Creating a Community for Myself: My Path Towards Resiliency

This is a long post. I was asked by someone at one of the Mental Health Teams in my city to write about my experiences with creating a community for myself and how it has helped my mental health. They want to share it with people they are trying to help. I thought I'd share it with you.

Creating a Community for Myself: My Path Towards Resiliency

Social isolation has been one of the most difficult symptoms of my depression for me to overcome. When well I am open, bubbly, extremely extroverted, trusting and want to be around people. When I am in a Major Depressive Episode (MDE) I turn inwards and isolate myself from the world, even from close friends and family. Seemingly simple social tasks, like answering the phone, or returning e-mails, become experiences that fill me with dread.

My illness presents itself as Major Depressive Disorder: an illness that consists of "episodes" of Major Depression, usually followed by periods of wellness. My depression is anxious and there is a component of "bipolarity" to it; meaning my mood cycles between severe lows and extreme highs. Both these symptoms make my depression more difficult to treat.

My most recent MDE has been treatment resistant, or "refractory" to medications and other treatments for 7 years. This means despite my trying literally more than 30 different medications and combinations of those medications, having ECT and participating fully in psychotherapy once, and for long periods, twice a week, I remained severely depressed and anxious, while periodically cycling up close to hypomania for a few days for most of this entire 7 year period.

With my depressive symptoms refusing to budge with medication, my psychiatrist and I work in therapy to help me in other ways. One of the major areas I have been working on in therapy is lessening my social isolation, and increasing meaning and purpose in my life by "creating a community for myself". This is a very difficult endeavor because my symptoms: Depression, Social Anxiety, Isolation, Amotivation, Fatigue Concentration and Memory Problems and Cycling Moods, work against my ability to help myself change, meet people, keep social commitments and often do anything beyond survive. Even that seems hard sometimes.

The process of change and creating a sense of shared meaning and community with others has been very slow and has never followed a direct upward trajectory towards wellness. I move forward, only to have my symptoms drag me backwards again. It has been a one step forward two steps back experience. I am, however, moving forward slowly. I do see this improvement. Before I just kept going two steps back over and over again.

When my psychiatrist first introduced the idea of creating a community for myself, a community that would help me become more resilient, that would accept me for who I was, that would add meaning to my life, that would help me move out of my isolation and into a world that both interested and supported me, I thought he was the crazy one. I felt so depressed and anxious, and I was so isolated; literally laying on the couch, or hiding in my bed all day. The task seemed impossible. How did he think I was going to manage such a difficult task?

I started safe and small. I was afraid to be around people, so I thought maybe being around animals would help. I began walking dogs for the SPCA. It got me out of the house. That was a big step.

Then a year or so later I began volunteering for [an arts festival in my city ]. To volunteer I needed to write my resume and go for an interview. I was absolutely terrified, but I pushed myself to do it with the help and support of my psychiatrist and with the belief that I might find a community that interested me.

I was very sick at the time and switching medications periodically. I was so scared each day I was scheduled to volunteer, sometimes even for days before my scheduled volunteer day, but each time I went I was greeted by my co-workers and my supervisor, people did not seem to notice I was sick, even if I thought I was not doing a good job I seemed to manage the tasks, the people I volunteered with were very nice. Each day I volunteered I gained a bit more confidence in my abilities. My second year with The festival I became so depressed I could not continue volunteering. To take care of myself I gave notice and stepped back from my commitments. This was a setback, but not a failure.

A few years prior I had become a member of a therapeutic art clubhouse that offered art classes to people with mental illnesses. The first class I took was Beginner's Drawing. I remember being so anxious about going to the classes. I was afraid I would be rejected, or not fit in, or be so bad at drawing I would be humiliated by my failures.

The instructor allowed me to be whoever, and however, I was on any given day. By the end of the 10 classes I felt a sense of community with the instructor and the people in the class. Motivating myself to reach out to other human beings and to leave my house and participate in a community was a huge step for me.

Still very ill, I took a Pottery class at the Clubhouse and then an Intermediate Drawing class. Each time I had to go to class I would feel sick and anxious. There were days when I really have no idea how I managed to get there. I believe my commitment to joining and participating in each class, having a scheduled and structured activities for myself and my psychiatrist's support, provided me with enough external motivation to go to each class.

It was not easy. I was always so anxious before I went to each class. Usually that anxiety stuck around for the first hour of the class, however often it never left me the entire class. It was hard to stay, but with the supportive environment and the support of my psychiatrist I forced myself to stick with my commitments. As each class went on I became more and more comfortable with the environment and with the people around me. Showing up to these classes was like behavioural therapy: A type of therapy that desensitizes a person to things they fear by slowly introducing them to the thing or things they are afraid of, until finally they become no longer afraid of the thing they fear.

My experiences at the [Art Clubhouse] awakened the slumbering artist inside me. I had never been artistic. In fact, drawing stick figures was the extent of my experience with the fine arts. I had always loved art; other people's art, but never believed it was possible for me to learn what I loved. With the [Art Clubhouse] experiences and successes to back me up I took a huge step from the Art Studios and decided to try an Adult Education class at [a local Art College]. It was a difficult, but rewarding experiences and my love for drawing began to grow.

Driven by my new found joy of art I began volunteering at the [Art Clubhouse]. I participated in cleanup days, and showed up for their monthly meetings. I began to meet more people in that community. The more I participated in the community the more it began to feel like an even safer and welcoming community. I had discovered a group of peers who not only shared my love for art, but who also understood and accepted me for who I was.

One day I saw a posting for an assistant to the printmaking instructor. I took another large leap and applied for the position. I cannot even express how difficult this was for me. I was very depressed at the time and cycling rapidly between severe and anxious depression and a sense of euphoria brought on by my new found feelings of social freedom and a sense of meaning and purpose I had not felt in a long time. After being the Printmaking Assistant I applied to be the Beginner's Drawing instructor's assistant. Each time I assisted the instructor my anxiety became less and less and my comfort level, and my enjoyment the studio's community improved more and more.

I now volunteer to teach Art classes. I teach Beginner's Drawing, and have taught a short Printmaking group for young adults. I am about to teach my third session of Beginner's Drawing classes and a session for young adults in drawing, printmaking and painting. Even better than this I have discovered I have both a love and a developing talent for acrylic painting. To top it all off I have somewhere to go to share this joy with and even more important, I now interact regularly with people who support my artistic endeavours.

Through a supportive and caring community I have discovered meaning and purpose in my life. I am becoming the person I always wanted to be. Never in my life have I felt like I was on the right path. I feel like that now and this feeling has healing power. My experiences at the [Art Clubhouse] have opened a world for me I never knew existed. This community has lifted me out of isolation and is moving me closer in my quest towards healing my soul. I cannot say enough how important creating a community for myself is contributing towards my climb out of depression and towards resilience and increased wellness.

Is Public Privacy Possible?

Last session I managed to tell Dr. X. most of the things about my obsessive thoughts. It was extremely difficult, because he was the source and the subject of my thoughts. I was looking at my stats and saw that he had visited my blog a few times and looked and numerous sections (labels) in my blog. I became scared he would feel I was disrespectful to towards him in some of my posts.

Despite my earlier offer this year to let him read my blog, when he did I became scared I had disregarded that there are two of us involved in my therapy, and that I was too open about who I see him as, and how he and I interact. I was fearful that my blog crossed some boundary; that I exposed him more than I it was right for me to do. I could not stop worrying that I had destroyed our relationship.

He assured me I was always respectful; that that was part of my personality. I still feel unsure about whether I cross Dr./Patient boundaries in my blog posts. I feel my blog is immensely helpful to my mental health, but I also want to ensure I respect other people's privacy. I worry that he was just saying that to make me feel better. That is a problem for me, not trusting that people are saying exactly what they mean, that they are not placating me, rather than having an honest conversation with me.

I use my blog to augment my therapy with Dr. X. I have mentioned before that often it acts as a preparation tool. A sort of 'practice run' for the next therapy session I am going to (or sometimes that preparation takes place over and over, until I am able to say what I need to say). I also use my blog to debrief myself after a session.

