Fatigue and Depression

How can I love my nieces so much, yet feel relief that they have gone home? I am exhausted. I feel physically sick and I am so tired. It is not a sleepy tired, but a feeling like my whole body can hardly move. I'm shuffling my feet an just sitting here staring off into space: wasted.

Fatigue and exhaustion are a huge part of my depressive symptoms. I can be up, really up if I have to be; like with my nieces, but the cost is huge. As soon as the occasion for which I need to be strong, up and projecting a happy me is over I feel almost like I am going to collapse.

I was severely depressed (as part of this MDE) for the two years before I left work. I worked as a facilitator/teacher/program development specialist for a large corporation. My job was high paced, challenging and full of social contact via courses, classes, management training, management of a training team etc.

I would cry all the way to work, stand at the crosswalk thinking intensely about stepping in front of the oncoming bus, visualize myself hanging myself in the handicapped washroom; and then step into my work building and be "on", bright, happy, outgoing, welcoming, caring, kind etc, etc. towards every single person I met.

When I left for the night I could barely open the door to leave the building. I was that exhausted. I would get in my car and speed as fast as I could, praying my car would lose control and I would die. I would get home and hit my head over and over and over. I was so angry with myself for being unable to extricate myself from a job that, while I was that depressed, was literally going to kill me.

I still have the same patterns. I cannot help but make myself into the "happy" person I believe others need me to be when I am around them. The trouble is it takes so much energy to be that person that when I leave the scenario/person to go home I want to throw up I feel so tired.

I think what I do is called a "reactive mood". From what I understand it, and the fatigue, are markers of a subtype of depression called "Atypical Depression", along with other symptoms I have like eating more and gaining weight when depressed (vs. the person who stops eating when depressed) and wanting to sleep much more.

Fatigue was the reason I sought help from my family doctor. It is always the first thing that happens when a depressive episode sets in; and that, and a decrease in eating are the first things to go when the MDE begins to wane.

Despite my medications lifting my mood enough for me to manage a bit better, the side effects of the medicines are keeping me fatigued. I also am still having huge problems with mood lability and the "reactive mood--->fatigue" cycle.

My nieces are so beautiful and soul enhancing, but I made the right decision to not have children. You would not believe how much I love and adore my nieces. However, if I had to take care of children 24/7 I am certain I would die of exhaustion. I also made the decision to not have children because my family has multiple people in it who have bipolar disorder, or major depression, or anxiety/panic problems. I seem to be a mixture of all three and I just could not bear passing these on to another human being.

I am certainly not saying people with mental illnesses should not have children. I marvel at the love and attention many of my friends with these illnesses are able to provide their kids. I am just saying for me, I could not manage that responsibility, no matter how much I loved my kids. I can barely take care of myself much of the time.

My Lovely Munchkins

I have these 4 beautiful munchkins (AKA neices) staying with me for 5 days so I will be off showing them the city and enjoying their company. We are going to the folk festival and Science World, and swimming, ad to Grouse Mountain....so I probably won't have time to write here until they have gone home...wish me luck! I might need it;>)

Metaphors that have helped me Cope with Suicidal Thoughts

Recently, I have had numerous (different) people Google my blog over the past couple weeks by the search words "I want to die", or "I wish I would die", "I want to die, help me". I have those feelings and thoughts a lot of the time.

I worry for the people who are looking for help so I will share a few bits of wisdom my pdoc has shared with me. This is not a preachy post, or a post telling anyone to do anything other than that which they choose. This post is just me expressing some things that have helped me. Maybe they can help you too.

In my experience, once I get through the obsessive suicidal thoughts, either by talking openly with my pdoc about them, or by wrapping myself in a blanket and hanging on for dear life, the power of the feelings over me usually fades. I cannot say the feelings ever really go away, but I try hard to survive them.

I was just reading something my pdoc wrote about how he likes to use metaphors in his practice to help his patients. He does, and his metaphors stick with me. With his use of metaphors and similes he is really good at making something insurmountable seem possible. I have shared some of these before, but I'd like to share them all together:

1) Think of yourself being on a well built, strong and sturdy ship. The wind and the waves are trying to force the ship off course. They are howling and waves are sweeping over the bow. These external forces are trying to sink the ship, to drown you. During these times it is your job to hold onto the rudder and steer. You can't stop the wind and waves, but you have some control over where the ship goes. (I almost always think of this when my depression is threatening to kill me with suicidal thoughts. It is all I can do sometimes to hang on, but I do)

2) I often feel like I am making no progress, like I am doing the same behaviours over and over and over. Like my cycling mood keeps repeating and repeating itself. Dr. X. used the metaphor of a piece of classical music (or any music really). As the movements progress there is repetition, but each time it repeats there are subtle, sometimes barely recognizable changes, until finally the piece reaches it's crescendo and the repetition becomes a glorious change.

I really like this metaphor. To think of my life as a piece of slowly changing music is a beautiful thing. If I look at my diaries from 2001 I have made enormous changes, but if you asked me on any given day I might say I will never change. My perspective is skewed while I'm in the middle of a depressive episode. I cannot see that the many subtle changes become huge change over time.

3) "Be like a tree". In this simile Dr. X. explained to me that there is nothing within the tree that sucks the life sustaining moisture out of the ground and up into every tip of every branch. He said it is the presence of an external pressure that lifts water to each of the trees branches: Evaporation. Evaporation lifts the water out of the ground and up through the tree.

He tells me this so I recognize that we all need external help to keep going sometimes. Modern psychology seems to tell us we should all be able to stand on our own, that the push to succeed, or to become well ,must come from inside ourselves. I don't think this is true. Neither does Dr. X. We are born into society as social animals. We rely on social networks and others to help us do some of the things we do.

In this simile he is helping me recognize that asking for help is not a bad thing, but an ordinary act of an ordinary person. Maybe it means I need a personal trainer to help me get to the gym, or maybe the regular appointments I keep with Dr. X. are there to help keep me on track. Maybe by scheduling myself to do things at a specific time everyday I am provided with enough of an external structure to both get me going and keep me going.

