Hollow

This post will not be eloquent, or elegant. I seem to have lost my ability to write. That is why I have not been posting. I have lost my voice. I cannot seem to "create" anymore, whether it be painting, drawing or writing, my creative self, my artistic spirit seems quite literally to have disappeared.

I am not sure why. I am still severely depressed (and getting worse...again), so I know that affects me, but even when severely depressed I usually am at least a bit creative. Since I had ECT last year, and/or since I began taking Lithium I have lost both my creativity, and have been having great difficulty with my memory.

Anyways, I was just thinking about what to talk about in therapy. It seems like I get to therapy and I have no idea what to say...sort of like not writing here, or not being able to create. I feel like I can't express myself the way I need to. So I was just thinking about what is most important for me to deal with and I made a list.

1. For the last year I have had extreme memory problems. I get lost in my own city, confused when trying to navigate, even in places I am extremely familiar with. I forget appointments, stand up friends, can't remember what I just read, have huge holes in my long term and short term memory and feel so frustrated and stupid I want to scream. Dr. X tells me it is "pseudo-dementia", that if it were real I would not know I was having these difficulties. This idea enrages me. This "fake" dementia...is adding to the already huge ruins of my life.

I feel angry, because my memory problems are REAL. This problem is severely affecting my life. It is also making me feel even more depressed and anxious, I feel stupid and slow. People look at me strangely, judge me, and are annoyed I can't remember things. It is getting worse.

2. My constant negative thoughts, racing and going around and around and around incessantly all day. It is to the point that the only thing I look forward to is taking my sleeping medication so I can stop the thoughts.

3. I am angry with myself for loosing track and control of my life. I Intellectually i think I understand I have a mental illness, but on some, deeper, more important level I think I am in denial that an illness has made me this way. I feel like I did this to myself for some reason. I let myself get off track. If I really tried harder I could get better. If I really wanted it I could change.

4. I am so sick of feeling sick all the time. So tired of how fatigued I feel every single day. I feel so fatigued that I don't want to do anything. I literally have to FORCE myself to do the smallest of tasks. I am so sick of it being so much of an effort to do simple things.

5. "Compartmentalizing"...I feel like I am not a consistent person/being. I feel like I change to be whoever I think people need me to be. It is exhausting. I have no idea WHO I am.

6. I want to die...This seems to be the only consistent thought I have. I know I have talked about having suicidal thoughts before, but I feel intensely uncomfortable discussing the details and the depths to which these thoughts engulf me. I feel like the thoughts (an therefore myself) will be seen as childish, or attention seeking, or that they will be dismissed. I feel ashamed for having the thoughts, but I need someone to tell them to.

7. "I feel hollow", Sylvia path said this in the movie "Sylvia", then went on to explain she felt like she was a shell and there was a huge emptiness within. I feel exactly like that, It is even worse since ECT/and or Lithium. My creative spirit, my desire, my abilities, my being has disappeared.

It feels like dying is the only way all these problems will disappear. I see no way out.

There is No Hope

I feel physically sick. I am so fatigued I feel nauseous. I have no energy. No motivation. No ability to get myself to do anything. All I want to do is sleep. I am so depressed I can't even do that.

So I stare at the ceiling thinking I can't take this anymore. I can't live like this anymore. I cannot survive this depression anymore. The life I have is not worth all this pain.

I have to go visit my family in a few days. I am dreading it. They all want me to be happy. I want to be happy, but the energy it takes to be who they need me to be completely overwhelms me.

I wish I would die. Finally this would all be over.

What do you do if nothing helps your depression? How do you keep going? How do you survive?

Why Can't I Get Motivated

I want to go kayaking; slip through the ocean quietly and peacefully. I want to go camping. Pitch a tent, build a big fire, stare at the stars and listen to nature's peacefulness. I want to go for a bike ride. I want to go for a hike. I want to paint three paintings. I see them in my mind. I need to get them out of me.

I sit and stare at the wall. I want o change. Really I do. I want to be different. I want to DO things. I want to be active. I want to be busy.

The dishes pile up, and up and up. The laundry pile gets bigger and bigger and bigger. I feel completely overwhelmed by just the ordinary responsibilities of life. I feel overwhelmed even though I barely do anything.

I get up out of bed. I walk the dog. These are the two consistent things I manage to do.

Mostly, I feel suffocated by my existence. I feel ashamed for how little effort I put into helping myself get better. I feel like I waste Dr. X's time, because I know what I need to do. I need to DO. I need to get active. I need to participate in life. I need to work, to contribute.

Why then, do I just sit there staring at the wall for hours on end wishing my life would change?

Lithium

The types of thoughts, and manner of thoughts I was having when I wrote the post, ""How are you? "I'm Okay."" seem to have slowed right down since I increased my Lithium dosage.

A few weeks ago I was having extremely rapid suicidal thoughts, mixed with a rapid self deprecating/loathing "voice" inside my head telling me how awful I was, and how my boyfriend was trying to leave me, and how I should just end it all. The best way I could describe my mind at the time, with it's "machine gun" like thoughts, is to say it was "manically" depressed.

Like the referenced post I had a piece of music relentlessly, rapidly and repeatedly playing over and over in my head. My thoughts were so distressing and so unforgiving I really wanted to just remove my brain from my head. I thought I was really going mad, so I increased my mood stabilizer: Lithium.

Almost immediately after increasing the Lithium I felt some relief. A few weeks later I still feel depressed, but I am having more moments of relief and the bad "noises" in my head have slowed right down. With the demise of all that negative energy I feel a sense of hope again. I feel like maybe I can feel better. This is a huge relief. Thank you god...whoever you are.

"How Are You"? "I'm Okay."

I haven't really written for a long while. and for days now I have been wanting to write about this...and then in my last post I saw the last commenter comment about a similar dynamic when people ask how you are. So I am going to let it out...

It makes me crazy'(er) that I can never be me with anyone. When my sisters or stepmom, or dad call they sometimes ask how am. Sometimes they avoid the topic altogether. My usual response is either, "I'm okay", or "I'm not feeling so great". If I say the latter the topic changes so fast to something else that it is obvious the question was just a polite conversation opener.

My sisters and family are good, loving people...It must be the chronicity of my illness, the awful person it makes me become, and the neediness of myself that has them pull away from me so much.

A couple times I have tried to express how I need help because x, y, z is happening; i.e. I have been honest about how depressed I feel. The topic changes, or the person tries to get off the phone as fast as possible...and the stops calling or e-mailing completely to protect themselves.

What I most often want to write when they ask how I am , and I am unwell, is: " I am feeling really scared and depressed. I cannot stop thinking about suicide. The noise in my head, telling me to kill myself, telling why it is the best thing, planning how to do it, etc., won't stop. I feel like nobody loves "me".

They love the "me" who laughs and is funny and upbeat...that is part of me, but often that part of me comes out when I am trying to help others feel okay around me, or if I am trying to not act as crazy as I feel. When I want to be cared for, or loved, I try really hard to suppress, or minimize all the things about me that others either cannot handle, or understand, or will take as proof that for their well-being, they should get me out of their lives...NOW.