I often wonder how much of my session I remember "correctly". I remember reading Irvin Yalom's "Every Day Gets a Little Closer: A Twice Told Therapy. In the book he recounts how he and a client wrote about each therapy session and then exchanged notes. In particular he was astounded by how different he and the patient saw the session. Things he felt were really important, the patient either ignored, or glanced over. Much of what the patient found helpful was the relationship between herself and her pdoc.

In my sessions I am often so emotional I cannot think straight. Writing reinforces things Dr. X and I discussed. There can sometimes be problems for me though, when I misread something in my session, or if my symptoms are bad and I am feeling 'paranoid'.

I place the word paranoid in quotations, because I am never sure if I am paranoid, or if what I sense, see, hear really happens. I really feel I have a gift/curse for picking up on small vocal cues and sounds, details, messages and body language that others miss, or do not recognize they are showing. My theory is that because my father was so unpredictable in his rage I learned to sense infinitesimally small cues and changes in his behaviour to prepare myself for the flight/fight/freeze response before things happened.

Something that might support this theory is when, in first year university, I volunteered for a study that was measuring the relationship between hearing and depression. I was extremely depressed at the time. They put me through a flurry of hearing tests and seemed to be astounded at what I could hear. They told me I could hear sounds in ranges that people were not supposed to be able to hear.

Anyways...back to Dr. X's privacy. I again want to assure my readers that I respect your privacy. Dr. X seemed surprised I knew he had visited. The only way I knew it was Dr. X. (or was pretty sure) it was him, (a particular person) was because of his particular server. It had shown up before when he looked at some of my paintings in a session.

You will notice I have two statistics sites,"Sitemeter" and "Statcounter". on my blog. One gives me information about numbers of visitors, where they come from (cities and countries, and how long they visit my site(these are not accurate and usually show as 0) . Sitemeter also tells me how people got to my blog, (e.g. what they googled to get here).

Statcounter provides a bit more information about which pages people viewed and things like that. In Sitemeter it supposedly shows the latitude and longitude of visitors, but please know that it is not accurate in terms of where people live. I was very concerned when I first signed up for it as it appeared anyone with Sitemeter could track the address of my IP.

Rest assured, I checked it out and that is not the case. For instance anyone who posts from Vancouver shows as living at one particular address, on the same street. I have tested this out with a couple friends, and even people I do not know who show up have the same Lat/Long...so it is NOT GPS co-ordinates. In fact, my Lat/Long shows I live in the middle of the Fraser River miles from my house.

I have these stats counters on my site because I am an info junky. I find it interesting to see people from all over the world vi sting, to see how many people visit, because I want to know if I am keeping people's interest, or posting about things that people are interested in. My blog is about my therapy, but I also want to make it relevant to others.

If you have any questions about your privacy and these two statistics programs, please ask me, or add them to your own site and see for yourself what they provide. I believe if you click on their icon (at the bottom right of my blog) you can read more info about them.

Confession

The Confession (Dicksee 1896)

I am not Catholic, but was brought up Anglican; which is close enough. The two churches' teachings are pretty similar except where it comes to divorce and birth control (and of course we have no Pope, the Queen is head of our church).

While I no longer practice my childhood religion I somehow feel deeply tied to the church and its rituals. It is very strange, because I do not even believe in God, but there is a peacefulness about walking into a church that is only rivalled when I step into Dr. X's office.

The other area the Anglican Church differs from the Catholic is the practice of confession. I have often wondered how freeing a regular, completely anonymous confession, the penance given afterwards, and the simple act of being told you are forgiven must be deeply satisfying and soul refreshing.

I suppose therapy is supposed to be like that, but there are always secrets and fears of what will happen if you open yourself up completely and 100% honestly to your therapist or psychiatrist. Fears about how the other will react, how their reaction will affect your relationship, how, even if there is no outward reaction, a seed of discontent, distrust, or even anger will be planted. The fear that some of those seeds will grow into plants, and the plants will give rise to more plants that negatively impact the therapeutic relationship.

I try extremely hard to allow myself to open up fully to Dr. X. in therapy. The day I met him I sensed immediately he was a person I could talk to. Which was strange as I had so many "man" issues I never really felt safe around men. I think I was extremely open with him during my first interview. Some people entice me to be open, but I am also a fairly open and participative person. A little too much so sometimes. By the time I met Dr. X. I had been in and out of therapy so many times that I understood I needed to let go of my fear of being judged and get everything out of my head in order to receive the help I needed.

There are things though, that I cannot seem to get out, cannot seem to say, to Dr. X, or on my blog, or to anyone. Probably important things, but shame, guilt and fear holds me back. I feel ashamed about things I do, or feel, and the words to explain these will simply not come out, no matter how hard I try to get them out. I think over and over that I should talk about these things, but it is as though I am physically mute, unable to speak about certain things I do or feel.

Often this fear of embarrassment, or abandonment, or punishment holds me back for months, or sometimes years, before I can finally tell him what I want to tell him. Every time I have done that he has reacted in an accepting and positive way. So why do I still find it hard to talk about some things?

I remember reading about this psychotherapeutic phenomenon in Irvin Yalom's, "Existential Psychotherapy". (A book that feels like it was written for me). He gave an example of a patient being terrified to talk about something, Eventually the patient managed to write it down on a piece of paper. When The Dr. read the note it said something like "I pick my nose". Hardly earth shattering, or shameful, yet to the patient, based both on his inability to say what he did, and the lengths to which he avoided saying what he did, it was both of these and more.

I believe my "secrets" are held private for a variety of reasons. One problem is some things I do or feel or sense seem so bizarre that I do not even understand why I do, feel or sense them. It is like someone completely different from the real me is rallying my thoughts and obsessively dragging me into doing things. I worry they will only be proof that I am a bad or extremely weird person. They are not even really earth shattering things, nothing illegal, but I am so afraid if I talk I will be rejected, or seen in a completely different light, no longer cared for, or thought to be crazier than I already am. I know I am being a bit cryptic, but I am trying to prepare myself to get things out of me and this is one small step towards really opening up completely.

Therapy is not like confession. It is not anonymous. The confessor knows their "confessee". The relationship is intensely important to the confessor. There is always a sense of potential instability or loss; a "contrived"genuineness (e.g. What therapist is going to say..."That is the absolute, most bizarre thing I have ever heard?...even if it was?); and an unsureness of the strength of the relationship, in part because while the therapist may love their job and like their patients, therapy is, after all, a financial transaction on the part of the therapist. The therapists are never (I don't think), or can never be as invested in therapy as the patient. The therapist has many patients, but the patient only one therapist.

For the patient there is more at risk in therapy than in confession. We, the patient and the therapist, are mere humans. Thetherapist can say everything is okay; that my thoughts and actions are normal, or symptomatic of my illness, but they may not really believe that to be the case. God, if he exists, is capable of forgiving anything. Pdocs and therapists are mere mortals. People whose feelings get hurt, who reflexively react to some information, who have fears and and joys and belief systems that may or may not conflict with their patients ideas. For me it is sometimes hardest to explain things to people who are most important to me.

Anxiety and Obsessions

The past few weeks I would say overall my mood has been better, although it's lability is still showing. I always am feeling bad in the morning and then better midday, and then I get exhausted around 4-5pm, have a long nap...or just laying down from exhaustion (1-3 hours) and feel a bit revived.

The problem is my anxiety is getting worse, and worse, and worse. I am not sleeping as well and I have a weird sensation inside me that I can only describe as an obsession. I have increased my valium, but it is not helping.

Do you remember when you were young (a teenager) and you fell inexplicably and madly in love with someone and you could not stop thinking about that person. Do you remember the feelings that seemed like a mixture of intense energy inside you that was off the charts, anxiety, a sense that you were helpless in terms of your obsession, feelings that were out of your control, strange and made no sense. Am I making any sense?