External structure and external support systems, like a set coffee time with a friend, or volunteering responsibilities, or a daily time set aside to meditate, or go for a walk, might be like the evaporation helping the tree. External structure and a small amount of external pressure might help us regain and sustain activity and maintain our growth.

The I Need a Little More Levity Meme

I have been having a rough time...so I am going to try to make myself laugh and/or think happy or silly thoughts and remember strange or bizarre times that made me go "huh? I'm making up my own Meme (Where does that word come from anyways??? I always thought it was an anthropological term for symbols used in cultures...Note to self: must look up).

Please...If you decide to do the meme let me know so I can peek on your blog.
hopefully I wll find out more about a few of my fellow/fella bloggers AND make them laugh along the way...Here I go:

My Levity Meme:

1) What is the strangest thing someone has ever said to you?
I walked out of a really sad pdoc appointment into the sunshine. A man approached me and with the sun behind him I could not see his features, but he looked like those iconic paintings of jesus, with the glow of light around his head. He looked directly at me and said: "God says everything will be allright" and then he disappeared. I started to cry, it felt intensely spiritual.

2) If your friends had to describe you what would they say?
I have a kind heart, but it is easily broken. I laugh easily, but cry easily too. I want so much to love, but am afraid to trust. I care so deeply, yet feel so alone. I am loyal.

3) Name 5 of the stupidest things you have ever done. (This should be easy for me)

1) Run across the ice at a charity Curling event. While doing so clipped the foot holds, managed to catch my balance, but was going so fast I hurdled towards the lane dividers, tripped and broke both my elbows on the ice
2) At University was invited to become an honours student in Sociology and declined. I was more interested in Philosophy. To this day I wonder if I had chosen Sociology would I have gone on to become an academic, something I always wanted?
3) Try on a pair of leather pants in high school. I was really skinny, but not skinny enough, and when I bent down to pick up my shirt my kneecap had nowhere to go but sideways. I tore all the ligaments in my knee...it was agonizing and embarrassing as when I was trying to get an ambulance the store clerk kept yelling that I was not leaving with those pants on (WTF?) I couldn't get my knee back in its socket.
4) When I was a naive 18 I got in a car with a stranger who offered me a ride home from the pub. He was an older man, and seemed trustworthy. He dropped my friend off and then proceeded out of town to the top of the mountain where I lived. In the middle of nowhere he pulled the car over and asked me what I would do if he raped me. I was terrified, but scared the crap out of him when I told him in gruesome details exactly how, if he hurt me, I would ensure he never was able to do that to anyone again.
5) Smoked a joint in high school at noon hour (well maybe more than one), started literally hallucinating in my french class. Went out into the hall and the walls were coming down on me. I slipped and broke my leg really badly when I was freaking out in the bathroom. Note to self: Pot is not good for me...I'm not saying its not okay for others, but I seem to have the opposite reaction than everyone I know)

4) What was the first thing you heard this morning?
This is funny: "Want a lollipop?" (My husband as he rolled over and asked for a ...(well you know). (blush;>)

5) When you were a kid, what was your "ideal" day? Get on my bike early in the morning, take off with my friends for a hike into the forest for a picnic and then go to the swimming pool from 1-4 and swim in the sunshine all day, go home for dinner and then head back to the pool for swim team practice.

6) What was the best concert you ever saw?
"Butthole Surfers", with "Jane's Addiction" as the opening act. I'd never even heard of Jane's Addiction. They were so amazing. The more fun I had, the more I began to drink. The alcohol fueled the wild woman in me (what some pdoc's have told me is manic). I became wild and started making out with the stranger behind me, everything seemed so surreal and perfect. Then I got a beer bottle broken over my head by some rowdy out of control drunk (hey at least I'm into love when I'm drunk)...and I never even noticed I was having such a good time.

7) If you could have decided to be anyone in the world (living or deceased), who would you have choosen to be?
This is hard. I was thinking Ghandi, or the Dali Lama, but more than anything I would want to consistently be ME...but the well me. The me who believes she can do anything. The me who is afraid of nothing, who in fact loves to take risks. The me who loves a challenge and gets excited by new things. The me who loves people and feels loved and cared for by others.

8) Sex? or Chocolate?
How about sex with choclate on top?

9) What is the strangest/most bizarre thing you have ever seen? When I was a kid I had a really wild imagination. I was reading "Amityville Horror" and had just got to the part where the house shuts of all the sounds of all these murders taking place in the house; makes it so no one outside can hear the screams coming from the house.

I went to bed and put the book outside the backdoor (in my mind all horror books had to leave the house at night...don't ask...an OCD thing). I closed my eyes to go to sleep and when I opened them I saw Satan on my ceiling: clear as day.

I began to scream and scream to my mom and dad for help (they were in the bedroom above mine), but as loud as I was screaming, no one came to help me for what seemed like forever. I thought my room had shut my screams out like the house in the book I was reading. Suddenly my Dad appeared and was screaming: "What the hell is going on in here?" Satan disappeared and I've never seen him since.

I was obsessed with God/Satan, Heaven/Hell as a kid and wouldn't sleep most nights because I worried so much about what I had done wrong. My family wasn't very religious, so I am not sure why I was so crazy insane about it...anyways I probably imagined the whole thing, but to his day I vividly remember SEEING Satan...not just imagining him.

10) If you were the first to meet a friendly alien what would you tell them about our planet and its inhabitants?
Run for your lives! You don't have a hope in hell of surviving here. We are all about to destroy ourselves. Maybe come back when we are gone.

Outside the Circle

I went to a big party on Thursday. First, I hate big gatherings. Something about them always send me into a dissociative state. Actually I know exactly what it is about them that sends me both metaphorically, and in my mind, literally, out of the room during these occasions: Social Anxiety.

If you met me one on one, in person, your first reaction would be that I am outgoing and social, you may even find me interesting, because I keep up on day to day issues, am well read, educated, talkative, a good conversationalist, caring, kind and interested in your stories. You would believe I had the ability to talk to anyone, because I am usually really good at projecting that persona and, to tell you the truth, I usually can talk to anyone for brief periods of time.