I understand why this happens. It would be hard to have a sister/daughter like me. I understand, but it hurts me so much that my family doesn't try to help me, or somehow let me know I can call them if I need help. I feel so intensely alone.

Even with my pdoc I am afraid if I tell him what I really feel he will think I am overstating, or that I am crazier than I am. I often leave his office thinking God I must drive him crazy. I try to be/say/express less suicidal thoughts/ideas/plans than I really have, or am, or really feel. I tell him I have the thoughts, but I don't think I have been able to express their relentlessness inside my brain; the way, over, and over and over, and over, the thoughts speed through my head, telling me to:

"...wrap a rope around my neck, wrap a rope around my neck, do it, do it, do it, do it do it...shoot yourself, kill yourself, hire someone to kill you, no one loves you, you are alone, completely alone, lonely, this depression just keeps getting worse, and the worse it gets the more people move away from you..."

"...your family doesn't want you anymore, they only want you when you are okay, they don't want to hear about how you need help, they want you to just go away. So my brain says to me, over and over, "...do it, do it, do it, hang yourself, wrap a rope around your neck, etc., etc." All the while, that Violent Femmes Song, "Why Can't I Get Just One Kiss?" is playing rapidly. obssessively, over and over inside my brain...like I can't get away from the song, or the thoughts.

I can't tell anyone these things. I even don't want to write them here, because all I want is to get them out of my head. I am venting; trying to help myself find some relief.

So I answer, "fine, been feeling a bit down, but that's okay"...WTF!!! "...that's okay"?."...a bit down"???? This will never end...end it.

Becoming Me Again...and then losing myself all over again...

These beginning statments were written Jan. 28, 2010:
I cannot think of any other way to describe the transformation of my "self" that has taken place over the past 7 weeks. Over the past two or three weeks I have witnessed my rebirth.

Until the past three weeks I believed I was gone forever. I believed my depression had taken me over, taken me away, destroyed my self. I was giving up. My hope had disappeared. I never believed I would find hope again. I was wrong. There is hope. It is possible for me to feel better. There is a chance I will become well again. Thank God!!!!


I have been gone for a long while. I went to the hospital the first week of January, because I could not manage my depression anymore. I asked to have Electroconvulsive therapy again (ECT) to try to lift my mood a bit. I was hospitalized for it, because I did not have anyone to help me do it as an outpatient. I really believe I needed to be in the hospital, and that the stay helped me too.

First, in the hospital I met so many wonderful people. My first two roommates were sent to me by God, I am sure. They helped me find so much hope in such a difficult circumstances. It is really incredible what the love and care of another human being can do for another person's soul. Second, in the hospital I could let go of my responsibilities and just do things for me. I have a hard time taking care of "me" in the outside world. I don't know how to just be. I am always so worried about everything. I can't seem to just let go anymore, and just be. Something about being in the hospital gave me the "permission" I needed to just be. That seemed to help me.

The afternoon I wrote the above, for the first time in years I actually felt like the real me, the happy me, the enthusiastic, happy to be alive me, for more than 2 or 3 days at a time. As I wrote about my "rebirth, I felt I was truly at the beginning of my rebirth. Then the last few days happened....I have not felt like that at all.

I feel myself sinking again. Even after ECT (maintenance ECT) yesterday a.m. I did not seem to feel any better. Today I feel so depressed again, I am afraid I am slipping back into my old patterns. I feel no hope. I feel alone. I feel like a burden. I feel hard to be around. I feel overwhelmed and overwhelming. I feel like I am sinking back into the black pit and sinkhole from which, only a few days ago, I believed I had escaped.

I am so scared my "rebirth", was just a blip; scared I am returning from whence I came. I cannot manage that idea.

It Gets Worse...

It seems I am being blocked at every angle. After seeing Dr. X. yesterday I called my sister to see if I could drive 5 hours to her place and leave my dog with her while I went into the hospital.

She owns her own home on 2.5 acres of fenced in property. She has two dogs that my dog adores. When we go there it isn't anymore work to take care of one extra dog, because really all she needs to do is put out an extra bowl of food and water (which I, of course, would bring with me, so there is no extra cost). I have dog-sat all three of them for a few days at her place before and found it no more difficult than taking care of my one dog.

At first my sister said sure, bring him up. So I made arrangements with a friend to take the 10hr return trip with me. A couple hours after my sister said okay, she phoned me back and said, "Can you find somewhere else to keep your dog?" I told her I had no where else to go. She said she couldn't take the dog, and I could hear her husband yelling at her in the background.

I got off the phone and started crying. I felt completely abandoned at a time when I really need my family to help me. It was really hard for me to reach out and ask for help. I know the dog is my responsibility. I know when I got the dog I made a decision to care for him. I also know I am an adult and need to take care of myself...

I know all this, I am generally, despite being so depressed, very, very independent. I always have been. I rarely ask my family for help. I feel so intensely alone.

It seems like my family thinks I could choose to be different if I just tried harder. Honestly, sometimes I feel like I am being treated like a drug addict, or a family member who is a criminal, rather than a family member with an illness. It feels like my family has decided that tough love , cutting their ties and there losses, and allowing me to hit rock bottom is the only way to saveme from myself. It is as though they feel that if they just push me far enough away my problem will disappear.

My other sister phoned me last night and I was really honest with her about how I was feeling. I told her that sometimes I feel like no one in the family cares about me, like the only way my family would recognize I need help would be when it was too late to help me.

She said, "that is just the depression talking, and they love me, but they have their own families".

I replied," I understand that, and I know your families take a lot of love, attention and time. I try not to ask for help, because I know you are all busy with your own lives, but for me, you are my family. I have no family of my own to help me. I have tried to find help in the community, but I cannot afford to pay very much, and there are no resources that I can find to help me get the treatment I need right now" . I feel desperate for help.

"We cannot understand what you go through.", she said.

Very calmly, but assertively I decided to be completely honest about what it feels like to be me, with my illness, in my family. I asked, "Why have none of you ever taken the time to learn about what it is like for a person to be clinically depressed? Or asked me what would help me? Or even sat down and taken the time to find out what it is that I struggle with. Not one of you has read a book, or tried to see how incredibly hard it is for me to manage an illness like this. Why has no one in my family (except my Mom...but she is dead)...cared enough to learn how to help or be supportive of me?"

When I write what I said down, I feel guilty for saying these things. My intention was not to make my sister feel bad, but to get her to see why I might feel so alone and uncared for in the only family I have. For years I have avoided expressing how saddened I am by the lack of support I get from my family. I am desperately in need of some support now, and I don't feel like I can get through this alone anymore.

I cannot imagine one of my sisters, or my dad or stepmom, becoming chronically and severely ill for years, and my not wanting to help them in anyway I could. To me, that is a familial responsibility, and an extension of your love for that person. Caring for family no matter what seems to me what a family is all about.

I know I cannot dictate, or change, how other people feel. People show love and feel love in their own way. People understand the role of, and their role in, the family in their own way. Knowing all that doesn't make me feel any less alone.

