away. Let go, don't struggle and accept these sensations as part of who I am? How do I do that?