I say usually, because often I approach a social gathering and I feel like I am not really there. It feels like I am sitting on the outside looking in. At these times, even when I am talking to someone I get the impression that the conversation could be carried on without me, and that others are being dismissive, or rejecting me, or that I am brutally uninteresting and my conversation skills have disappeared.

At the party the other day the whole time I felt like an outsider looking in. Some of it may have been the people at the party, but most of it was me. It was a birthday party for one of our friends, who happens to be one of the wealthiest people in this city. His house is a 13000 (yes thousand) square foot heritage home on an acre and a half lot in the exclusive area of the city. Our friends are beautiful people. They are involved in tons of charitable work and do so much for so many organizations here. I really care for them and when I am at there house for a small dinner party I always enjoy their company.

Thursday was different. The guest list was filled with some of the most elite, powerful and wealthiest people in the city. And there I was, no job, no money and a chronic mental illness; feeling like the prospects for my future were slim. It is not the lack of money that made me feel like an outsider, but the lack of a life that felt worthy of being there.

I tried to make conversations with numerous people, and of course the first question out of people's mouths is always, "what do you do"? I decided before the party that I was going to say I taught art classes, which is sort of true. I do volunteer to do that 3 hours a week.

So a party goer would start talking to me, ask me what I did. I would say I teach drawing classes. They would then ask where. I was stupidly unprepared for this question, but impulsively decided to tell the truth. "I teach art at a clubhouse for people with mental illnesses". I may as well have said I have a mental illness. The conversations became stilted and always ended abruptly.

One person asked me where I taught classes and I told them. They said "oh I do work for the Boys and Girls club in that area. I asked him what kind of work he did for the club. He looked at me like I was out of my mind to not know who he was and haughtily said, "I don't WORK there, I am on the board of Directors". He then promptly turned away from me and began talking to someone else. After sitting there staring at their backs while they exclude me from their conversation I finally got up and left the area. I felt like a pariah.

So I spent the rest of the party sitting by myself, having anxiety attacks and just waiting until it felt like I had put in a reasonable amount of "face" time. At 10:00 I excused myself, thanked the hosts and got in my car. I burst out into tears. All I ever want is to feel accepted for who I am.

I can't tell you how many times at that party I just got up and went and sat in the bathroom to get away from the feeling that I was a complete outsider; to feel some relief from an intense, shameful shyness and sensitivity that was making it impossible to interact. The more scared and alone I felt, the more I began having dissociation and feelings of depersonalization.

I am Blessed

All I have to say today is that I have the best psychiatrist on this whole planet He is absolutely unbelieveably consistently supportive. He is so important to me, and it is clear he cares so much for me. I honestly cannot imagine meeting a pdoc I feel more confident in, trust and care for more than Dr. X. Something cosmicly perfect was in the air the day he and I met. We were meant to be patient and doctor. Our session today was heartbreaking, but soul defining.

A Life Not Worth Living

I don't know about all the medications I am on. I feel like stopping everything and seeing what I'm like for "real". I do not see the medications consistently helping me. I felt a surge of okay to good mood for the first while on Prozac, but for the last couple months my mood has been all over the map...up, down, really down, down even farther and up again.

I would have to say my mood overall (in the last 3-4 months) is better than it was before the Prozac and Valium and Tegretol and Dexedrine, but is It good? No way. It is not good. It is still mostly very, very bad.

I do not think of suicide almost everday like I did before, but I still have days and sometimes more where I think suicide is the only choice. Where I dream about how to do it, how to make my life finally end.

I still feel hopeless much of the time. I am so tired I am finding it almost impossible most days to get going. By that I mean the basics like having a shower, brushing my hair, getting dressed in anything other than sweatpants, leaving the house, painting, doing the dishes, cooking, cleaning, do my volunteer work(come on now...it's less than 6 hours a week. How hard can that be? Anything beyond laying in bed, or surfing the internet seems like an impossibly difficult chore.

It is 3:54 and all I have I managed to do today is to get out of bed at 9:00, shower without washing my hair and get dressed at noon, play my guitar for 15 minutes and sit at the computer waiting for 4:00pm when I feel it is a reasonable time to have a nap.

I will nap until 6 or 7pm, not be able to cook dinner, but maybe manage to make myself a fruit/yougurt smoothie, watch t.v. for a couple hours and then feel like it's okay to go to bed and then it will all begin again tomorrow.

This is not a life worth living. This is waiting to die; waiting for it all to be over, waiting for an end to this search and struggle for purpose and meaning in a body that cannot find the will, the power, or the energy to create or develop that purpose and meaning.

In retrospect: Please read this

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.

My BRAND NEW car!!!

This may appear to have nothing to do with my depression, but it is closely linked to my becoming more resilient. My new car symbolizes an increased desire to live. That may not make sense to anyone, but here's why I say that.

I have needed a new, or at least newer car, since I began seeing Dr. X. more than 6.5 years ago. The car I had was a 1986 car and always having problems. When my mom passed away Dr. X. and I discussed my getting a new/newer car. I refused as spending that amount of money, when I didn't think I was going to live much longer, did not make any sense to me. I did not want to spend money on a car when I could leave it to my husband instead. I did not want to live, and did not see myself in the future. Dr. X. and discussed this numerous times over the past couple years. He understood how symbolic a gesture it would be for me to buy a car.

On top of my not seeing myself existing in the future, I had intense panic and anxiety about going to the dealership, test driving cars, dealing with salesmen etc. Just thinking about trying to do that felt like an impossible task. These fears revolved around my difficulties dealing with men, anyone I saw as an "authority" figure, my fears of embarrassment and a million other fears. I would try to walk onto the car lot and then I would have to leave because I couldn't breathe, or felt like I was going to pass out with fear.

A month and a bit ago my sister came over and she helped me go look at cars and test drive a couple. It was easier with her there. She understood my fear and we had a plan to deal with the salespeople as a team, so I felt safer, protected, supported. I was inching my way towards getting a new car.