I feel like I really am so depressed that unless I can get more help than I have, unless I can somehow get some relief for awhile, I don't think I can continue in this life. It is too much for me to handle. I feel like a person, screaming in constant pain, and there is medication that could help them, but no one is willing to give it to them, and they are unable to get it themselves.

You know what scares me and saddens me about this whole situation (trying to get outpatient ECT, lack of family support, lack of community support and resources, bizarre and unhelpful treatment protocols etc...What scares and saddens me is that I know there are people who are far more mentally ill than I am, whose families have either completely abandoned them, or were never there for them in the first place. Compared to lots of people I have a caring family and I have a difficult time living with my illness. How hard must it be for those who literally have no one? The world is a sad and confounding place to me.

Kafkaesque Bureaucratic Nightmare

My life already feels like a bad dream. Today, trying to get the care I need, in the manner I need it made me feel like I must be a character in a Kafka novel.

My province's (BC) Mental Healthcare system's rigid and top down dictatorial, rule bound, and unsympathetic, inflexible bureaucracy seems to forget that people with mental illnesses require "patient's needs focused care" (rather than bureaucracy-needs focused care), just like patients with physical illnesses. Right now I am frustrated, angry, even more depressed. I had an appointment with Dr. X. today, because I want a referral to receive ECT as an outpatient. He contacted the ECT coordinator at the hospital, and they said I had to have someone with me for 24 hours after each treatment. Period.

It didn't matter that last time I had ECT I was fine and able to care for myself a few hours after the procedure. My only option if no one was available 24hrs/day, three days a week, was to go in as an inpatient.

I felt really annoyed and angry about this, thought it was ridiculous and one of those irritatingly bureaucratic rules where people forget that patients have varying needs, and flexibility would go a long way towards helping patients get there needs met. Patients getting their needs met is what a hospital is supposed to be about...isn't it? The next thing that happened showed me just how unpatient focused BC's Mental Health system can be. I have no idea how people who are even more ill than me get the help they need.

So...Dr. X. and I discussed my going in as an inpatient. I asked him what he would recommend for me, knowing how I am feeling, and he thought going in as an inpatient would be the best thing. Despite really not wanting to be an psychiatric inpatient...for lots of reasons: loss of autonomy, stigma, scrutiny, potentially getting a misdiagnosis in my file, because a new doctor sees something in the 20 minutes they see me, that my careful, diligent, and intelligent psychiatrist has not seen in my nine years of treatment, loss of freedom, being away from my dog, having to share a room with someone I don't know, phobia of getting bedbugs or lice from a public bed, etc. The reasons are many and and varied, and each of them really impacts my fear and lack of trust that I will be treated fairly. I am afraid I will be harmed, rather than helped by an inpatient stay.

...despite all that, I agreed to go into the hospital.

This is where the real Kafkaesque bureaucracy begins...
I asked Dr. X. to refer me to the hospital next door to where his office is. This is where I went before for ECT. My experience had been okay, and some of it had been really positive. I trusted that going there would be okay.

What follows is none of DR. X's doing...I could tell he wished he could send m,e to the Mood Disorders ward I went to before. I appreciate all he has done to help me and can see he tried to help me, but the system has too many blocks, rules, and idiotic systems in place to allow him to refer me to the University Hospital...

Dr. X told me he cannot refer to the mood disorders ward at the University anymore. All referrals for inpatient ECT had to be done at VG Hospital's emergency department. I listened carefully, thinking he could send a referral to the emergency department and then maybe they phoned me when a bed became available.

They wouldn't make a severely depressed people, (who had a diagnosis, and whose personal psychiatrist was recommending inpatient ECT), sit in the emergency room all day or all night, go through a slew of questions and questionnaires by nurses, psychologists, social workers, residents and doctors: They wouldn't make me sit in an emergency room when I was feeling this unwell and knew what I needed to do to help myself...would they?

They would. In order to be an inpatient I have to go to the emergency room, sit there patiently and politely for potentially hours, and even then I may not be given ECT.

This enrages me. I do not believe that a chronically physically ill person, who had a specialist who had seen them for years, and who now wanted to refer her for some kind of surgery, or other "in hospital" care or program, would be told to send their patient to emergency, where they would be interviewed poked and prodded by numerous hospital staff, and if and when a hospital bed became available, then MAYBE they would be admitted for the specialist's requested plan of action.

I do not know how, in the 21st Century, so much discrimination, and inadequate and downright awful treatment, of people with mental illnesses is allowed. I am telling you...if ECT helps me I am going to make it my business to fight for changes to increase the accessibility, availability, and flexibility of treatments and resources available to people needing help for mental illnesses.

I will patiently accept my situation right now, and go through all the hoops and rigamarole to get the help I need, because I don't want to labelled as a difficult patient, or a borderline. I need help so I will work within the system for now, however,...

The system has pissed off the wrong person. I am going to make it my business to see that in the future mental health patients are treated with the respect, the patient focused resources, and the dignity every human being deserves. I do not mean I will blame the doctors, or nurses, or even individual administrators. I might blame the governments insufficient funding and support for mental health services:>0

I mean I will volunteer my time to work towards seeing positive structures, regulations and individualized, patient focused support systems and care are available to ALL people with mental illnesses. My first plan of action will be to find a way to ensure that no person wanting ECT is made to wait in the emergency room, when a referral from a regularily seen psychiatrist should make it easy enough to call the patient when a bed is available.

Physically and Mentally Ill: Will this pain ever end?

I am not doing well at all, both mentally and physically. I feel so exhausted and fatigued that I feel sick. The pain in my hands and arms is getting worse too. On top of that my whole body aches in almost a flu-like way. I have no fever, and no other flu symptoms, but you know how your bones ache when you have the flu, I have a milder, albeit still achy, throbby painful version of the flu-ache.

Despite being so exhausted I cannot sleep, which makes me even more exhausted. I am also getting more and more concerned about my physical symptoms, because they seem to be getting much worse and I seem to be getting more symptoms. Last night as I tried to get to sleep I remembered that around the time my hands started to hurt/lose mobility I had used an powerful insecticide throughout my house, because a friend of mine had discovered an infestation of bedbugs at their house.

Although I never saw, and have never seen (thank god), any bedbugs at my place I was concerned some may have been introduced into my home on the clothes/shoes of my friend, so as a precaution I sprayed my place... (a lot...I was freaking out as I have a phobia of bedbugs and lice). I opened all my windows and door while spraying, but numerous times while spraying I was overcome by the fumes. Last night I started worrying that I have poisoned myself with the insecticide, and that is the cause of my symptoms.

On some level I know I should not try diagnosing myself, and should wait patiently to see the rheumatologist in mid-December...but I can't stop worrying about what is happening to my body. I just can't manage being physically and mentally ill.

My mood is also extremely low right now. Despite trying to push myself to do things I have cancelled my choir, and my singing lessons this week, because I feel so depressed and physically ill. I am so tired of trying to get better and failing so miserably. I'm not sure I can manage this much longer.

What Does a Depressed Person Look Like

The entire time I have been off work I have been sure that my insurance company is spying on me. This fear has caused me so much stress and grief. Dr. X. has really tried to encourage me to keep trying to play, smile, do things that I enjoy doing, despite both my depression and my concerns about the insurance company seeing me enjoying myself.

