Why Didn't I...

I slept most of the day yesterday. I just do not want to be here. I'm too tired and everything is too hard to do. I cancelled going to a drop in writing class today, because I just don't want to see anyone.

Yesterday, as I tried to sleep, my puppy would curl up beside me on the bed. The bad thoughts would come. I tried really hard to speak lovingly to my puppy, tell him how much I loved him, pet him, feel how soft and velvety his floppy ears feel, sense the warmness of him laying next to me. I tried every time the thoughts came to fill my mind with thoughts of love, and caring, but the thoughts both wouldn't go away, and then began to challenge me:

Why didn't you get your oldest niece to call 911? The police would have stopped the dog attack?

Why didn't you take a stick and poke the attacking dog/s in the eyes, or ears, or some other vulnerable place? That would have stopped the attack.

Why didn't you run up to the house and grab the axe? Why didn't you hit the attackers with the axe? That would have stopped the attack.

Honestly, even if I had the presence of mind to think of those things during the attack, I do not think I could have maimed or hurt the attackers. I didn't want the dogs hurt, I just wanted the attack to stop. I couldn't have killed, or maimed them, anymore than I could permanently harm a human. When I was hitting them, and throwing rocks at them I was trying to stun them, or distract them so they let go of the puppy.

Yet beyond the initial playback of the attack, over and over in my mind, is the feeling and playback of criticisms in my head that I did not do enough to protect and help the puppy; that as a caregiver I did not live up to my responsibilities to protect my sister's children and her dogs.

Some of it was my fear. The dogs were huge and powerful Husky/Akita/Wolf cross dogs weighing appox. 150 lbs each. Also, the fence where the attack was taking place was short...only 4 feet tall. The dogs were almost as tall. I was scared they would jump the fence and attack me, or grab me if I tried to go into their yard and haul them off the puppy. My first thought should have been to protect the ones in my care. I should have done more.

I think the thoughts keep coming, because in my life I never have been afraid of dogs. I always felt I would be in charge if a dog became vicious. I had been around large police dogs my whole life. There was a sense of complete panic and helplessness during the attack that I cannot get over. It has affected my sense that I have the ability to protect my puppy. I love him so much I feel terror that I might lose him because of a mistake I might make.

What if my Depression Is Related to Physical Brain Trauma or Illness?

I am scheduled to undergo a C.A.T. scan of my brain(?) head(?) this Wednesday. I am having some strange problems along with my depression that are worrying me. I am concerned that concussions and head traumas I endured earlier in life may be responsible for both my ongoing, refractory depression and my recent concerns. Here is what I am experiencing:

1) Extreme word retrieval problems. Throughout the day, and almost every time I talk with someone I will go to say something and I cannot find the word or the thing. It is always a simple words I cannot find.

For example, in my session three weeks ago I was describing my learning blues guitar techniques and then how the teacher and I would play together, each listening to the other and making up music that went with the other's playing. There is a word for this. it is simple. As soon as I described it Dr. X. said the word. When I got home it was gone again. After a week of thinking about it it finally came to me a few days ago, and now, for the past 4 days I cannot find the word, even if I try concentrating on the definition for a long period of time. (it is not "accompaniment, or duo, or duet...but something that expresses the making up of the music as you go along...if you think you know the word PLEASE share it with me...it's driving me mad)

2) Confusion/concentration/memory problems.
I feel a sense of being elsewhere (not dissociation) but confused easily by directions, where I am in my car, driving etc. I feel like I cannot stay on task for any length of time, my mind is constantly wandering from thing to thing. I put things down and can't find them a few minutes later. I walk into a room and cannot remember why I am there. I am putting things in strange places. The other day I was looking for the disinfectant wipes I keep on the kitchen counter. I had just used them. I looked everywhere; cupboards, bathroom, other room in the house..then 2 hours later I found them in the fridge of all places.

3) Saying strange things/speaking strangely.
Examples:

• My husband asked me why I wasn't watching T.V. I wanted to say "It's a commercial", instead what came out of my mouth was "It's a nude"...it was disconcerting.
• Then that same day I tried to say something and I started to speak, but it came out as a stutter. I couldn't get it out. I've never stuttered before in my life.
• Then last night I went to say "Turn it down" (the T.V.), but what came out was "make it soft."...which is sort of similar, but not what I meant to say....it's like my brain is shuffling my words.

4) I am tripping and falling and bumping into things much more than usual.

I have fallen and hurt myself 3 times in the past two weeks, before that I almost fell through our front window and about a month and a half ago I fell all the way down my sister's staircase. I am tripping all the time.

On Thursday I told Dr. X about all the head injuries I have had. I am pretty sure I told him before, but he said I hadn't. I have had two confirmed concussions (once at 5 or 6) when I fell from a 12 step stair landing headfirst onto the pavement below, and then at 17 when I was in a really bad car accident.