I am having problems with those types of feelings right now. Not really directed at a person, rather directed at a fear I have hurt someone, or exposed someone, or been selfish and caused someone else to worry, or feel bad. I feel sick that I might have said things I did not mean to say, or opened up and this person may have misunderstood what I actually meant to say (vs. their understanding what I said)

I feel that same sick feeling I did when I was young and cheated on someone, or did some foolish thing without thinking of the consequences of my actions. The feelings of regret I felt after the fallout of an intense upswing in mood, and my inability to set boundaries for myself had me doing things that destroyed a relationship.

This post may not make any sense, but I needed to get out all these guilty feelings...because they are eating me up inside. I suspect some of my increase in anxiety this week is driven by these obsessive feelings of guilt and betrayal; feeling that I have been disloyal. Not all of the anxiety is related to this though, as those feelings have been clearly increasing over the past 4-5 weeks. I sort of see it is possible the anxiety is feeding the obsessive worrying and guilty feelings; making me worry excessively about things.

Rethinking Wednesday's Session

I am not sure what was up with me Wednesday. I entered my session feeling despondent and down about not being able to hang onto the feelings I had a few days prior about being ABLE to change my life, being EXHORTED by my dream to change my life, feeling SURE the switch had finally flipped and I was magically better.

I recognize today, there is no "switch"...it is more like a light dimmer that I need to turn up very slowly to bring more light into my life. The switch is what I don't want or need. It represents the endless cycling mood states I need to get out of.

I was rereading some of my posts, and I recognize that I do have a lot of cycling to my moods. I also understand what Dr. X. meant on Wednesday when he said he worries my higher moods, in conjunction with less sleep, might be unsustainable. I see it, but I wish they were sustainable. Problem is the higher I go, the more likely I am to crash afterwards.

I also see that when my mood is high, it is generally not a bad thing...I don't go off and buy houses, or gamble my life savings away, or cheat on my husband, or do anything that is potentially harmful to me or anyone else.

In fact, that state is a state of freedom for me; freedom from social anxiety, depression, anger, freedom from all the symptoms that haunt me when I am depressed. I also do not lose my insight into my mood state. I can tell when my mood is high. My high mood is really high, but not pathological in any way.

I don't know what it is, but I am often afraid people are lying to me, or hiding things from, or keeping things from me, or spying on me, or have some secret agenda that they don't want me to know about. I think my concerns about my "real" diagnosis being withheld from me fall into that category.

Dr. X. has told me there is a "bipolarity" to my depression. We have also talked about the tendencies in my family, especially on my paternal side, towards hyperthymic temperaments; how my well might be higher than many people's well. It really does describe me perfectly.

I think I was being weird when I got all concerned about having bipolar disorder and not being told about it. Part of my worry stems from the fact that my cousin has Bipolar Disorder, and though undiagnosed, my Uncle had all the symptoms of it as well.

So I worry I am headed that way. The only way I can see it sometimes becomes a problem is for others in my way when I am really hyper. I know I sometimes overwhelm others. Also, I do worry that my high mood will become so high I won't be able to control myself. I think that worry stems from some of the wild, and stupid things I did when I was younger when I was high.

When high I absolutely could not say no to anything...which frightens me now. What if I go high and cheat on my husband, or cannot control my sexuality, or take off with some stranger. I did do those things when high before. I worry I am capable of that again.

Why does it really matter to me one way or the other. If my treatments are helping me, if the mood stabilizers have slowed the cycling (or at least made it less drastic), if I have a really great therapeutic alliance with Dr. X. who really cares what my diagnosis is. Plus, why would Dr. X. not tell me the truth? In my experience he has always been forthright, open and honest about everything during my treatment.

I think part of the difficulty is that I see things in black and white. Grey areas are difficult for me to understand, to conceptualize. I am the product of a very black and white upbringing. My home was very top down authoritarian. My Dad being a policemen lived by very strict rules/laws. I like to think I am open minded and able to understand life is not so simplistic, but some of my belief systems are so hard wired in me it is difficult to change, grow, and understand concepts that sit outside of strictly laid out guidelines and rules.

It is really funny though:

...what I love most about my therapy with Dr. X, and Dr. X. himself, is his refusal to see things from a dogmatic perspective. I love that he challenges the status quo. He feels like the perfect role model for me; the person who is best able to challenge my strict adherence to rules, the person most capable of helping me learn to both see, and accept that life, like a beautiful drawing, is full of many, many shades of grey.

Getting Back on Track

The post I wrote yesterday turned into a completely different post than I originally set out to write. That happens to me sometimes. I start writing and find I have 2 or three themes going on in one post. Often I split them into separate posts.

What I set out to write about was about my life's new "Constitution" as laid out in my post last week: "Today is My New Birthday". I woke that morning and it became so clear my dream "The Wolf Returns" was passing me important, life enhancing and life changing messages.

It has happened before: my dreams sending me messages. In 2003 I had a dream: "Transformational Dreams" that compelled me to finally leave work after trying to allow myself to take that step for more than a year. Three weeks after my "Transformational Dream" I left work. Most of my leaving was because Dr. X and I had worked hard on my believing I needed to leave to help myself, but the dream passed a message to me that felt urgent, life changing and intensely important.

The dream, "The Wolf Returns" felt full of that same intensity. I feel compelled to heed its messages. So a couple days later it became clear to me the dream was exhorting me to reset my values, my life's "Constitution" and to take care of myself in a way I have never been able to.

So I boldly laid out my plans for the new me in my blog.

The next day I crashed. I felt intensely embarrassed that I had been so brazen as to commit, not only to myself, but to anyone reading my blog, that I was a suddenly changed human being. So the next day, and the day after that I pretended I still felt as brave. Inside I was so depressed and had slipped right back into the old me.

I spoke with Dr. X about this. He told me if a country has no written Constitution, no written values and goals, it is easy for the people to slip outside the informal values of the country. A written constitution sets out formal goals, a formal structure for the way the country wants to be, the goals towards which the country and its citizens want to work towards.

A written constitution does not mean the country will immediately achieve the desired way of being, or that it will always stick within it's written goals. It takes time, mistakes and practice to follow a formal constitution.

My set out goals and values are like that. Change takes time and practice. Moving in the direction you want is not always simple, and you will slip and fall back into old ways of being. Things will happen that get in your way, that cause you to return to old way. It is important to have your goals clearly set out in front of you, so you can get back on track.

I felt so much better after he said that. I left my appointment feeling like, "okay I slipped, but I can work to get back to where I was when I wrote my values statement". I feel really blessed I have the pdoc I do. Every week I feel I can get to my appointment. If I can get to my appointment I have someone to help me get back on track. That is a great feeling.

Does Diagnosis matter?

This post is partially inspired by Sara at "My Sad Alter Ego". Her post "How I cured my Personality Disorder Without Even Trying" started out tongue in cheek (although I sense she also feels she is misdiagnosed)...She Starts, "Quit going to a psychiatrist! And voila: Borderline-be-gone!(Yuk yuk)"

(please Sara correct me if I'm wrong about your feeling you have been misdiagnosed). I have known a few people who have been misdiagnosed as having Borderline Personality Disorder, only to be told years later...whoops, you actually have Bipolar Disorder.

I guess my BIG question for this post is, "Does a diagnosis really matter? Or is it sufficient to treat the symptoms people are experiencing, regardless of what it is called?

My appointment with Dr. X. was difficult to begin with, but by the end I wanted to stay and talk longer. I hate the 50 minute hour. I would give anything to go for a walk for a few hours with my pdoc. To really have an extended appointment in a different setting.

I hadn't written about this this week, because I made such a bold statement about my life suddenly taking a new direction, that I was reborn and had become a new person. I felt embarrassed when two days later I found myself in another state of depressive hell. My entire new personal "constitution" disappearing before my eyes.

I told Dr. X. about my revelation. I explained that I believed my dream was LITERALLY sending me a message, telling me to let my old me die and to become a new me. He looked a bit concerned, until I said I understood it was ME passing me the message, that it was my subconscious. It wasn't like I was getting third party messages. I do however, believe I get sent important messages especially from from my dreams, but also from nature; when I see coyotes in the field, or a bald eagle flies directly above me, or a plant passes me a message from my Mom. I feel some sort of mystical connection to the natural universe.