He says, act like they are watching you and do it anyways. I have tried really hard to do just that, but my worries about the insurance company misconstruing my joy in the moment, with wellness, and my ability to return to work, keeps me feeling terrified about doing things. It seems I may be worrying for a reason.

Over on Shrink Rap there is a post that will scare the hell out of anyone who is depressed and on disability. It tells the story of how a woman placed photos of herself on facebook showing her having fun and vacationing. Her insurer removed her from disability benefits for her depression partially based on how happy she appeared in her pictures.

The article made my me outraged, but it was the 668 comments after the article that made my blood bubble and boil. I could not believe how little so many people understand about what it is to live with and try to survive, and recover, from major/clinical depression.

I organized the comments by "agree", and the fourth most common agreed upon comment was:

• 525 people agreed: "...it is clear this woman is a scam artist".

Not far down the page were more unbelievable "agree" comments...

• 262 people agreed, "...I hate to be cruel but from the facts presented, I'm leaning towards support of the insurance company's side. If she's ok to take trips, have parties, and go bar-hopping, how is she not ok to report to work every day? "
• 212 people agreed..."Oops, looks like you got caught to me !!! Back to work we go....like the rest of the depressed workforce of today"
• 143 people agreed..."This woman sounds like a real go-getter"

How is it "clear this woman is a scam artist"? She posted pictures of a smiling self, enjoying the company of friends and a vacation on the beach. Do depressed people never go out with family or friends? Does major depression always preclude smiles, laughter and enjoyable moments on vacations?

I know for me, smiles come easily sometimes, and must be forced or faked other times. Even if I am severely depressed, I often find myself in situations where my mood suddenly lifts for a short period of time (when I teach art is an example). I have been so depressed I felt suicidal, unable to get out of bed, and was sure I was unable to get to my class...and then I walk through the door, see a student and my persona suddenly switches into high gear, and no one in the world would ever guess I was depressed. The problem is, afterwards, I almost always need to nap because I exhaust myself.

Does my ability to lift my mood mean I am not really depressed? I have wondered about this a lot. I cannot reconcile my depressed self with its thoughts of suicide, plans for suicide, hopelessness, and intensely low mood, with the persona that seems to be bubbly, personable and for some moments maybe even "happy".

I know that others have a difficult time believing I am depressed sometimes because I often am able to hide my sadness, or even become "unsad" for short periods of time. This has caused me a great deal of stress, because people are constantly underestimate, and often dismissing, how sad I am, and how much my depression impacts and continues to destroy my life, and my desire to live.

Another commenter writes, "If she's ok to take trips, have parties, and go bar-hopping, how is she not ok to report to work every day?" Can a person, who is truly depressed go on a vacation and enjoy any of it?

For me my depression often stops me from doing things, going places, being with people, but I still push myself to participate in these activities. Sometimes I even enjoy the activities I do. Can you believe I am depressed and actually enjoy some things? I do sometimes go away on a vacation.

Most of the time I still feel as depressed as I would be back at home, often the stress of being away from home is too much, but sometimes, the vacation provides me with moments of relief, and a break from myself. Do moments of relief mean wellness? Does it mean I can work?

Whether I am able, or not able, to work is complicated. When this depressive episode began I was severely depressed and somehow still managed to work at a job that required a great deal of energy and effort. My fear of losing my job pushed me to keep working well past the time I should have kept working. I struggled for two years to maintain my work, but near the end I shut down completely and would sit and listen to people at work explain things or discuss things...yet I could not understand what was going on anymore.

I know for me stress really triggers me and increases my depression. Currently I do some volunteer work, but only a few hours a week. I know I am not able to manage more than a few hours right now. Even with just those few hours it takes me a long time to recuperate.

I feel so scared I will not be given the time I need to get well, that I will be told I need to go back to work before I feel well enough to manage working. I question myself everyday about how it is that I am able to participate in life; write in my blog, volunteer, take singing lessons, see friends, yet am unable to manage working. I guess the simplest explanation is that the singing lesson is an hour long and then I can go home and sleep. My volunteering is a few hours a week, then I can go home and be alone, and sleep. My blog is just all the thoughts already in my head, being typed onto the page. It is cathartic for me to write...and then I can sleep. My friends know I am depressed, so I can just be most of the time.

I don't think that my sleeping after every little increment of work, at a job, would be very acceptable to any company. There is a term called "Presenteeism" that is replacing "Absenteeism" as what a company is not looking for. A person who shows up for work, yet is not well enough to fully participate in work costs companies a lot of money in lost revenue and work accomplished. The "Presentee shows up, does very little, and gets paid. It does not help the company to have a worker who is unable to fully participate in work.

Anyways I ramble...but I want to show that people who are severely depressed can sometimes lift themselves enough to do things others might perceive to be impossible to someone who is unaware what depression is really like. This just points to the resilience of the people pushing themselves to help themselves move towards wellness.

It Hurts

I cried myself to sleep last night. This week has been like that. I feel overwhelmed by all the responsibility to get better, to help myself, and to move on in my life.

I feel like I think I try hard, but really I do not. I vegetate at home a lot. I stare at the wall half the day and wish I could change. That is getting me nowhere. This life is no life at all. It is hell.

Yesterday afternoon I had a short period of hope, that if I could manage to do all the things I enjoyed, or all the things I wanted to do, if I just did all the things that made me happy, I would become happy. Just the thinking about how to get myself, how to force myself, how to push myself to do, instead of just think about doing, exhausted and overwhelmed me. I feel useless, hopeless, helpless. Completely lost.

Last night I opened up the bag with all my hoarded medications. I want so badly to end this life. I wrote my sisters a note a few days ago. As I sat staring at all the medicine I tried to figure out how to exit and make sure my dog is okay. That, and the fact that I don't even have the energy to kill myself, is the only thing that stopped me. How sad...that besides my dog, my low energy and inability to do, is the only thing saving me.

I Wish My Family Members Cared Enough to Become Informed

Please do not treat me like I am not trying hard enough, or if only I tried harder all would fall into place. Severe and Chronic Major Depression is not like that...not for me anyways.


Me: "Sister I need help. I don't know what to do anymore. I am so tired all the time. You know how people with cancer or hepatitis feel so tired they can't do anything? I feel like that. Exhausted. I am scared. I have suicidal thoughts all the time. I am so sick I want to give up. I won't because I love you and our family so much, but I can't handle this anymore. I need help."

Sister: "You are not sick. You do not have cancer, or hepatitis, or any other illness. All you need to do is get doing things. Get busy. Go kayaking, go for a walk, do your art."

Me: "I have an illness that makes it hard to do things most times. I have no energy. I am sick."

Sis: "You are not sick, you don't have an illness. You are depressed."

etc., etc.

I am lost. I really am sick. Last week I asked my sisters to call me every couple days, just to let me know they love me and care about me, I felt it would help me stay here. I felt really proud of myself for asking for help. Once again though, I reached out for help and have been pushed away.