Over and above that I have had to have stitches due to head injuries twice, once at 16 when I dove into the pool and hit my head on the lifeguard chair's diving ramp and the other when I fell headfirst off my bicycle. I hit my head on the side of the pool in a diving accident. I fell at the pool at the top of the water slide and knocked myself out for a few seconds; I incurred a compression fracture in my spine in that fall, I was bucked of a horse into the hole we had dug to build our new house, again landing head and arm first...and the last one I remember was rollerblading for the first time (and of course being an idiot with no helmet...my feet went straight out from under me and I landed back of head first on the pavement. I ha a massive egg shaped swelling where I landed.

Anyways, I started thinking, what if my depression is caused by an undiagnosed brain injury. Does medication help if it is a brain injury that leads to mood disorders? (I know that can happen because the girl I was in the car accident with had severe mood changes and personality changes following the accident). I also am worried the problems I am having might indicate an illness above and beyond my depression.

M.I.A.

Literally! I have been so active...I have been missing IN action. My mood seems to have lifted to the point that on Sunday I would say it was the first day in 6.5 years that I felt "Well" most of the day...not too high, not to low, no anxiety, cheerful, bubbly and vivacious even around strangers, confident in my self image; basically my well self.

I say almost well because the last few days have been like that too, but at about 4pm everyday I am so burnt out I feel sick and have to sleep for 2-2.5 hours. Then after about 1/2 an hour awake I feel a bit refreshed again, but evenings I feel really low key and fatigued.

I have had such an interesting week. I went to a mental health conference on Thursday that was one of the most interesting conference I have ever been to. There were three key speakers:

• Dr. Steve Onken (a social worker from Hawaii)
• Dr. Maggie Bennington-Davis is a psychiatrist and medical director of Cascadia Behavioral Healthcare, Portland, Oregon (USA)
• Amy Long (both a person with a mental illness and a psychiatric nurse)

I won't try to encapsulate their ideas, but I would like to share a few key things I am going to change, either in my beliefs, or my actions as a result of the conference. I made them into "I will" statements. Here I go:

(based on Steve's talk):

1. As I become the ancestor, I will be remembered for my voice, not my silence. This is based on an old Hawaiian saying ("As we become the ancestors, we will be remembered for our voice, not our silence). As of this moment I am "outing" myself as a person with a mental illness. I will not be afraid. My voice is powerful and I am going to use it.

2. I will speak up an challenge any "microagressions" I see in the Mental Health Care community. Microaggressions were described as subtle and not so subtle ways, through words, or social structures and concepts, that mental health staff distance themselves from the shared humanity of people with mental illnesses. An example would be "staff only" signs on washrooms (like we don't want clean washrooms too).

(based on Maggie's talk):

Her talk about how the brain changes in response to trauma and later "re-traumatization" was fascinating. I will try to capture the essence of her talk...please remember I may get some of the details wrong as I am no neuroscientist oir psychiatrist, but this is what I think I "heard":

She spoke of three areas of the brain that "manage" experiences. The amygdala, which is like a primitive responder to sensory information. It chooses, without benefit of rational thought, whether to Fight, Flight, or Freeze (FFF). Most regular daily sensory encounters go through the amygdala and then into the hippocampus, which acts as a filing system, and then your prefrontal cortex gets the information and decides what to do with the information.

When we encounter a traumatic experience, or traumatic sensory input, we skip the hippocampus/prefrontal cortex experience and go directly into FFF mode("Hypervigilance, Action, not thought, Cognitive diminishment, increased aggression, loss of impulse control, speechless terror") Bloom 2001.

The next time we encounter something similar, or the same traumatic sensory input, we become "re-traumatized". Over time it might happen than seemingly subtle "re-traumatization, can cause huge FFF responses( "traumatic Re-enactment, Chronic aggression, Dissociation, Chronic hyperarousal which interferes with cognitive clarity {and} loss of (or failure to develop)affect modulation" Bloom 2001.

Part of the problem seems to be that the more we are re-traumatized, the more our hippocampus and prefrontal lobes diminish in size, so not only are we on myper alert mode because our amygdala is working overtime, we are slowly losing the capacity to add reason to our reaction in these situations.

She was not talking about PTSD, but of other kinds of trauma. My personal trauma that I kept thinking of as she talked was about the way my Dad could be when I was growing up, and sometimes even now. He was extremely dismissive of anything I ever did. I wanted so badly for him to like me and to be proud of me, but he always pushed me away. He also had the capacity to become enraged out of the blue. He became extraordinarily intimidating and scary to a little girl (he was a policeman and he KNEW exactly how to scare the crap out of people to make them do what he wanted), he also sometimes became violent towards me in these rages.

To this day, any experience I have with anyone in a position of power or authority is coloured by my childhood experience. It takes very little to make me cry or cower, or feel abandoned or dismissed or rejected.

This is what I was conceptualizing as "re-traumatizations: A man coming towards me quickly and me fleeing in terror, A boss saying something negative about me and me being flooded with memories and tears, just like my Dad is standing over me berating me, A person stabbing their finger in the air and I am back as a little girl with my dad stabbing my chest with his finger, pushing me backwards, scaring the hell out of me.