Anyways...Mysticism aside...Dr. X asked me if I was the wolf in my dream if perhaps the dream was telling me I have much more power and that I am much more calm and sure of myself than I give myself credit for. I definitely see that aspect of myself when I am well, and I especially see that when my mood goes extremely high.

This led to my asking him about both my medications and my diagnosis...the diagnostic labels are something he really does not like to place on patients. He seems to believe in treating symptoms, avoiding labels ("labels are for insurance companies", he once told me), and ensuring that a patient's subjectively positive experiences are never pathologized. I like his approach, but I sometimes also feel extremely confused by his avoidance of a diagnosis.

So yesterday I asked him straight out. "Do I have bipolar disorder? I know you have told me you have never seen me manic, but have you seen me hypomanic?"

(Inside my head I am thinking: "If I do have Bipolar Disorder just tell me and then I understand the importance of being on all this medication, also, I am thinking...you provide me with medication and lifestyle advice all of which is in keeping with what I understand helps people with bipolar disorder. You also talk about managing my cycling mood. Sometimes I just need to KNOW the truth about what is happening inside me. I feel sometimes I am being kept from the truth. I need to know what I am up against. Does this type of cycling lead to a higher potential of mania if I don't take medication? Are you worried about my switching into mania? If not...why the hell am I putting my body through all these medication trials? Why don't I just let my high moods happen?)

Instead of all those questions, feelings and statements all I ask is "Do I have Bipolar Disorder?"

He hummed and hawed, looked at me and said, "I don't want to patholigize your good moods. I have seen your mood so high that I believe it, in conjunction with the lessened sleep that accompanies those mood states, makes me believe the extremely high mood is unsustainable. Some could argue that you become hypomanic".

Me: "Are you afraid to tell me I have Bipolar Disorder? If I don't have bipolar disorder why am I on all these medications? Especially, why am I on a mood stabilizer? Maybe I don't need that medication."

Dr. X.: (paraphrase) No I am not afraid to say you have bipolar disorder. I don't want you to see your good moods as a bad thing.

Me: Well, how do we know if I should be on all this medication?

Dr. X.: Unfortunately there is no "test" to say you should be, or not. We need to determine that based on how you are feeling...I see with the Prozac you have had many more better times, or days than you have on any other medication.

Me: Well, maybe I should try going off the other medications, because maybe it is the Prozac that is making all the difference. I'd especially like to get off the Valium.

Dr. X.: I agree going of the Valium at some point might be a good idea, but I would rather it be when you are sleeping better than you are now, and when you are less anxious.

Me: I understand, but what if I switch my Valium for that new medication you were telling me about (Pregabilin)...I note that at this point our session is up.

Dr. X: This is a really important conversation. Let's talk about this next week.

Oyy. I really think I do have bipolar disorder. My highs are way too high...I know that. They feel like I have become some kind of god. Like I am better than well, am perfect, am adorable and fascinating, charismatic and completely free. It is as if I have somehow melded perfectly with the cosmos. The world changes and I see far more intensely and deeper than I ever see when I am depressed, or even when I feel well. Problem is...It feels soooo amazing to feel that way, and it is an intense departure and relief from my depression. I wonder if a mood stabilizer is holding me down. I have not felt any highs since I began mood stabilizers. I miss the relief. What if I could be that way all the time. Life would be amazing.

My Zebra Paintings

I finished the "zebra" paintings for my niece. Each is 12" X 12" on a deep canvas (1.5" thick, which gives the paintings more dimentionality as I have painting all the sides to make it look 3D).

You may/may not remember, but the theme is Zebra stripes and purple. My sister did not want pictures of zebras, rather parts/sections of zebras or paintings that used the stripes...and purple had to be somehow integrated int each picture.

I will post:

1) Top Left...the original photo that inspired the painting

2) Top right the way I cropped the photo and chose a portion of it to paint

3) Beneath these in the centre...My Acrylic painting rendition of the cropped photo...with a bit of purple added for niece loving measure.

A) "Zebra Mountains" (I changed it a bit from the first one I posted)

B) "Zebra Lily": (I did one version that had a yellow centre, hated it a repanted it to have a water centre, which still reminded me of flower stamins)

C) "Zebra Face" (This is my favourite...the eye is shaded with different tones of purple)


I feel pretty pleased with myself and what I was able to do...especially the face. I could have done more shading on the face, but I liked the purity of the white and black. In fact the white is a mixture of yellow and white, which looked really yellow until it was placed next to the black. I love how that works.

Honesty in Therapy

Recently quite a few people have found my blog by googling "Honesty in therapy", or "How can I be honest with my therapist?", or variations of that theme. Today I will share some of my experiences with Dr. X and hopefully they will show you that being honest in therapy takes a huge amount of courage on the part of the patient, but also that the therapist or psychiatrist has to show they are worthy of that honesty in order to facilitate your being truly open with them.

I cannot think of a single instance where Dr. X. was judgemental about things I told him. I can think of many instances where I felt he ", "should be" or "would be" judging me. I can also think of many times where I can see now that I was "paranoid" he would judge me. In retrospect though, his refusal to label or judge my behaviour has allowed me to be honest in therapy.

Sometimes it has taken me a great deal of time to get to the point where I am able to share information. I weigh the odds of the information hurting me, or affecting Dr. X's relationship with me, or my relationship with him. I often spend weeks, sometimes much longer, worrying about opening up about something. Everytime I finally have opened up and been honest it has taken a huge weight off my shoulders.

Those who read my blog on a regular basis might notice that I use my blog to prepare myself to open up, to tell the truth, to Dr. X. A few times I have been intensely suicidal, lethal medications in my hand, and instead of choosing to take the medications I have written about how hard it is to express that kind of suicidality to Dr. X. Often it is because I am afraid of how he will react, or that he will take away my freedom. He never has, and the talking about it always de-escalates my suicidal feelings and reassures me I can trust him. (Note: I now trust that if Dr. X. did place me in the hospital against my will, he would be doing it for my own well being. I recognize that there may be times where I, or others, are not able to make those decisions for ourselves)

Sometimes if I absolutely cannot get the words out, if I simply cannot open up or tell Dr. X. the truth, I will print off what I wrote in my blog, or I type out the feelings and print them out. In my appointment I then hand the written version to him to read. As he reads the note I sometimes feel so ashamed of who I am and how I act, but I also recognize that he cannot help me if I do not let him know exactly what is going on.

At these times he usually reads the note and then is very silent, waiting for me to speak. Always these moments have been catalysts for more open conversation, and every single time they have promoted and reinforced a deeper sense of trust between myself and Dr. X.

I remember one time I waited 2 or 3 years to tell him about something I had done years prior. In retrospect, especially after telling him, I held so much guilt and fear inside me for such an unextrordinary piece of behaviour.

When I was in second year university I had a fairly short, but extremely severe Major Depressive Episodes(MDE). I would sit in my classes and all I could do is cry. I could not get the energy to shower for days at a time. Everyday I would go sit by the beach trying to get myself to kill myself by getting in the water and just swimming out to sea until I could swim no more.

In a couple of my classes nothing made any sense to me. It was as though I was sitting there, but the professors were talking some other language. I was having a particularily difficult time understanding lessons in one of my philosophy classes.

So, in desperation, believing there was a magical solution to my problem, I decided to look up the professor. I found out he lived near me. Believing it to be the magical answer to my not understanding his class, once or twice a day I would walk past his house. I believed that each time I walked past his house, all his knowledge would somehow magically transfer to me.

When I became well again, when my MDE ended, I felt so much shame about what I saw as a kind of "stalking" behaviour. I could not believe I would have done something so bizarre. I was afraid I was dangerous, and that if I told Dr. X. what I had done he would think I was too weird to be trusted. I was afraid he would be afraid of me. So I never told him or anyone I had done that.