I am so depressed I am having a hard time functioning. No one sees it. Not the Art clubhouse, where I have tried to explain I need some concessions during this time; not my family...who are telling me not to phone.

On some level my boyfriend is there for me and I really appreciate his being there, but I brought up the fact that I wanted to go to the hospital for ECT and he flipped out; saying if I went to the hospital I would be abandoning him.

I tried to explain that my going to the hospital was nothing about abandoning him, and everything about taking care of myself. He said:, "Don't turn this around." (as though I am abandoning him, but just excusing it by saying I am helping myself???? I don't get it.

He constantly denies I am depressed, or that I have anything to be depressed about. The latter may be true, but from my perspective it seems I am depressed...even if most others in my life don't think so. I really get confused with his attitude, given he has a mental illness and is depressed himself.

I feel so intensely frustrated that those closest to me are telling me I do not feel, or look like I am, depressed. I feel like screaming I am so frustrated. I know I must annoy others...but imagine what I feel like, never getting well....nothing ever working.

I do have a couple people who are very supportive. My friend E is a saint. I feel blessed that she continues to listen to me and be by my side. Same with Dr. X. My boyfriend too, despite his denial of my depression, stays by me and holds me when I need to be held. I have met a new friend to...A and she is so sweet. I hope I can be the friend all these people need when they need a friend.

You might think it was a blessing for others to believe you capable of big things, but sometimes, when a person like me is extremely ill it is hard for others to see such a "strong" person needs help.

Please, if a family member has a mental illness, and is struggling, please take the time to educate yourself about what your family member is struggling with. I feel abandoned and dismissed by my family. I love them so much, yet given I have struggled for years and years, have lost my job, and have basically lost my interest in life...I feel pretty hurt that they have not taken any time, or effort to educate themselves about how these mental illnesses impact the people who have them.

I feel like they do not love me enough to even spend an afternoon at a depression information session, or to read about what it is like to live with severe and treatment resistant depression, or even to come over to my place and go see Dr. X with me. I feel really alone when it comes to my family. So alone I cannot even express it in words...

I'm an Afterthought...and that hurts.

I feel like just sitting in my corner chair and staring, or laying in bed all day...waiting impatiently for each minute, each hour, each day to end.

Dr. X says...(I am paraphrasing with my understanding of what he said...I can't remember exactly what he said), I need to hold on to the moments of happiness, or the moments of joy I do have. That if my mood remains like this I need to try to recognize there are moments that I enjoy.

That is not the life I want. I do not feel a life with extended periods of intensely painful and severe depression symptoms punctuated by brief moments worth experiencing is, for me, a life worth experiencing.

I know, and believe that for some people this might work, or sustain them. I think I used to manage by knowing this would pass, and things would get better. I no longer believe that. I am so tired of trying, and failing to get well.

I am so sick of trying treatments, therapy, medicines that never work, tired of trying to explain what is going on to my family (who I love so immensely it hurts). It hurts so much that I love them and need them and want so badly for them to understand me, to reach out, to help me...and they don't seem to get how much I need them.

I was thinking about why, at 44, I still so desperately need my family's approval, love and support. It feels so childish. I realized yesterday that a life is worth experiencing and living if you have someone who thinks of you on a regular basis. It is as though you really exist if someone wants and needs you here. I mean really needs you...in the way I desperately need my family.

I used to feel my Mom was like that. She would call me and ask how I was, and as if I was okay, or wanted to talk. She always had time for me. She went out of her way to love me, to visit me, to include me in all family functions. I remember thinking there was something pathological about how much I needed my Mom all the time. I was very independent and too care of myself, but always there was an underlying need to be loved by my Mom. It seemed unadult like on one hand, but on the other hand her love sustained me through even the worst of the worst.

Now I feel like my Dad and Stepmom see me as the "problem child" and have taken a ..."wait til she hits rock bottom stance"...as though I were an addict in need of toughlove, rather than mentally ill. I feel as though they actually avoid me.

note: I don't believe addiction is treatable with toughlove...I think it is an illness too. I think all humans need love and compassion to fulfill themselves.

My sisters' have their own family's to worry about...so I am a passing thought. I feel so alone. I feel lie a burden. I feel like I am an afterthought, a sister and daughter who has completely disappointed her family. I feel avoided. I want my Mom back.

What if Nothing Ever Works? Is Life Worth Living?

This post is just another blah, blah, blah about how desperate I feel. Please do not read if you are annoyed by me and my morose being, or if you are triggered by dark thoughts.

I am not writing this to reach out, or to help anyone. I am writing this because the urges and images inside me are overwhelming me. I need to get all these bad thoughts out of my head...I guess in a sick way my writing like this is a coping strategy.

Given my decision to write this blog, not just for myself, but for others to read, I often find myself afraid to write what I really feel. I try really hard to be genuine and honest, but sometimes I feel my unrelenting, chronic illness, its symptoms, my thoughts and behaviour might annoy, overwhelm, trigger, or burden other people.

This feeling of overwhelming and burdening others happens in my "real" life too. I feel if I share the truth, speak the truth, open up completely to my family and friends it places a heavy load on their shoulders. What the hell are they supposed to do with the information? It feels selfish to share such detailed and frightening imagery and information with them. So I keep the heaviest part of my load inside me, and then days like today happen and I feel like the load will tip me over and flatten me.

I have been sitting here on the verge of tears for the past few hours. At one point I called my Dad, ostensibly about something he might be able to help me with, but really I wanted to scream..."help me". Reason took over. My Dad doesn't even think I need help...definitely not the person to reach out to.

When my Stepmon asked me how I was, I so desperately wanted to reach out for help. I heard my voice quiver. About to break into tears I managed to squeak out, "fine". She did not notice and took my "fine" at face value.

I am not fine. My suicidal thoughts are so strong right now. I was in the gas station today, staring at the packages of rope. My brain kept saying buy it, buy it, buy it...do it, do it, do it. I managed to move away from the rope, only to be drawn to it again...three or four times. I left the gas station with no rope, but not without an intense desire to die.

How do people survive chronic MDD. As the years go by with nothing able to help me for any length of time Iam losing my resolve, my will to fight, my desire to live. I cannot see how it is possible to keep trying when I still feel so much severe depressive pain, isolation, fatigue, attention difficulties, memory loss and amotivation...these things have completely destroyed me.

I had lots of friends, went to school, worked hard, , both physically and socially. I did everything you are supposed to do to have a happy life.

I am not the person I see inside me now. I have become some monster. I have become the epitome of hell. I have become an empty vessel, an inanimate being, the living dead.

I am a zombie; dead inside, but walking directionless, searching and praying for a way to make the death destroy my shell as well. Why did this happen to me. I always tried so hard to be alive, vivacious and passionate about my life, and other people's lives.

Now, everywhere I look I find myself searching for a way out of this life. I see an car accident taking me away, a truck running me over, a rope hanging me in a tree, a dog leash and choke chain slipped around my neck and over the bathroom door, a leap from the Alex Fraser Bridge, a fall in front of the train, ...a note pasted on my door...someone help my dog.