To push me a little closer towards a purchase I was about to lose access to the vehicle I was driving. For the past two years I had been borrowing my husband's truck (and he was driving my old car). Each year cars here are tested for carbon emissions; and this year there was absolutely no way my car was not going to pass aircare without expensive repairs to it's exhaust system. My husband wanted his truck back. We live on a farm and the only way to get off the farm is by car, there is no public transportation out here.

So, about three weeks ago, fueled by my fear I was going to get stuck on the farm forever, and the beauty of a pretty okay day (maybe fueled by a tiny bit more valium to calm be down), in terms of mood and anxiety, I called up the dealership and made arrangements to purchase a new car. It was an act towards deciding I was going to stick around for a while; that the car and the money I spent on it was not going to be wasted because I was going to be here to use that car.

Yesterday I bought and picked up my BRAND NEW car...just 3km on it when I drove it off the lot. I have never owned a new car before. I am very excited and I absolutely love it. Yay me!

What Makes me Canadian...and proud of it

New and Improved Version: I fixed the links that weren't working before...enjoy!

Happy Birthday Canada

A number of years ago, back in university and anthropology professor assigned us an essay topic: How do you define what it is to be Canadian? Today being Canada Day ( this year we celebrate our 141st anniversary of Confederation), I thought I'd tell you 100 things that make me love being a Canadian. (this might be very difficult) (okay I only made it to 71 (bit over half of 141), but still pretty good.

1) Neil Young is Canadian...and he rocks! I love Neil Young.
2) I have lived literally from coast to coast...I've lived in Newfoundland and all the way to Vancouver Island...and everywhere in between.
3) I moved to Banff right out of high school. Banff is surrounded by the Canadian Rockies and is the iconic (albeit tourist related) "Canadian Wilderness".
4) I can tell the difference between a deer, a caribou, and elk and a moose.
5) I can tell the difference between a black bear and a grizzly and know what to do if I encounter either: Try to slowly back away from both. While doing that talk in a calm smooth voice to the bear. Do not make eye contact. Do not throw your back pack away...it will protect your back/neck/head if you need it. If all else fails play dead and protect your back, neck and head. DO NOT RUN...grizzlies have been clocked doing 50 km/hr...you will not outrun a bear.
Preferable tactic: Do not run into bears. Make lots of noise while hiking, bear bells don't work...and may actually increase your chances of being attacked because the sound makes the bears curious.
6) I know the song formerly known as "the Hockey Night in Canada song" Dun, du, dun, du dah; Dun, du, dun, du dah; dun, du, da, da dada..."etc. (you have to be Canadian to get it)
7) I know what it is like to drive across the prairies, and drive, and drive, and drive ad infinitum.