A couple years into therapy I began to feel safer with Dr. X. and I forced that story out of my mouth and into one of our sessions. After listening carefully Dr. X. said (paraphrase), "What a beautiful story you have told me. It is wonderful that you were able to have such a magical belief in the way the world worked; beautiful that you were able to suspend reality and have such faith in a mystical type of transference of knowledge".

I was overwhelmed with relief and finally was able to talk to him about my fears that I had been stalking the professor, or that I might be capable of stalking another human being. I never wanted to SEE the professor, it was the act of passing his house that was so important. We talked about how I have OCD symptoms and and vivid imagination. He told me I was not stalking the professor, rather I was suspending reality and looking for a unique way to help myself in the class.

I recognize now that I may have been having some kind of psychotic delusion during that depression, but Dr. X never used those words. He gently helped me see the magical nature of my thoughts without judging me, or making my experience a bad one. It was simply a different experience than most people might have. He assured me he knew I was not dangerous, or a stalker, that I was a human being trying to understand her world.

Being honest with him then, and his positive reaction to what I saw as a frightening and terrible flaw in myself, set the stage for my feeling more and more free to express myself and be honest in therapy. Honesty in therapy takes guts and determination on the part of the patient. It also takes consistent compassion and kindness on the part of the therapist or psychiatrist with whom patients entrust their information. The therapeutic alliance that is created between an open, willing and brave patient and a welcoming, compassionate and consistent therapist is what facilitates honesty to take place in both directions. I feel blessed I have such a therapist.

The Photographer in Me

July 2006, In memory of my Mom the summer following her death I planted dark flowers all over my deck; almost purple/black salvia, and deep purple heliotropes and I found this deep, dark colour of nasturtiums and planted them everywhere. My Mom absolutely loved nasturtiums and I absolutely loved my Mom. I love this photo. It feels so solitary, yet peaceful.

I have a thing for fungi. I love all the different kinds of mushrooms, toadstools, and fungus I find everywhere. You have to click on this image to make it huge to appreciate the beauty and perfection of these tiny fungi.

I took this in December last year (2007). I was walking my dog Bert in the blueberry field, as I turned the corner the sky in front of me turned black, but the sun shone intensely behind me. I ran all the way back to the house (few acres) to get my camera, because the light behind me was bouncing off the the white bark of the birch trees and they were almost glowing in front of the black sky. The dark and light intensified the red in the wintering blueberry bushes, and the green of the moss. It was not quite as dramatic by the time I made it back with my camera to take the picture, but I still love the contrast and intensity of the red and green.

This is a similar shot, and only a week or so later. I liked the contrast of the dark sky against the snow and again the intensity of the fiery red blueberry bushes.

In my photography I try to relay my spiritual connection to the natural world. Nature always astounds me with her variety, her perfection and the ingenuity with which she encourages and brings things to life, but also in the beautiful ways she assists in the process of death and decay; which itself becomes imperative for her process of renewal. She is pure poetry.

Today is My New Birthday

(Photo: by Aqua, "Transformation", August 2008)

In respect of, and to reinforce the powerful message, Wednesday's dream , "The Wolf Returns", sent me: Today I am changing my life. I am throwing away the old me and moving in a different direction. From this day forward I am reborn.

I will never feel any remorse or guilt over anything I did in the past. I accept that I did what I was able to do at the time. I will never again feel guilt for being depressed, or on disability for depression. I will accept that I did not cause this illness. It happened and all I can be expected to do is try to make myself feel better. I will also accept that sometimes my illness makes it difficult to do anything to help myself. During those times I will do whatever I CAN do to keep trying.

As of today here is the new me:

• I am a painter.
• I am an artist.
• I am a writer.
• I am an art teacher.
• I am a photographer.
• I am creative.
• I am disabled by my depression right now, but I am NOT my disability.
• I will accept my disability income as a blessing and a gift that allows me the opportunity to grow into the human being I am meant to become.
• I will be here today, and present now.
• I will not worry about tomorrow.
• I will soak up today.
• I will see all the beauty in the world, like a new child, through my new eyes.
• My life will be full of beauty, and I will recognize that.
• My new life will be full of love and I will pass that on.
• My new life will be full of compassion, for myself and for others.
• I will accept my mental illness as the catalyst, the mother and the origin of, my new and improved life.
• I will embrace my depression like a mother embraces a crying child. I will hold it, and care for it, and accept that the crying may pass, or it may not, but the crying child is always a beautiful being trying to express his or her needs to the world.

The Wolf Returns

(Photo by Aqua, Grey Wolf at Grouse Mountain)


I could not both get to sleep and stay asleep on Wednesday night. My anxiety is increasing and with that my sleep is getting worse again. I slept in snippets of a half hour here, and an hour there. After a pattern of waking and sleeping I woke at 4:30am and finally must have fallen asleep sometime between 6 and 7:00am, because I had an awful nightmare right before waking to go see my pdoc.

I dreamt my two sisters and I climbed towards the top of a mountain. The final climb was a set of stairs that zig-zagged up to the top of the mountain. Atop the mountain was a huge modern building, not unlike the building I used to work in.

We went inside and instantaneously I began being attacked by 3 coyotes who were trying to bring me to the ground so their big, pure black wolf companion could finish me off. I was trying to protect my sisters, but none of the canines seemed interested in them. The coyotes kept grabbing my hands and arms, and trying to attack my head; kept trying to force me to the ground. All the while the black wolf was stalking me, waiting for me to slip to the ground so he could pounce on me. I kept fighting back, calling to my sisters to help. It appeared no one would help me.

Suddenly I looked up and my sisters were behind a counter with the coyotes on the other side. My siblings were negotiating our release with the coyotes and offering them food in return for our safe escape. The coyotes agreed and told my sisters to leave through one door and me to leave through another a bit farther down the hall.

I saw my sister's safely on the outside of the building, but as I went to go out my door I saw the black wolf standing on the other side of the glass door; waiting to kill me. The coyotes told me to open the door and let the wolf in, quickly slip out and slam the door shut.

I did what they said, and the wolf slipped in, and I out. However, as I shut the door I quickly realized that the door opened outwards and it would be easy for the wolf to simply push the door open and come after me. I saw my sisters had disappeared and knew they were safe.

I began to run in terror. The wolf pushed the door open and began chasing me down the stairs. I was running so fast my feet were not touching the stairs. I was hanging onto the handrail and leaping from stair landing to stair landing. Each landing was 6 stairs apart. I was becoming dizzy from the switchback like staircase. I misjudged one of the landings and flew over the railing and into the abyss of the mountain gorge below.

The wolf followed me, but I was dead before he got to me.

I woke absolutely terrified.

Interpretation ideas?

The Coyotes: They are trickster figures. Figures who, in North American First Nations mythology, facilitate our seeing the lighter side of life, who sometimes have noble purposes, but also sometimes are playing with us and can be cruel. They represent the uncertainty of life, the uncertainty of the direction life can take us. They can bring light to dark situations (in fact the Raven...a trickster figure in Westcoast First Nation's mythology tricked a princess into opening a box that contained the sun, thereby releasing light into the world. ("The Raven Stealing the Sun" myth).

I run into coyotes on our farm all the time. They are a symbol of hope for me. They seem to appear when I am desperately depressed and need a reminder that I can survive this illness. It seems strange that they seemed to be doing the opposite in my dream..trying to facilitate my death. Although maybe my death is the only hope I have?

Or maybe they are referencing my being saved by a symbolic death? The death of my old life; the life I keep clinging to, the life that drags into feeling guilty for the new life I am trying to make for myself? My change from doing what I think is right, into having a life filled with doing what I WANT to do.

I know in the dream I wanted to survive. I fought and fought when the coyotes were trying to bring me down (but maybe I was fighting there lesson to allow my symbolic death, my important change, to happen. I ran hard from the wolf to try to save myself. It just did not work. I died anyways...and not even from the wolf, from a mistake I made. (my misjudgement of where the stair's landing was.

The Wolf: He has never appeared to me as pure black before. Throughout the dream I knew and felt it was symbolically important that he was pure black. He was impending doom, stealth and pure fear. He was patient in his efforts to bring me down. He waited, not once interrupting the coyotes efforts to drag me to the ground. He was over confident that he would succeed in killing me one way or another.