Invalidated

Sometimes my therapy works to help me understand why certain patterns repeat in my life over and over again. Today's therapy was like that.

Therapy always leaves me feeling "heard", and (mostly) understood. This is something intensely important for me. I think today's session revealed why these two things are extremely interconnected and even more importantly, why they are so important to me and my well-being.

I just returned from a short vacation at a horse ranch and spa in the B.C. interior. I went with my beau, my friend E and my sister and 2 nieces. I haven't seen my sister for a while. When she came to my house in preparation to leave she told my boyfriend and I that my Dad might "pop in" to the ranch to visit.

This information put a damper on my vacation from the start. I love my Dad, but he is often not very nice to me. I find him very difficult to be around. To me it seemed intrusive for him to jut show up.

When I mentioned my stress about Dad coming my sister began saying things like:

• "He's not like that".
• "You need to give him a chance".
• "He does not treat you poorly".
• "He is always nice to you".
• "You know Dad, he just doesn't know how to talk, and you make it worse by getting hurt by him"
• "You have to get over your problems with Dad"

I felt completely letdown by my sister. She has seen my Dad reduce me to tears more times than probably I can remember. She hears and watches him ruthlessly tease me and belittle me. I thought she recognized why I so often feel hurt by how it treats me. Apparently, according to her, Dad isn't the instigator, in fact, he does not treat me poorly at all. It is just my wrong perceptions that hurt me.

I am willing to concede, that after years of emotional, and at times when I was a child and a young teenager, physical abuse, that I am sensitive to how he treats me. I know sometimes I overreact to small triggers. I believe though, that this overreaction is not my fault, but the fault of a man, who is supposed to be my father, continuing to abuse me, and destroy what little self-esteem I have left. At times I think he belittles me, and holds back his love from me, for the fun of it, just to watch me fall apart and cry.

It is funny (not ha, ha...but strange funny) that this weekend when my sister and I were canoeing near my Dad's canoe, we sped up really fast and in unison yelled, "Dad, look at us". We both cracked up when we realized some small child inside ourselves was still screaming, "Daddy, Daddy, look at me, look at me".

To make things worse my sister also began lecturing me on how:

• "no wonder you are depressed. you sleep so much, how are you ever going to get well if all you do is sleep?". (this comment came 1/2 way through the vacation, just when I was marvelling at my ability to do as much as I was, when I felt as depressed as I felt)
• "If you did more you would get better" (neglecting that to do more I would need to have the missing motivation, energy, and mood, and ability to do more...all these have been ripped from me throughout this MDD
• " You are never going to be someone unless you get doing things." Translation: your life will never amount to anything if you do not get back to work. You are choosing to stay depressed. You are only an important person if you are working and contributing to society.

There were more comments like these throughout her lectures...the thing that really hurt me, was that I thought she was the sister that understood how hard I try. I thought she understood how depressed I am, and how that impacts my ability to do things.

On top of this my boyfriend talked to me about how, "You are not sick, nothing is wrong with you" A statement that left me feeling really unheard, and misunderstood. It is not that I want to be sick, or seen as sick, but I also do not want others to think nothing is wrong with me, and I am just to lazy to try harder in my life.

I talked to Dr. X about what went on with my sister and my boyfriend, but I could not really place why I felt as hurt as I did. Dr. X said maybe it was because I felt invalidated by their comments.

That is EXACTLY what I felt and feel when these kinds of discussions take place. My family is not listening to me. They are not understanding how difficult this battle is for me. I feel like I am battling for my life, but they do not even acknowledge I am in a battle. They see my difficulties as a character flaw.

Dr. X and I discussed how both my sisters', and my Dad's expectations of performance are mirroring the malevolent feelings of guilt I have about not working; how the family belief system is so ingrained in all of us that it just keeps replicating this guilt, and guilt inducing, behaviour in everyone in our family. It is true. I belittle and poke and prod myself to do more, do something, get going, get active....Get better...get back to work. I have become the voice of my father, and the voice of my sister...that why it hurts so much to hear. I am hearing the same guilt producing words I hear every single day from myself.

I know my sisters both love me. I think my Dad probably does too. When I realize their voices are replicating negative patterns that are held deep within our family's psyche. I recognize these thoughts and feelings are held unconsciously, and so deeply they may always be there.

On many levels I know my sisters, my Dad, and my boyfriend are really trying to help me. I understand they may see their comments as encouraging, and helpful. I think they want what is best for me. Sadly, when I hear these kinds of comments I feel he exact opposite: I feel unbearably guilty, alone, unheard, and invalidated.

Suicidal Ideation

Last night my boyfriend looked at me and said, "don't go to the hospital. You are not that depressed". A few days back I told him I was thinking of having ECT done again. He was adamant that I not do this.

If I try to express how depressed I am he has a tendency to say, "You are okay", "You aren't depressed", "Your not that depressed". I have tried to explain what it feels like to be inside my head. It never seems to register with him. Either he does not understand how desperate I feel, or he does not want to understand.

I know some of it might be that I try hard to be as okay as possible around him. Two reason drive this: my fear he will leave me if he knows how messed up I am, and my respect and support for his own difficulties with mental illness.

He has attempted suicide before, years ago, and I see the external and internal scars from his internal pain, his sadness, the scars on his arms from cutting. This, and my knowledge that his father committed suicide, stop me from openly and honestly expressing how I feel. I also know he was hospitalized against his will; so I recognize his distrust of the system. I do not want to add to his stress in these areas.

Our relationship feels strong and intensely beautiful in so many ways, but it is new for both of us. I do not want to risk losing him by exposing myself as fully as I need to for him to see how desperate and depressed I feel, for him to understand what I am fighting against, for him to know I need to get better than I am to survive my illness.

He kept saying over and over last night..."you are okay", "You are not that depressed", "We are all depressed", "Just get more exercise", "Push yourself, you just need to force yourself to exercise and it will be better". I found myself sobbing silently beside him, looking the other way, feeling completely misunderstood; my symptoms and their power over me dismissed outright.

Last night, as I sat beside him, I could not say "I am so depressed I want to hang myself". I did not express how my wanting to hang myself is a desire gaining so much power I am afraid I will succumb to it. I did not say these things because his father hanged himself to death, and he attempted suicide in this manner. I was afraid the information would be too much for him to deal with.

I want him to think I am strong and powerful. I want him to feel attracted to me, not repulsed by me...so I cover my true feelings up, and then cry and feel isolated when he does not understand me.

In my life talking about wanting to commit suicide is so taboo that I feel intensely alone in my thoughts. This divide, this avoidance of the awful suicidal ideation I deal with on a regular basis, creates a cavern between myself and the people I love. It makes me feel intensely alone in my struggle to survive my depression. It makes me pull away and isolate myself from those I love.

Today my mood is crashing again, after lifting for a few days. In part I think the fall is a reaction to feeling misunderstood and isolated from my boyfriend and family. When I crashed a few weeks ago, and as I was crashing last night, I tried to reach out or support. Both times I hit a brick wall with my family.