8) I know the word "Eskimo" is not politically correct...It's "Inuit"
9) I went camping almost every summer as a child. My Dad was a "Dogmaster" with the RCMP, which means he was a police dog handler, and had spent many many hours for years tracking lost people, or people who did not want to be found. He taught us to love and respect the wilderness. These times were some of my happiest.
10) I know that the Europeans called the First Nations People "Indians" because when they landed in Canada they thought they had arrived in India...Duh!
11) I can name all 10 provinces and 3 territories (I actually KNOW we have 3 territories).
12) I have been snowshoeing many, many times as a child.
13) Downhill skiing is a favourite winter pastime for many Canadians...and I'm one of them.
14) I actually understand the rules of Hockey, and the point of the game (I can't say that for any other group sport except maybe water polo)
15) I have participated in that great Canadian coming of age game: "Beer chugging"
16) I know it is pronounced Nefeunland, not NEW FOUND LAND.
17) I know what the Common Wealth is.
18) I love the Queen...even though it is a bunch of pomp and pageantry. I think it's a quaint tradition, and I want to continue participating in that pageantry.
19) Gordon Lightfoot is Canadian...who can beat the iconic "The Wreck of the Edmund Fitzgerald as a classic Canadian song. (This video has some great pictures of Canada, its people and the power of the ocean)
20) Joni Mitchell is Canadian. I love Joni Mitchell. I love her song "Big Yellow Taxi" and have been singing it (and can achieve the highs AND lows in the song) and playing it on my guitar for the past few weeks. My Mom used to sing Joni Mitchell's songs to us when we were kids.
22) I know how to survive (and get found) if lost in the woods.
23) Camping is a favourite pass time of mine
24) As is Canoeing
25) I know Canada has more Bald Eagles than the US...Should have been our national symbol
26) Our national symbol is the beaver...almost everyone snickers about that.
27) I have seen the fossils at Drumheller Alberta...a very cool place to visit.
28) Unlike my fellow Ontario countrymen who believe the world revolves around Toronto...I know everyone would rather live in Vancouver...hip, warm, artsy, laid back,tons of beaches, mountains...we have it all.
29) I have seen whirlpools in the ocean big enough to swallow a huge boat.
30) I know what "Skookum" means.
31) I love smoked salmon.
32) I BBQ all year round.
33) I love maple syrup...and use it in everything from salad dressings to marinades and of course on pancakes.
34) I can make a beautiful snow angel.
35) I have seen mosquitoes as big as my hand in Winnipeg, Manitoba (well maybe that's an exaggeration, but they are pretty damn big)
36) I have lived near the Columbia and the Fraser rivers..two of Canada's most famous rivers.
37) I know what the "Great Divide" (or Continental Divide) is. It is a line across Canada where on one side the rivers run towards the Atlantic ocean, and on the other side they run towards the Pacific ocean (no lie)
38) Even though I'm a pacifist, I am proud of our Veterans in World War I and II. My Dad said almost anywhere he went in Europe people spoke fondly of Canadians and their contribution to winning those wars.
39) "Oooh..your Canadian let me help you". Once people in Europe realized I was Canadian and not American..their whole attitude changed; suddenly I became part of the family.
40) I speak "Franglais" a sort of brutalized anglicized version of french. Bonjour Madame parlez-vous English...PLEASE???
41) Despite my difficulties learning French (It is the only course I have ever failed in my entire life...I took it again and passed though). I am glad we have two official languages, and when I've been to Quebec I try really hard to speak French...but I am really bad at it. At least I try.
42) I have built an igloo.
43) I have made and eaten Bannock.
44) I have ice skated on numerous frozen ponds, including one year on the pond on the farm (it is unheard of for it to get cold enough, long enough for that to happen here in Vancouver, but one year it did.
45) I know that what we call a creek in B.C. is actually a "brook" in Newfoundland.
46) I have seen killer whales up close in the wild. They are so beautiful it is indescribable.
47) I love the Vancouver Canucks (even though I'm not a big hockey fan).
48) I know that "football" in Canada is that game where ridiculously huge men bend over a lot and try to do something with a pointed spherical (sort of) shaped ball: A game, the rules of which, only about 100 people in all of Canada understand while the rest pretend to understand.
49) I have been to Magnetic Hill in New Brunswick...it's a road where it seems as though you are going uphill, when really you are going downhill. It has some kind of optical illusion properties so if you park in neutral at the foot of the hill your car actually rolls "uphill".
50) I love lobster
51) I've seen many icebergs off the coast of Newfoundland.
52) I have lived in 5 different Provinces.
53) My father is retired from Canada's iconic police force: the RCMP. He was a member for more than 40 years. Three other family members are , or are retired, from in the RCMP. It is a family tradition
54) I skied in the Canadian Rockies many times as a kid...Jasper, Banff, Lake Louise. Great ski hills.
55) You see nature everywhere, even in the city. I saw a coyote cross 57th and Victoria; a very busy major intersection. He looked like he knew exactly what he was doing too.
56) Blueberries in B.C. are on really tall bushes, where the pickers often need to use step stools to reach the top berries. In Ontario and the Maritimes the blueberry bushes are short and you have to bend over to pick them.
57) In one day I can swim in the ocean, sail, go play golf and drive up to the mountains to go skiing at Whistler/Blackcomb...that's how close this city is to everything.
58) If you like to swim outdoors "Kit's Pool" in Vancouver is the longest pool in Canada...137 Metres, and it is a salt water pool.
59) I actually know the words to our national anthem..." O Canada". A huge number of Canadians have no idea...they changed it in the 1970's and it confused everybody.
60) I know all sorts of names for snow: sleet, slush, powder, crunchy, wet, dry, snowstorm, blizzard...the list goes on.
61) I have been caught in a blizzard before, when I was young, 8 or 9. I thought I was going to die. I couldn't see where I was going and it was minus 40.
62) I lived on a farm in the prairies as a child and we had horses, ducks, chickens, geese (all pets of course). We had to hand carry water down to the barn and it was hell in the wintertime, but I still look back at that period of my life and think it was idyllic.
63) I've shot tin cans off the fence with a rifle when I was a kid (under my Dad's careful supervision of course)
64) Hand guns are illegal in Canada...Hallelujah
65) Speaking of which...k.d.lang is Canadian. Her version of "Hallelujah" is awe inspiring.
66) and on that note: Leonard Cohen (who wrote "Hallelujah") is Canadian too. His poetry and his music is haunting. This you tube video of "Suzanne" has subtitles (dutch maybe?)
67) Robertson Davies was Canadian. His book "The Deptford Trilogy" , made up of three books (Fifth Business, The Manticore and World of Wonders), it is a marvel of a book.
68) Margaret Atwood is another great Canadian Writer.
69) as is Rohinton Mistry (while born in Mumbai, India, he immigrated to Canada in 1975). His book: "A Fine Balance" is one of the best books I have ever read.
70) In Canada we have a public medical system. This means we all have access to the health system. While all you ever hear is the negative news about public health care, I have always had the best care and feel blessed to live in a country that cares for its citizens in this way.
71) and finally...I love that Canada has adopted a multicultural approach to its people and its new immigrants and not a melting pot approach. Existing and new Canadians are encouraged to keep there beliefs, and practice their cultural traditions as opposed to being pushed to assimilate into becoming a typical "Canadian". That is the great thing...there is no such thing as a typical Canadian. This is what makes this country so interesting and continually fascinating.


We all came from different places, different backgrounds; some like our first nations people have lived here for centuries, and some of us may have entered this country today. We are a great and fantastically interesting mix of cultures, religions, and peoples who hold one thing dear to our hearts, our freedom and our democracy...and if you ever watched the Canadian parlimentary channel...you know how much they fight to ensure democracy sticks around.

I love being a Canadian.

(oh yeah...and # 72..."Canadian Girls Kick Ass"

Recurring Nightmare

My latest painting. I have no title yet. It represents a nightmare I have over and over again, where I am being chased through the woods and some kind of post apocolyptic landscape full of broken down buildings and homes, tons of rubble and cement everywhere.

I run, and I run all the while screaming help me, help me! My husband and Dad stand off at the side and watch. No one tries to help me.

Finally, in desperation I climb up onto a big peice of cement to try to save myself, but I fall. The wolf is snarling and on top of me. He is foaming at the mouth and he is about to bite my head or neck and I always wake up at this point absolutely terrified.

When I wake I can't tell if it was a dream, or real. Usually I have to go to the bathroom upon waking, but I am too scared to get out of bed. It usually takes me a couple minutes or more before I calm down, realize it is a dream and am able to climb out of bed.

Getting Rid of Those Labels

Over at the Shrink Rap Blog Dinah has written a very interesting post called "True Emotions".In the post she describes a patient:

"...the patient was floridly manic. I don't remember the details, what I do remember was that she was running on empty, high as a kite, going 99 revolutions per minute, you name the cliche. There was a reason why she was on an inpatient unit and not being seen by an out patient doc. She wasn't getting better and, as is often the case with people suffering from mania, she had no insight that she was ill, she was feeling good-- really good-- and oh so energetic, and even louder than that, and so what's the problem here?

...I'm trying to reason with her, and finally, she screams at me in a way that stays clear long after her name and the details of her life have oozed from my memory, "You're problem is you're not Italian! You don't understand TRUE EMOTION!!" She had a point."