Maggie suggested when these re-traumatizations occur that we try to use "cognitive wedges" to eventually retrain the brain's capacity to be "re-traumatized". Eventually if we are able to do this enough, the hipocammpus and prefrontal areas of the brain will begin to grow again. Those areas will become more in control of what used to be FFF reactions to external "re-trauma"

3. I will practice using cognitive wedges whenever I encounter a situation that feels like it is a re-traumatizing situation. A cognitive wedge requires that when the re-traumatization sequence begins we IMMEDIATELY start doing some task, any task, that requires you to use the cognitive areas of your brain. Examples she gave me was go into the washroom and try brushing your teeth with your wrong hand, or try reading some difficult passage, or write with your wrong hand...anything that takes the brain away from the amygdala reaction and to a prefrontal reaction.

4. I will be careful that as an instructor I do not do anything that may re- traumatize someone. In order to not re-traumatize myself if/when I make a mistake I will forgive myself and ensure the the mistake leads to a change for the next time a similar situation happens.

(Based on Amy Longs Talk):

5. I will remember that if I am alive, I am coping. I never got this before. I remember Dr. Shock replied " I am glad to see you are coping!) to one of my posts I wrote when I was really feeling close to the edge. I didn't understand what he meant. I do now. Thanks.

6. I will never ever use the word "recovery". I will instead say I am "developing my resiliency". Whenever I here the word "recovery to do with mental health I feel like I am failing, because I never seem to recover. If I do feel better I always seem to crash shortly thereafter. I feel like I am not doing what everyone else does when I fail to recover. I think developing my resiliency, so I am able to fight the depression better each time it shows its grotesque self to me is a better description of how I am working towards feeling better over time. I may never recover from this battle, but I can always add more solid layers of resiliency to my suit of armour

Anyways...it was all very stimulating and interesting. I learned a great deal at this conference. The really cool thing was that after each speaker they had a panel of three people (different people for each panel member) responding to the speakers speech. Each panel included a mental health care professional, a person with a mental illness, and a family member of a person with a mental illness. I learned as much from them as I did from the speakers. Whoever organized the event did a great job.

...aqua

A Switched Flipped Yesterday and...

A switched flipped yesterday and my mood lifted. Well, in fact, I will retract that statement.

"I flipped a switch and my mood lifted"

I take responsibility for lifting my mood...and Dr. X. if you are reading this sit down:
I joined a guitar class and seriously played my guitar for the first time in years!

And guess what...it made me feel so good. The experience was mostly extremely pleasurable. And then...we played again this morning! And guess what else...though I woke up today exhausted, the music and the inspiration of other's music, and the safe camaraderie in the drop in session this a.m. was again soul enhancing.

Dr. X. will understand how hard this was for me. Years ago, when I was in my early twenties, I hung out with a large group of people. Before and during part of second year University I was dating one of them. Music was my life.

From the time I was young I played ukulele(no lie), the guitar and drums. I listened to all the music I could get my hands on. In my late teens and early twenties I went to see live bands every week, all the time. This was when the grunge movement beginning and was getting big on the Westcoast and I was enthralled by the energy of the music.

A couple girlfriends and I started a band. We had a practice space and practised all the time. It was so fun to sing and make music. Then I started university.

I became overwhelmed by the academics, partly because I was having to work to support myself, partly because I was trying to keep up with my friends outside university and partly because I hadn't been in school for a while and really was not prepared for how much pressure there was. I slipped into an extremely severe depression. As I became depressed my boyfriend cheated on me (on purpose) knowing I would dump him. He told me I was too depressed to be around.

This did two things. It set me into an even more severe depression and it made me lose contact with all my friends. All my friends were mutual friends with him. So along with the relationship ending, all , but one of my friendships ended, our band ended and I stopped going to listen to bands. I also put down my guitar. It was too painful a reminder of so much loss. I became even more depressed and sought help, which helped with the depression, but never helped me pick up my guitar and play again. I literally didn't play it again for years.

Dr. X has tried to get me to play, because he knows music creates a sense of joy in me. I made a couple weak attempts to try, but it just brought back too many sad feelings.

In the impromptu lessons yesterday (that we planned at the Art Clubhouse on Monday) I almost cried numerous times when I was playing. I have so many feelings of loss and abandonment tied up in my guitar. I was terrified I would be so bad and I would embarrass myself. I did embarrass myself, because almost twenty years away from an instrument does not a good guitar player make, but I survived the embarrassment. Dr. X. has tried to help me so many times to allow myself to be embarrassed and live through it. He has advised me to take a behavioural approach to my embarrasment. The more I let myself get through those moments, hopefully the more I will learn to feel less embarrassed.

While I played my guitar in the lesson I almost cried from fear, shame, and embarrassment, but I kept trying and I received so much encouragement. A group of us are planning to meet for lessons and jam session every week.

I am so glad I took that step to force myself to try to play again, despite all my fears and all the bad memories attached to that guitar. It felt like yesterday and today were an attempt to create good memories with the guitar. That is a huge step in the right direction. I can tell it helped me, because my mood lifted during the first guitar session continued to lift today despite being exhausted this morning. After I started playing the guitar at the studio it was like I woke up. I began to joyfully make up lyrics and sing out loud and strong along to the blues riffs we are learning. I love music.