I rarely mention my suicidal urges to my sisters, or my boyfriend. If I do try to be open out of fear and desperation for myself , I sometimes try to explain how depressed I am; "so depressed I don't want to be here" might be what I say to my sisters. Instantaneously they brush my feelings off with an, "Oh, don't say that. How do you think we would feel if you did that?" I know it would hurt them if I commited suicide, but what about me? I hurt all the time.

My sisters do not want to hear how sad I am, and my Dad, he has never once ever asked me if I am okay...not once. He has phoned me to say my stepsister was depressed and needed help. He has told me how crazy he thought my going in for ECT was...4 years after the fact. He has never asked if I was okay, or if I needed help, or if I was having any success with my treatment. He has certainly never asked me if I was at risk of committing suicide. I am.

When my Mom wasalive she was a nurse. She used to talk openly with me about suicide. She would even ask me if I was having suicidal thoughts or urges. With her I would always leave the phone call feeling heard and relieved that someone knew, someone wanted to know. Someone loved me enough to ask and actually listen to my answer. Why is it so important to me that others understand how depressed I am, and how hard it is to be this depressed? I have no idea why.

I wish my family (and my boyfriend) understood how desperate I feel; how much I need and want them to understand me. I want so badly to be able to tell them my truth, for them to talk openly with me even if it is difficult to do, and for them to acknowledge that I am ill. I want them to say this is not my fault. I want them to say, "I AM trying hard enough". I don't want them to feel hurt by me and my awful thoughts, but I need help with them or I am not going to survive.

Whatever...I don't know why I need so desperately to be understood; maybe because I don't understand either. Last night my boyfriend kept saying, "you need to address what is making you depressed. Nothing will get better if you don't change those things".

At that point I began sobbing so hard I had to leave the room. I have been in therapy for years a fact that screams to others and to myself, "things" are causing my depression, and I need to change those things." Despite a sense that there must be things that are making me depressed...I honestly feel like all the things I want to change, would fall into place if I was not depressed.

I would get a job, clean my house, do more things, isolate less, stop obsessing about suicide, dance, play music, ski, eat well, sleep less etc...if only I weren't so severely depressed.

No one wants to acknowledge this raging rhinoceros, named "Suicide", rocketing towards me and racing after me every where I go. So I write here, because at least I can say how I feel.

Things That Make You Go ...Huh???

I usually let these kinds of ideas wash over me, but this article, "Depression is Not an Illness" is so draconian, and, from my experience, mistaken that I had to respond.

The writer claims to be a retired , licenced psychologist. I worry others will read his post and feel their illness is their fault, or that somehow they are to blame for being depressed. I find it hard to believe that a person could be in the field of helping others...especially as a psychologist, and be so judgemental and mistaken in their understanding of a very difficult to deal with mental illness. My experience has always been that the major depression always shows up before all the activities he suggest cause depression show up/or disappear. My depression leads to my eating poorly, isolating, becoming inactive etc. Not the other way around.

This was my comment to him about his article...long-winded, but in support of all who struggle with MDD (or any other mental illness, I needed to say what I said...

"[My comment on his site...]
I am actually flabbergasted by this post. Not sure if it is satire (I hope so) or for real. I hope you post my response so others like me do not feel blamed for not relieving and avoiding their MDD. In case you don't I am going to post it on my website.

I struggle with MDD. I have had numerous clearly defined episodes throughout my life. Until this current episode I was the epitome of what you suggest makes a person happy, yet I still fell into severe and often lengthy depressive episodes:
good nutrition
- fresh air [I routinely biked, skied, swam outdoors and indoors, hiked, camped, canoed, gardened, walked everywhere was outside much of the time]
- sunshine.[.see above]
- physical activity[...ditto]
- purposeful activity[...worked(loved it), went to school(really, really loved it), danced, played music, created art, wrote, helped others]
- good relationships, [beautiful friendships, very open, nothing we could, and did not talk about.]

For me severe depression really did just pop out of nowhere. There was nothing wrong with my life during these episodes...I had a great life. It was the depression that stopped me in my tracks, not the other way around.

When you wrote, "When things are going well in our lives, we feel good"...I understood immediately that you misunderstand MDD. The sad thing about MDD is that even if things are going well this illness destroys a person's ability to feel good.

I find it difficult to understand how you treat people with depression when you place so much distance and dogma between yourself and your patients. When you say,

"Many of these individuals lived on a diet of soda pop [I can count on my hands the number of sodas I have drank in the last 5 years], cigarettes[don't smoke], and salami sandwiches[I think the last salami sandwich I ate was in high school...I'm 44]. Others drank enormous quantities of alcohol [I used to drink periodically...like many other happy people I know...until I got as severely depressed as I am now. In which case it drove me to drink more to try to help my symptoms]. Few ate vegetables regularly[ was vegetarian.so did well here]. Many stayed indoors almost all the time [see my above list of favourite and common activities]. Physical activity was almost always minimal [ditto]. Purposeful activity – i.e. activity directed towards some kind of goal – was seldom present [university? , and good honest, open relationships almost non-existent...[great friendships?]...

...Chronically depressed people, however,are individuals who have been neglecting these areas for years. They spend the vast majority of their lives indoors, watching television and eating snack food. They are often over-weight, have no goals other than the next TV show, and although they may have many acquaintances, they do not share their concerns and worries in an open and honest manner"

...it struck me that you believe very strongly that "we"are so very different from you. We just don't try hard enough to be happy. If only "we" would try harder, "we" could be as happy as "you".

Have you ever really worked with someone with clinical depression? Contrary to your statement that we are indoorsy, crappy food eating, inactive, solitary, lazy, unfocused, fat, slobs.. [actually slob is my word...it's how i sense we seem to you) people with MDD are a wide range of people...some of us even active, outdoorsy, friendly and friend supporting, anti-t.v., fit and interested and interesting people.

It becomes clear you have never understood what it is to be depressed when you state, "Depression or despondency is not as acute a sensation as pain". In the past I broke both my elbows at the same time, had a severe case of CMV related hepatitis that required hospitalization, have broken my leg, my ankle, my wrist, had three concussions, was injured in a car accident, had a doctor drill into my leg bone for bone marrow, basically have suffered a lot of physical pain.

NOTHING is as painful as severe and chronic MDD. When I broke my elbows I had just come out of the hospital after having ECT. For the first time in years I felt mentally well. I REFUSED any pain medication for my physical pain, for fear that my psychic pain would recur. NOTHING hurts like mental pain...NOTHING.

Hidden

I know there are people who are depressed who are depressed around everyone; people who are melancholic, or outwardly irritable. I am generally not one of those people. When around others I usually can either fake it and be sociable and pleasant, or my mood actually does lift for the time
I am interacting.

I suppose many would see this as a gift...the ability to pretend, or actually become "normal", i.e. my pleasant self, when I need to. It may seem something like a superhero's ability to become an ordinary human when walking amongst the general public.

There are costs to this way of being. When I am severely depressed the energy it takes to be what I think others need me to be is exhausting. I often leave a social function feeling so much fatigue I want to throw up. The second I walk out the door intense depression sets back in, and I feel exhausted; even more so than my general day to day exhaustion.