The post is really important for me and probably for other people who are receiving psychiatric treatment. When I read Dinah's post I felt so understood, like I do with my pdoc, but not like I do around other health professionals, or my family, especially my husband. I do it myself too: Dissect every tiny mood change like I'm going to go crazy either too high, or too low. It's hard to get better when I'm constantly worried about "how I AM".

When I read Dinah's post it reminded me of a situation I was part of a number of years ago. I commented the following below Dinah's blog, and I should remember this anytime I worry I might become manic...

" What a great post. Two other pdocs have given me the label "bipolar", but the one I see every week says I have MDD and a hyperthymic temperament. This I believe, but I can't help but worry every time my mood skyrockets. I am so scared I am going to go manic.

Even before someone tried to label me my friends would make fun of the hyper energy I have when I am well; my million ideas, my rapid speech, how loud I get (very loud...because I get so excited with all the ideas), how excited I get, how wild I get.

I almost bought into the labels until I went to my Great Uncle's funeral and met my Grandma's side of the family...every single one of them was like that...So "On" it was absolutely amazing. It was like being in a room with twenty people just like the well me.

We weren't Italian, and certainly, statistically, we cannot all have been manic at the same time: we just are a family of people whose personalities are exuberant, jovial, high, full of ideas, like to do a million projects at once, can fly from one idea to another and understand the connections between all these ideas with ease. Maybe everyone else was just "slow?"

The experience of being surrounded by so many people just like me was breathtaking and eye opening. I recently had the pleasure of meeting three more members from that side of the family; people I had never met before.

At a family wedding this little old lady came up to me and said, you must be "B's" daughter. I just had to meet you (she's talking really loud, and is exuberant, and excited, and very, very talkative). We have to stick together us "Family name".

No one is like us, listen to the din, the room, listen to how loud everyone is, they are excited and energized. We've always been this way. You stay here I have to grab "M" and "R" They are going to fall over when they meet you. They are just like us...and with that this 85-90 year old lady ran off to look for my new found relatives.

They all showed up, along with my uncle, my cousin, and my second cousin. The din was unimaginable. Everyone talking really loud, everyone butting into everyone else's conversations. Ideas flowing like rain pours in a monsoon, and all of us are keeping up with all the conversations. Never a pause to catch our thoughts or to let someone else speak.

Then suddenly we all went silent, looked at each other and burst out laughing. We are all just like Grandma was...it is too bizarre: Loud talkers, so excited about the world and all the things in it, a bit pushy, speaking a mile a minute, and no patience for people on the outside who don't get what is going on.

Almost the entire side of my paternal Grandma's clan have hyperthymic temperaments. When "on" we are more than on, when happy, we are beyond happy. I think that is why I have such a hard time with my depression...because when I am well I feel like I am completely in control of my life, I absolutely love being alive and I think this world is the most amazing place in which to exist. To lose that to depression is beyond devastating.

Stream of Consciousness

Jazz over at "In Pieces" has a great blog where she provides us with a writing prompt each day. Today I was stuck for something to say and her prompt sounds like an interesting exercise:

"Writing Prompt: Set aside twenty minutes or so and do a brain dump. Just write whatever is on your mind no matter how mundane or boring. Even if you have nothing to say, write that. The trick is to just keep your hand moving the pen across the page for twenty minutes. When you have finished, sit in silence for a few moments and ask yourself how you feel. Do you feel more collected? Less scattered? Consider whether or not a morning brain-dump might be a helpful thing to add to your arsenal of wellness tools."

Here goes:

I am really worried about Dr. X. His office called to say he was away sick this week. He is never away, for any reason. He hasn't seemed well the past couple weeks, in fact the past couple months he's seemed a bit distracted. Now I am really worried. Worried he is sick like my Mom was sick. What if he were. I couldn't bear to lose him. How would I deal with that? I know my mind is taking me down that negative road, and for all I know he could just have the flu, but it seems like he has been worried about something lately. I even brought up my attachment to him, and how much he means to me in our sessions a couple times, because I felt something was wrong.

My mood is dropping again. Part of it is that worry about Dr. X and his well being, and part of it is the letter from my insurance company. I now feel like I am being watched (once again). At the bottom of the request for detailed minitue (sp?) of my day and any work or volunteer work I do they are making me sign the form saying I understand all my statements will be investigated and that they will contact the people I volunteer for etc. They don't get it. The more they put the fear of being spied on into me, the more I believe i am being watched, and the more I am afraid to do anything that might indicate to the non-psychiatrist eye that I am well and ready to return to work.

I am one of those people who is able to put a face on when I have to, so the studio I volunteer at, and even when i was working, my workmates and bosses, never had any idea I was sick. I can hide behind a type of false boisterousness for short periods of time, but the price I pay is exhaustion and an intense need to be alone. I believe I am working really hard at getting well, but I know I am no where near well. I need more "safe" time more time to slowly build my stamina. 5-6 hours a week volunteering in a supportive environment, where I can call in sick anytime I need to, where I have complete backup, in no way resembles a fast paced and highly stressful workplace where I am in fear of losing my job all the time.

Last week I wanted to commit suicide so badly. It isn't even that I feel as bad as I did before. I just feel like I will never get WELL...the capitals are intentional and represent the well that is me when I feel empowered, completely not depressed, powerful and excited about life, social and extremely outgoing.

All I want now, even though I feel better than I did, is to hide away at home, not answer the door, keep the curtains closed (so no one can watch me).. I have the means and opportunity to commit suicide. Last week I didn't because all my nieces have birthdays in these two/three weeks. I do not in any way want my death associated with such joyous occasions. I just want to go, and i feel like the time is getting closer and closer.

I wish my family could understand that my going would be a blessing. My pain would end. I do not know if they understand how painful it is to feel depressed all the time. Even I did not "get" what depression really could become until these last 6-7 years. Before I was depressed, but nothing I went through came even close to the length and intensity of this major depressive episode.

I have to teach today. I feel stressed out and angry that i have made that commitment. All I want to do is crawl into bed and stay there. Hide form the world, hide from myself, avoid life...this in itself is a "little death". Maybe if I do this long enough I will disappear.