Dr. X and I discussed my dream. He said I needed to challenge the wolf. I get that, but what is it I am supposed to challenge? What does the wolf represent? If it is death, that is an inevitability...it would be futile. It could be my depression...but I don't know how to challenge it any more than I do. This dream is haunting me. It is telling me something. It feels so important. I cannot stop thinking about it.

Maybe the challenge is to STOP challenging the inevitability of real death (and the impending fear attached to that that comes from feeling like I will not achieve what I need to achieve, (.i.e. death anxiety) which is the cause of much of my life's anxiety and I think my depression. I fear I will not complete my purpose on earth.

Maybe the challenge is to ACCEPT my symbolic death, the death of my previous life, the fact that I am changed by my depression, by the difficult experiences I have encountered with each Major Depressive Episode...especially this latest one. I am changed. My old life is dead. Let it go. Move on bravely to my new life.

The wolf is black, because unlike all the other frightening wolves in my dreams who chase me and try to kill me and never quite succeed; this wolf succeeded, and the death of my old life is FINAL.

What Happened?

I don't know what happened in my session today. I have been feeling pretty anxious and my mood has been up and down, but for the most part this week apathetic and anxious...Is that possible. Seems to me the definition of apathy would include not caring one way or the other, so why the anxiety?

It is happening again; that same pattern that repeats itself ad infinitum:

• I begin to feel a bit better,
• I start doing things I like (art, volunteering to teach, visiting with friends)
• I take a look at myself enjoying things
• I think, if I can enjoy these things, do these things. I should go back to work! (even though it may only be a few days, or even parts of days of enjoyment)
• Then I start thinking, but if I go back to work I will only be able to work, and at a very part time level,
• And if I do that I won't have any energy to do anything else (given I seem to be able to manage one big thing or maybe two smaller things a day)
• So I will go back to work and stop painting, creating...doing all the things I need to do to help myself feel good.
• Then I will get more depressed
• Then I will have to stop work.

I know I talked about this a few days ago, but it is like a loud tape recorder in my head saying, : "I am doing something wrong, when I enjoy myself at the expense of working". "I am making myself vulnerable to ending up homeless and on the streets when I count on a third party for disability payments". "I am a bad person because I am not working" yadda, yadda, yadda.

So I spent most of my appointment crying. Stressed out about my vulnerable situation, stressed out about my (for some reason) returning angry feelings about my Dad and the way he treats me, and missing my Mom so much I told Dr. X her death feels like a bad dream.

Dr. X. tried to help me see I am on the path I need to be on. I expressed my frustration that I began seeing him in 2001 and here I am in 2008 with many of the same problems.

(Paraphrasing):

Dr. X: "You are making progress.

Me: "Who would say that? I don't think anyone would say that"

Dr. X: "I would, think of where you were in terms of art in 2001 (i.e. none) and where you are now with your art."

Me: Rolling my eyes at the comment.

Dr. X: Why did you roll your eyes?

Me: (Feeling ashamed I was so rude to have done that) I rolled them because I am not an artist. It is not like my art is going to help me get a job, or make money. It is not going to get me anywhere.

Dr. X: said something about it making me feel good doing it(my art) and myself doing myself a disservice by saying I am not an artist. It is not about the money, it is the doing it that is important.

Me: Crying and trying to explain how scared I am about not having a job, and not knowing if I was ever going to manage a job and stay well. (Thinking now: I kind of forgot about the part that I'm not well yet...I guess that is s/b the goal).

Dr. X: You have a stable, safe income right now. Try not to let that worry get in your way.

Me: Just sitting there silently, crying...(Inside my head thinking: " I feel like such a loser and that I will never get well and get a job. I feel like I failed at life. This is not what I wanted my life to be. I wanted to succeed, to prove to myself and my Dad that I am a good person, I am a hard worker. I do want to be something. I'm 43, and I still need to prove my worth to my Dad and anyone I feel thinks the same way as him...the definition of a person who needs to let it go and move on).

Rating my Mood

I haven't tracked these components of my mood for a while, but another blogger, Kara, at Overflow, mentioned wanting to track her moods. I used to do this every evening at the same time. I made up a mood chart that worked for me. It was a great sheet to bring into my pdoc and show him, or tell him in certain terms what my mood/s had been doing. It was through this that I really noticed a cycling pattern.

It is a table I made up in MSWord, but I cannot find the original...so I took apicture of a blank copy. If you want to make up your own it is pretty easy in word.

I simply place the corresponding # in the column/row. It is really easy to see any cycling patterns, or to see if medications or sleep are associated with mood. I find the chart worked well for me. Over the years I perfected my scoring system as follows:

(Click on the image of the mood chart to enlarge it)

Row 1: Mood (Happy/Sad): 1/2 suicidal, suicidal thoughts/plans, 3/4 severely/moderately depressed, 5 flat/apathetic, 6 feel okay to good, 7 Target = 7...Feeling good with moments of feeling great, 8 feeling really high, 9 hypomanic, 10 manic

Row 2: Mood (Irritability): 1 rage, 2 hostile, 3 agitated, 4 irritated, 5 moderate, 10 none


Row 3: Mood (Anxiety): 1 panic,2 severe anxiety attacks, 3 severe anxiety, but no physical symptoms, 4, severe-moderate anxiety, 5 moderate anxiety, 10 none

Row 4: Sleep: # of hours and whether I was awake asleep, awake asleep etc.

Row 5: Fatigue: 1 extreme, 5 moderate, 7 not fatigued, 10 extremely hyperactive

Row 6: any exercise

Row 7 Medication and Other: used this to list meds, med doses and med changes I use a system of upwards arrows (increase dose), sideways arrows (dose remains same), or downwards arrows (lowering dose) and put what ever milligram/s of whichever med I am changing, leaving the med area blank if no changes are made since the previous day.

You can easily make up your own rating scale. I found this worked well for me. I hope it helps someone.

In My Dreams I Could Paint

Aqua, Collage, 2002 (a bit "weatherworn"...but intact)

In my last post I mentioned I had photographed some of my earlier drawings. I have shown you my paintings before. I only fairly recently began to take an interest in art. In fact, it has only been since this MDE started that I even began truly exploring my artistic side.

I have always loved art and have always been "creative". I loved to make things...jewellery, decorating birdhouses, making designs on stepping stones out of stained glass...crafty kinds of things, but I had never really drawn or painted.

When I was young I had recurring dreams, both at night and during daydreams, in which I could paint. In the dreams I so clearly saw every detail in the objects I observed. I would take out my paintbrush, or pencil, or crayons and I could replicate the objects perfectly. When I woke this was never the case. I could see, but whenever I tried to draw or paint I was awful at it. This feeling was further enforced by my grade 4 art teacher who told me I did not have the skill to create art. I never wanted to try drawing or painting again. Why do something if you are not good at it?

Well in 2002 I became brave and tried something I was not good at. I took an "Introduction to Drawing" class at the local Art College. One of the first lessons was to draw my hand using no line, only tone. I did not even understand the concept, until I went home and drew and drew and drew for a few hours. Suddenly, using tone alone (shading on a scale of 0 (white) to 10 (black) and various gray tones in between) my hand appeared out of nowhere onto the page. I finally "got it". I created a picture of my hand without drawing a single line...I amazed myself. I was hooked.

Throughout that drawing class we were told to do patterning and pencil control exercises every evening. We were to draw two boxes on each piece of a pad of paper that was 4 inches by 2 inches.. The exercises were meant to help us understand how each pencil felt, moved and created light and dark shading (2b pencils being harder and creating lighter shades of gray and black, 4b softer creating darker shades and 6b pencils allowing darker shades yet). It was also an exercise to help us practice drawing patterns over and over, because in nature repetitive patterns are often the case.

So I drew and I drew and I drew. It was hypnotic. I discovered that while I was drawing the patterns, and focusing on the drawing, my relentless and often violent suicidal thoughts would disappear; my anxiety would dissipate and my rage would become less and less. The drawing slowed my mind enough so I could, for the time I was engaged in the activity, just "be".