The other difficulty I encounter, and this one I find so frustrating I want to scream, is that people don't believe I am sick, or depressed. If I reach out, or open up and bring up how depressed I am, I often (more often than not, hear so many stories about how friends, relatives, family members of the person I am talking with suffer from a depression much worse than mine.

Sometimes I just let the comments go, because it is not a contest...if they think that is the case who am I to argue. So often though I feel like my pain is being dismissed as mild, or not worth worrying about, or even worse, that I am being told I am not depressed at all.

This happened last night. I managed to open up to someone about my mood disorder and they immediately told me their sister had a depression "...much worse than {mine}". The sister had had a breakdown, ended up in care and during one episode became catatonic and had to be hospitalized.

That sounds like a very severe depression to me. It is very sad. How though is it worse than mine...years and years of cycling, no medications that consistently help, or if medications help side effects that impact my life, isolation from most of the people I know, loss of my job, paranoia, fear suicidal ideation loss of pleasure, fatigue, inability to motivate myself...and an increasing sense that I want to die all the time?

Last night every time I would express what my struggle was like this person would interrupt half way through to explain how I wasn't that depressed. Eventually I just became quiet and listened. I felt really dismissed and vulnerable for opening up myself only to be told others are far more depressed, and that I really had not experienced a "real" depression, not like other people have.

I am sure some others are far more depressed, though I do not understand how a person would manage to stay on this earth much more depressed than I feel sometimes. It is a brutally difficult battle at this severity.

I am sitting here right now, just trying to hang on. I feel so isolated and scared. I cancelled a volunteer luncheon I was supposed to go to because I am so depressed I feel physically ill. I know I will be in trouble for cancelling, because I have missed so many meetings recently, but I just don't have it in me to be fake, or for my mood to increase to please others, only to make me more intensely depressed and tired later.

I know it is weird that I care that others see how depressed I am. It is not that I want others to see how depressed I am, or to say yes you are severely depressed, or even to empathize or sympathize. I just want others to know I am not slacking, or lazy, or using the system, or getting disability for something that isn't that difficult to manage. I want others to know I am struggling against an illness just as severe and real as any physical illness. I want others to know I am trying as hard as I can, but my enemy is vengeful and strong. Maybe too, I am reaching out for help.

This needs to End...NOW.

I am scared of what is happening to me. My mood is cycling all over the place and the switches are shifting suddenly into either my behaving in weird ways, or I suddenly become so intensely and severely depressed I fear I might hurt myself.

I woke at 7am this morning. The second I woke I felt that black pit of hell in my stomach. I was so depressed I felt physically ill...and it got worse. At 7:30 I was trying to make a coffee, and I picked up a knife (the only thing close) to stir the water and coffee in my french press, and suddenly I had an intense urge to end it all; to stab myself over and over 'til it was all over and finally I was at peace.

It felt so urgent; as though stabbing myself was my destiny. I stood there frozen, helpless to stop myself, and the urge kept getting stronger and stronger. I felt compelled to do it.

I don't know what happened because one minute I was feeling compelled, and the next I was crying. I sat down and stared at the wall, unable to manage even a thought. I sat there so tired/fatigued I couldn't move. I sat there dazed and empty, in some kind of void...maybe in a dissociative state??

Even at 8:00 am it was so hot and humid. I wasn't feeling safe at home, but I had no one I could call. It was too early in the morning. I pulled myself out of the chair about a half hour/hour later, dragged myself and the dog out the door, and went to the ocean for both of us to cool off. It took every single ounce of my energy to get up and leave the house.

I sat on a log and cried. I felt, and feel, so lost; so completely and utterly confused, hopeless and unsure about what is happening to me.

Just the day before I was feeling pretty okay. Maybe a bit better than okay. All day the day prior, I was extremely sexually charged. To the point where I just could not get enough. When my boyfriend left for home I started looking at porn on the internet...and did so for hours, until 1:00 pm.

I know I have expressed my having watched porn before, but, but then, as was the case yesterday, this both is not "typical", or "normal" behaviour for me. Also, I have never watched 7-8 hours of porn before. It's just lately I have this insatiable sex drive and I can barely manage it. There is more to this behaviour, but I am too embarrassed to write about it. Surprisingly I do have a modicum of modesty left in me.

So last night I am okay, and this a.m. I sank so low I didn't think I could make. This has been the type of cycling that is happening, and I can't handle it anymore. I don't know what to do, because at this point, 8 years into this episode, it really does look like here lies my destiny...to be completely out of control of my mood for the rest of my life. I can't handle that.

All and Nothing

Today was one of those therapy sessions that was all over the map, covering everything and nothing at the same time:

• How much I am drinking,
• Why I am drinking more,
• My mood is lifting
• My mood is down
• I am detached
• I am tired all the time
• I am having trouble doing things
• My attempts to catch at reverse my feelings of being watched and judged,
• My feelings of paranoia about my landlord
• My inability to successfully stop my paranoid thoughts
• My extreme worry (read major anxiety attacks) about my application for separation and divorce from my husband; my husband wants a detailed ironclad agreement between us, meaning I have to provide statements, tax info, asset info ( the list is 3 pages long)...This kind of scrutiny and information gathering is intensely disturbing and difficult for me to manage,
• That I had unprotected (no birth control) sex twice this week despite having had a birth control failure the week before last and knowing exactly how stressed out I get about the chances of getting pregnant,
• Why I had unprotected sex despite having had...blah, blah, blah,
• How I am making poor judgements
• How only the birth control write off an example of poor judgement
• I had two dreams,
• What I thought the dreams meant,

And then finally..about 7 minutes before I have to leave Dr. X's office, what is really bothering me comes up: Am I going to be able to work again?

Shoot me now, but I cannot manage my life with the uncertainty of not knowing what I am or am not going to be capable of . On one level I recognize Dr. X is not a "mind reader" ha, ha...but on another level I want to know, at the very least, the odds of my being employable again.

What got me thinking about this again is my boyfriend. He has a M.I. too and has been chronically ill since he was very young. I asked him if he ever thought he would ever be well enough to be off disability. He just, matter of factly said , '"No".

I then asked him if it bothered him and he said, "No", I have accepted that I can only do what I can. I work when I can and don't when I can't.

In many ways I see how his knowledge of the incapacitating nature of his illness protects him from the type of feverish get back to work type schemes I come up with...like volunteering even if I am really sick, and being unable to say no to teaching, panicing about not working/not being able tpo work etc.

On the other hand I worry that if I were like that it would be a kind of complacency that would make me give up life all together. What am I if I am not a worker? My whole life (until I got so sick) I was a worker.

Dr. X enthusiastically explained (once again) that I am working...but he knows, and I know it is not the way I mean. I mean getting off disability contributing to the social well being of our country and fending for myself.

He says I am contributing to the country and community. He says all the people I teach art to are benefiting from my volunteer work. He says if he was working for the insurance company he would be proud to see someone the company is helping, do as much for the community as I was.

I just sat there protesting and bawling. I feel so much like I have failed; like I am a failure. Like I will never get better, never get well enough. I left his office sobbing and went into the washroom and cried. I just want to know what to expect for my future.