20 minutes is harder than I thought. I don't know if any of you get what I mean when I see death as an intense relief. I think anyone who has not been depressed has a difficult time getting it. Even my pdoc. I think he gets it on an intellectual level, but I think he believes the desire to die will end with the relief of symptoms. I don't think that is true for me, because for me...I KNOW the symptoms will return, They never go away for ever, and every time they return they are worse. What kind of existence is that. I wish we were allowed to be put to sleep. My biggest fear is surviving suicide. I am so afraid I will miscalculate my plan and end up both severely depressed and lose my brain, or be completely physically trapped in a body that won't work. I would choose euthanasia if it were available.

I still have one more minute. I guess there is an upside to my depression. I met my pdoc and he has enhanced the life I have. I also met lots of people online who have also enhanced my life. I am grateful for that. Thanks for listening.
(20 minutes are up)

I feel exhausted. This might not be a good idea for me when depressed. It was why I stopped writing in my journals...I became too negative and focused on my depression. When well I can see how it might help me get ideas out on paper. Thanks Jazz for the idea.

Meme from HBW (James)

A meme I got from James at Letters from the Sanitarium blog: (I kind of like some memes):

What kind of monster would you be? The funny. friendly kind, that hides under the bed and strikes up conversations with the kids, helps them with their homework, plays goofy games with them, helps them get through the difficulties of childhood, answers all the kids tough questions and then disappears as soon as an adult comes into the room

Do you have a crush on a celebrity of the same sex and if so who? Cate Blanchett...she is really hot mostly because of her intelligence and talent (she's also beautiful in a different sort of way).

What do you collect--if anything? Vases and bras...I live on a flower farm and I love bras; a girl can never have too many vases or too many bras. (maybe the bra thing is a fetish)

Do you have a favorite artist? (Painter. You can name more than one): Egon Schiele, Tom Thompson, Emily Carr, Van Gogh, Diego Valazquez and Dante Gabriel Rossetti.

Do you have a habit and if so what? I hate to say it, but like James I swear like a sailor sometimes (but I can be the perfect lady when I want/need to be), I say "like" far too often...it annoys me so much, but I cannot kick the habit.

Overall, do you prefer the city or being near nature and the outdoors? I like being in the country near the city (how's that for a flip flop answer?) I like the serenity and solitude in the country, but I love the accessibility to culture in the city...art galleries, plays, the symphony etc. I hate all the crowds and traffic though)

If you couldn't live in your current country then what country would be choose to live in? Denmark (I heard on the news the other day it is the happiest country in the world, they have a great social safety net, university is paid for by the country, people are encouraged to do what they love for work, and many people change jobs many times until they find the right one and the state helps people find the job they like, six weeks holidays minimum a year, and people do not struggle to make ends meet because they always have help if they need it)

Would you like to be famous? No...I get too stressed out all the time already. I could not manage the pressure, or the lifestyle.

Are you punctual or always late? Mostly I am early...I am obsessed with time and believe people who are always late think there time is more important than mine. (of course I am late once in a while, and then I get super stressed out about being late)

Where do you find the most peace? In the chair across from my pdoc in his office, in any swimming pool when it is quiet. I feel most at home in the water.

What three foreign languages would you like to learn most (you can choose one or two if you prefer)? French, Spanish, Latin

Would you travel into space if you had the chance? Absolutely!

Speaking of all these questions, what is the question that you hate the most? Why aren't you better yet?

"Ripe"

My latest painting is based on this photo I took of an iris in my garden:

Here is my Painting:

(The painting is actually more purple than blue, not sure why the photo of it looks so blue...maybe blue is my destiny:>(

Hell Disguised as a Blessing

There is something to the Bible's old testament story of the beguiling snake coaxing Eve to eat the from the fruit of the tree of knowledge in spite of her love for her freedom in the garden of Eden.

I feel like Eve after she has eaten the apple whenever I receive a letter or inquiry from my disability insurance company; Naked, overexposed and afraid I will be cut off from receiving support while I try to get better.

My mood has dropped immensely over the past two weeks. I cried on my way to my appointment today. I cried much of my appointment today, and most of the way home.

To top off a bad morning, when I got home, I found a letter in my mailbox from my insurance company wanting to know EXACTLY how I was, WHAT I had been doing and for how long, what I as able to do, who I see, if I am volunteering or working, at what and for how long, what I participate in, and sign the note at the bottom saying we can have access to all your doctors notes, thank you very much (my paraphrasing of the received letter).

This letter put the fear of God into me (only God is spelled "losing money to support myself before I am well enough to do so on my own").

How do I fill this form in? I am so conflicted because my mood is so unpredictable. If you had asked me 3 or 4 weeks ago I would have been positive I was getting better, last week not so sure and this week, back to square one.

I volunteer 5-6 hours a week (2.5-3) I teach beginner's drawing, the other I show up on a specified day and help people in the painting studio if they need help (often I just show up and do my own art and no one needs my helps, but I am there if they need me.

So I struggle. I think to myself, "well, if I can teach an art class, why can't I go back and teach a banking class? what's the difference? And I am really afraid that is how the insurance company thinks?

The problem is at the Art Clubhouse I put my best face forward (just like I did at work) and I am professional and outgoing, and reliable...no matter how I feel inside, because I feel that way is my responsibility. At work I never let my illness impact my work until the end when I was so sick I couldn't do anything but stare at my computer screen. Even then, because I was so reliable for so long, my boss never even noticed me crashing and burning.

What the Occupational Therapists and staff at the Art Clubhouse don't see is that spend all morning trying to get to the studio by 1:00pm and when I leave and get home at 4pm I am so exhausted I sleep until 6 and sometimes 7 or 7:30pm. I do this everyday, even if I've done nothing all day. I feel so exhausted I feel sick.

I cannot manage to clean my house. I have not been cooking anything other than pre-made dinners, or smoothies, or eating cereal except maybe once a week or even less, when I somehow find the energy to make dinner. Even when my mood was really good I could not get these things done.