The last day of the class we were told to bring in all the pattern drawings. We were then told to make a collage from all the patterns. I thought I would share mine today. As I was placing my patterns on the paper I was intentionally moving from darkness to lightness; a reflection of my shifting moods. When it was complete I really was amazed at what such simple, seemingly rote exercises could become and how it made me feel so much better while I was creating each tiny piece, but also the final collage.

Am I Forever Broken?

"How can you go so many years and not know you liked something so much?

My sister said those words to me yesterday when I was expressing how much joy I was getting out of conceptualizing, planning and painting the five paintings I have on the go right now and the others I have completed.

A comment Dr. Shock made on one of my past posts, about wanting to see my other art work, stimulated me to pull together and photograph an array of some of my early drawings from when I was learning to draw. I see so much progress and the switch into painting has increased my desire to create art tenfold.

How could I never have known I wanted to draw or paint? In university it was the pursuit of knowledge and that which was intellectually challenging that brought happiness and excitement into my life. I graduated with two degrees, one in Philosophy and one in English literature. My last 3 years of university were the best years of my adult life. To do well in both of those majors you had to love to read and write. I loved both. I never foresaw that it was the creative process, and not necessarily the intellectual process I may have been pursuing.

I am struggling now with how my love for art can fit into the life I want for myself. You may, or may not know I am on disability for my Major Depressve Disorder (MDD), and have been since early 2003. I really hate that I am on disability. It may be my Dad's voice that I have internalized, but I feel it is a societal voice as well. I feel I am not contributing, that I am using up precious resources, that I am a bad person for being unable to work.

I know that while I am having some good days my mood is extremely labile, and my anxiety is still not under control. For the past month or so I have felt better than I usually feel, but I am far from well. I also understand that the progress I have made is precarious and could topple with the slightest amount of pressure.

My pdoc has explained this to me, and even took the time to write me a note outlining why I am unable to work right now; a note I can read, and reread when I am feeling like I am today, when I feel guilty and unsure that I am doing the right thing. I have reread it today, but it is difficult for me to accept its contents.

What if I can never work? How am I going to deal with my negative self image for not working? Dr. X. keeps telling me I am working. He means all the work I am doing to try to become well, but also the volunteer work I am doing. I get that he is trying to make me see that work has many definitions; that work is not simply working for an organization for a twice monthly pay cheque. I get it, and I get that others need to step back from work to take care of themselves. I just cannot accept that for me. I define myself by what I do; by what I work at. I always have.

I want so badly to work again, but I know I cannot manage that yet. I can barely manage what I am doing right now: volunteering two half days a week. I feel exhausted after doing those things.

Also, I am not certain if anyone else is like this, but I am a "one thing a day" person right now. I can paint, or I can volunteer, or I can visit with someone, but I can't do them on the same day, and if I do those things I cannot manage to cook dinner or clean the house, or keep up with my domestic duties, actually even if I don't do those things I cannot manage the domestic stuff.

Will I ever get my life back? By that I mean will I ever be able to work a full time job, keep the house clean, go grocery shopping, mow the lawn, tend to the garden, help my husband on the farm, have a social life, have dinner parties every few weeks, and do continue working on and developing my art work? Will I ever be my old self?

Will I ever get my life back, or am I forever relegated to the sidelines; surviving and struggling so hard just to manage to complete, or sometimes just start, one thing a day?

Will I ever get my life back, or do I have to accept a new way of being. Has being this depressed for so long, and so often, destroyed my fortitude, my drive and my abilities? Has my depression and anxiety toppled the old me forever? I want to know what it is I am supposed to do. What is expected of me? What should I expect from myself? What does society expect of me? Does Dr. X. know what I can expect from my future? Does anyone else know?

I do know that I have an intense desire to paint and create. That is good, I have no formal training in art, I'm 43 I am certain I could not manage the stress of things like exams and essays.; the exams especially. I have too many problems with my memory and cognitive abilities. I feel so lost and so scared I will be stuck either on disability, or at a low paid, disatisfying job for the rest of my life. If the latter I know what will happen. I will spend all my time and energy trying to be the best low paid employee at "whatever company" , and all the things that bring joy to my life will be left undone and I will once again fall into severe depression and then I will be on disability at an even lower rate than I receive now.

I am stuck in a no win situation.

Disclosure

(**Note: I misunderstood Dr. Shock when I wrote this blog post. He agreed with Dr. X's type of disclosure. Misunderstood or not, his thoughts were the catalyst for my writing about this topic and it felt good to get it all out of my head. Thanks Dr. Shock).

You may have picked up from my blog that I am not only in therapy, but I am also intensely interested in the therapeutic process: The patient/therapist relationship, how that alliance affects therapy and how powerful a catalyst for change and growth a relationship with a trusted therapist can be.

This post is inspired by my curiousity about that process. Recently Dr. Shock has written a series of posts about the Dr./Patient Relationship. They are all very interesting. I find myself both agreeing and disagreeing with one aspect of the Dr/Patient relationship he believes in. He disagrees with a Dr's self-disclosure (in particular when speaking of a psychotherapeutic relationship).

I for the most part agree with him. I think it is important for me as a patient to be able to project my difficult relationship communication problems onto Dr. X. When Dr. X "becomes" my Dad, like in my recent post "Letting Go of the Past", I am able to reflect afterwards and learn from the experience. It is during those moments when I learn the most.

I have had therapists who spent much of my session comparing their problems to mine, telling me everything about themselves. These have never been helpful therapeutic relationships to me. They begin to feel like they turn into therapy for the therapist instead. Dr. X. is not like that. He is very good at limiting self disclosure to almost nothing. While I have an intense desire to know him better, I appreciate that he reveals little to me, he is whoever I need him to be at any given time.

Recently however, he did disclose to me that he has been unwell, and that it appears he has MS. Dr. Shock finds this disclosure uncalled for (**Here is where I misunderstood Dr. Shock' position about Dr. K's disclosure...he actually agreed with Dr. X disclosing his illness ...read his comments and the posts on his site).

Here is where I disagree with Dr. Shock and the following disclosure about my past will explain why. (If you happen to read this Dr. Shock I would be really interested to know how you would manage a situation like this after reading some of why I think this self disclosure was imperative for my well being.)

I have had numerous situations that have intensified my fears of abandonment. The following were probably a few of the things probably the straw that broke this camel's back:

My Dad left my Mom when I was almost 17 years old. I came home from school one day and my Mom as gone. I had no idea why, or where she went. she just disappeared. It was traumatic.

A week later she returned home and suddenly my Dad disappeared. Although I discovered he had moved into his own apartment, again, there was no explanation as to why he left. I was distraught, confused and felt intensely abandoned both times. As the weeks wore on I began to fall into my first depression, but I had no time to help myself, because my Mom was disappearing too, only in a different way.

She began to drink, stopped eating, wouldn't get out of bed all day, began leaving us at night to go drink, lost weight to the point she began to appear anorexic, became so angry she was hard to be around (she is was usually the most calm and compassionate, loving person I have ever encountered). In a word she became severely depressed as a result of my Dad leaving. She desperately needed a job as she had no money of her own.

My Dad had always taken care of us financially. She could not get work, or manage to renew her licensing requirements to become an RN again because she was too sick. When asked my parents if we could see a counsellor, they both responded "it was none of my business. It was between them"

All I knew for years was that my Dad left. I had absolutely no idea why, or why he never came home. He was just gone. I made up all kinds of things in my head..." I was a difficult child, he didn't like me, he couldn't handle my sisters and I, he had just decided one day that he did not want to be with his family, etc." I felt intensely abandoned, sad, lonely, let down, ashamed that I had been such a bad person that I made him leave us. I had destroyed our family.

I felt abandoned by my Dad, but even though my Mom was physically still around, she was gone. She was inconsolable. She was one of those women who married for life. Divorce and remarriage were not options. It was so sad to watch such a beautiful, strong, and loving Mom become nobody without her husband. Without Dad she disappeared into severe depression for at least 10 years and remained moderately to mildly depressed until the year she passed away.

Two years after my Dad left I could not handle the feelings I felt for losing both parents, for not understanding why it had all happened, so I left home to get away from those feelings. I ran.

Four and a half years and three cities later I phoned my Dad and a man answered the phone. Suddenly, it became absolutely clear why my Dad had left my Mom. He was gay. For the first time in years I felt an intense sense of relief and understanding. I finally understood why no one would talk about it. It was the typical shame issue too many people feel about being gay.

Unfortunately, that was not true. My Dad had remarried, and now had a whole new family, a new wife and two sons, without telling any of us. He had left my Mom for a woman he had been dating for a couple years while still living with us. I can't even express the shock, and feelings of betrayal I felt, and to this day feel. My father marries without telling us, allowed us to suffer feelings of abandonment and fear we were the cause of him leaving, when all he could easily have explained what was going on. Maybe not when he first left, but at the very least before he married.

The woman he married was an absolute bitch. I rarely say that abut anyone, but she was the equivalent, and perhaps worse than, the epitome of the evil stepmother. She would draw you in, get you to reveal your souls deepest feelings and then use those to bait my Dad, and to make him angry at us. My little sister used to have to go stay with my Dad very couple weekends. She could hear my Dad's wife yelling at him about how he had to get rid of her. How she did not want my sister there, ever.

She destroyed any hope that my sisters and I could ever have a relationship with my Dad. My Dad has never once mentioned why he left Mom, or even the fact that he did. He never once stood up for us in front of his wife, or any other time tha we know of. Any attempts over the years to talk with him about his leaving and how it affected us ended in our being immediately silenced. This (among other things) left all his children with no ability to have any kind of trusting relationship with him.

What does this have to do with Dr. X's disclosure? Everything. Given I so often, so easily, and so strongly project my father onto him any sudden disappearance on his part, without my understanding why, would cause me to relive those feelings of abandonment, disingenuity, and deceitfulness all over again. Any trust I had in him would be gone, and I am not sure it could ever be regained, especially if I found out he knew, and had known for some time, that he might have to stop work for a while, or "disappear' for a while.

I am working so hard in therapy to learn that I can trust others, that people are genuine, that not everyone will leave me or outright lie to me, or lie to me by leaving out information. It has taken years for me to trust Dr. X. and to begin to feel safe.

On top of my Dad's deceit, and my intense sense of abandonment surrounding the way it all happened, I recently lost my Mom. She had been the only person in my life outside of therapy who really, really supported and understood me and my depression. She became ill with pancreatic cancer and died within 2.5 months of her diagnosis.

I am still having an intensely difficult time dealing with, not just her loss, but the swiftness of her death and the traumatic act of watching her die: watching her try to cling to her children, seeing her try so hard not to abandon us. The intensity of her will to survive, even after she fell into the final throes of death, gasping for air for hours, trying to communicate, when her ability to talk was gone, watching her not wanting to abandon this world and all she loved in it was so traumatic I don't think I will ever recover from the unwilling and unexpected abandonment of someone I loved so much.

Dr. X. needed to tell me he was ill to preserve the integrity and trust in our therapeutic relationship. He needed to show me he valued me enough to be honest and forthright about his potentially needing to cancel, or rearrange appointments. I needed to feel I was important enough for him to be open with me about WHY he was unable to see me; that it wasn't because he didn't want to see me, or because I was a difficult patient, or because he wanted to get rid of me. I needed to know I was not being abandoned and that I would be taken care of in his absence. Dr. X.'s decision to disclose his illness and the potential it had for him possibly needing to take time off work periodically was only decision he could have made given my background and the issues I have been dealing with.

A Perfect Day

Today was a really good day. I met with a friend and we went for a walk on the beach. I felt like I was with someone who gets me in all sorts of ways. Someone who sees the world around her like a child discovering new things all the time. I am like that too when I am feeling well and to some degree when I am depressed. I always have marvelled at how it is that such beauty exists in such a difficult world.

I marvel at nature and its awe inspiring beauty on every level. Natures colours and geometric patterns; her perfection and her ingenuity; her attention to detail and yet alternately her oversights. Nature amazes and enthralls me.

I watched my friend react with that same passion; both of us gasping in awe at the giant gelatinous masses of beached jellyfish on the shore. The translucent bodies magnifying and intensifying the colours of the rocks, sand and debris upon which they were trapped. I watched her try to save a jellyfish. An act of compassion and love for a creature so different from ourselves.

We both walked staring at the beach, searching for treasures to take home, or to take pictures of, to take home. She had better eyes than me and found the most interesting and unique items. She saw all the details I was missing and shared them with me; the spores of some kind of mold forming on a side of seaweed; the molds patterns made it so beautiful in it's own way; miniature seashells perfectly formed and teeny barnacles on a small stick, tiny, but no less magnificent.

Today felt like a perfect day. I was aware of myself; aware that I was very talkative, yet I tried to accept that overflowing bubbly talkativeness as myself and an expression of my joy and my feeling happy with what I was doing and who I was with. She in turn expressed how she is not as talkative, but that is just the way she is. We are who we are. We were who we are. It felt good to just be whoever I am; to revel in the sun, the ocean and the company surrounding me.

My Essential Self

I felt an intense sense of connectedness with Dr. X. today. I love those sessions where I feel not only understood, but also admired and fully cared for maybe even more because of my quirky behaviours.

I was telling Dr. X. how I went out with a friend and I had been really anxious. My mood has switched upwards, but so has my anxiety, irritability and I'm not sleeping very well. Anyways, I was so anxious and as a result I found myself talking, and talking...quickly, from topic to topic. I really wish I was less a talker and more a listener. So I said to Dr. X., very strongly, "I hate that side of myself!"

"Hate"?, he said. "That is a very strong word to use". I told him, "I do. I do hate the way I talk so much sometimes. I kept hearing myself talking and thinking...shut up and listen, slow yourself down, but I couldn't stop talking or slow down."

Part of it was my mood was up too, and I was really engaged. My mind explodes when people share their ideas and thoughts. It is like every idea they share sets of a million in me. Some people really trigger tons of ideas in me. I love being around those people. I just wish I could vocalize my ideas less and listen to their ideas more. I expressed how it sometimes happens during our sessions. I find myself interrupting him. I hate it when I interrupt people. It is rude.

Dr. X. looked at me and said I was often quiet and reflective. When I am feeling better I become ebullient and bubbly. He said never thinks of my interrupting him as anything more than an expression of my bubbly self.

I am quiet and reflective. Actually, for someone so extroverted I have intense social anxiety and am very introverted much of the time. More than anything just want to stay in my house and avoid the outside world. The quiet reflective me, is often the depressed me.

The well me is a little over the top. In fact when young and well I was unstoppable. I really loved that force of energy within myself. I loved that I was full of ideas, and interested in so many things. I love that I was brave and took wild and sometimes insane risks. I loved that I felt free to be whoever I was. It seemed the people around me loved my playful, boisterous spirit too.

I think I only began to hate that side of me at work, because I received feedback a few times from my bosses that I "overwhelmed" some of my co-workers. I overwhelmed them because I was a powerhouse and wanted to know more, and more and more. I did not just sit and just do my job. I invented and reinvented it. I took on all sorts of projects. I threw myself fully into everything I did. Some people just wanted to show up and do what was expected and go home. Which is fine. If that is what you want to do. I'm just not like that. I always wanted more; more responsibility, more new things to do, and more challenges.

So, maybe I don't "hate" my ebullience and passion for ideas and life when I am with someone who triggers these in me. Maybe I really love that about myself and am afraid I will be rejected if I am the real me. Maybe my trying to control my expressiveness, talkativeness and energy are holding me back.

I remember my best friends in university would all get a kick out of me sometimes when I began talking really fast and loud and rapidly switching from ideas to other ideas. We all joked about it, but they all embraced me and loved that quirk in me. I felt Dr. X. expressing that same kind of love for my energetic quirkiness today. That felt good.