I am worried that the insurance people will translate my being able to volunteer 5-6 hrs a week, and take a guitar class, and paint sometimes as a sign that I am well enough to return to work. I know I am not. I know I can only do those things at the studio because of the type of supportive and safe setting it is. I know I can only manage that volunteering because I know that when I get sick (which I always do) I have the option of backing off on any commitments.

Anyways, I feel sick about having to fill out this form. I don't even know where to begin when some days I soar, and others I want to stay in bed all day. This past two weeks I am nosediving into the latter scenario.

I wish I had not accepted the fruit from the poisonous tree. It ties me down, frightens me, limits my ability to try new things and makes me feel like I am doing something wrong by volunteering, makes me feel guilty for accepting money while I am not working. I am constantly worried I will lose my insurance before I become well enough to work again and take care of myself.

I wish I had been able to quit my job when I became ill. I wish I had not needed to rely on a bureaucratic organization, one that scares the crap out of me, to survive.

Clarification About my Recent Benzodiazepines Post

I received interesting comments from my last post (thanks everyone who responded to it). I think though that I may need to clarify what the post was about.

It was not about my difficulty coming off Valium, or my dependence on Valium, or any kind of desire to come off psychiatric medications. Rather, it was about the stigma I feel and the corresponding pressure I feel about being on medications that some people feel are too addictive and dependency creating to, as a pdoc, prescribe or, as a psychiatric patient, take.

It was also about the struggle I have in therapy to be independent and autonomous, yet needing to have my pdoc say; that may not be a good idea when that needs to be clear. Dr. X's supports our having an ongoing, autonomous Dr/patient relationship. I need that. I have many, many problems with autonomy, and independence and dependence; especially where men are concerned and even more so if that man is perceived as an authority figure by me.

I stated in my last post: "So, in keeping with not wanting to be addicted, and not wanting to be a drug seeker, also, because I was afraid the Valium was masking my possible TD mouth movements, three weeks ago I decided I should try to get off Valium."

Dr. X. never once has said I was addicted, or a drug seeker, nor has he ever even hinted at it. He has explained that taking these medications is like borrowing money from the bank; there is always a price to pay.

That price being dependency if I continue taking them, which may result in my needing more medication for the anxiety as time goes on. At which point there has to be a balance between our increasing the dosage to help my anxiety remain stable, and our looking at the side effects an increase in dosage might bring (i.e. memory problems, balance problems, attention or concentration problems etc.), and withdrawal effects should I decide to stop taking Valium.

It is me who feels the guilt and stigma of taking "momma's little helper". The fact that that term even exists speaks volume to how many people look at these medications with derision.

However, what if it really is "my little helper". What if ,taking it with my mood stabilizer and my antidepressant, it actually wards off my anxious depression? What if I can function better when I take it? What if this combination makes my life better.

Am I still addicted if I need a benzodiazepine just like I need an antidepressant and a mood stabilizer? I do believe I need medication, so why do I feel no stigma about needing Tegretol and Prozac, yet so much pressure to stop taking Valium?

Dr. X never told me to stop the Valium, in fact he subtly (maybe too subtly) questioned my reasons for wanting to go off and in his quiet, and unobtrusive way suggested staying on might be better for me.

So my post was not about me or him wanting me to stop taking the Valium, rather it was about the impetus behind my wanting to stop taking Valium: My feeling like I was a bad person for taking it.

Benzodiazepines and Me

In my appointment this week Dr. X. and I spent a lot of time talking about me and Diazepam (Valium). I take a small dose of Valium everyday, along with 600mg Tegretol and 30 mgs Prozac.

This mixture seems to have been the first to do anything towards helping my mood disorder's symptoms. I have taken some form of benzodiazepines (Lorazepam, Clonazepam, Temazepam and finally Diazepam) both short and long term off and on ever since I began seeing Dr. X. 6.5 years ago.

The short acting ones (especially Lorazepam) are a nightmare for me, because I get what seems to be withdrawal effects each day as they wear off and become really irritable, anxious and angry. Diazepam (Valium) has been different. It has helped me immensely.

My Major Depressive Disorder( MDD) is also accompanied by constant and debilitating anxiety attacks and sometimes panic attacks, insomnia, non-stop worrying, and some OCD symptoms; checking/rechecking, contamination fears and obsessive worries and thoughts.

This time I began taking Valium to ease my mouth movement symptoms and obsessive thoughts and music in my head (I am worried it is Tardive Dyskinesia, my pdoc suggested it is bruxism, but recently began wondering about TD too). The Valium seemed to stop the obsessive thoughts, allowed me to be comfortable in my volunteer role teaching art, helped me sleep, basically calmed me down enough so I can live a more relaxed life and not have constant anxiety symptoms. It also helped slow the mouth movements down a bit; although they are still pretty bad.

I read other's comments about benzodiazepines. The Shrink Rap psychiatrists, whose opinions I am interested in, and respect, seem very opposed to using them), also, I belong to an online support group and many people psychiatrists seem opposed to providing benzodiazepines for long term usage. I get the sense that these psychiatrists see long term need for benzodiazepines as a slippery slope to addiction and drug seeking behaviour.

So, in keeping with not wanting to be addicted, and not wanting to be a drug seeker, also, because I was afraid the Valium was masking my possible TD mouth movements, three weeks ago I decided I should try to get off Valium.

I informed Dr. X that this was what I wanted to do. He supported the idea, but told me to go off it very, very slowly; 10% or less a week. He said this would help me avoid some of the withdrawal side effects.

So I began. Within a week my good mood began slipping. I became more and more stressed, more and more depressed. By the time I went into this week's pdoc appointment I was slipping back into a deep depression. I had began craving alcohol again (and drinking again to relieve my stress and anxiety; something that I had stopped almost immediately upon beginning Valium again (a common pattern for me). I began isolating, not wanting to leave the house, unable to sit and be creative without being completely stressed out about how bad I was at what I was trying to do...the list goes on.

I asked Dr. X. about long term benzodiazepine usage. I asked him why he so readily provided them to me when so many pdocs and people seem opposed to the idea of anyone using these medications for long periods of time. I told him I had wanted to stop taking Valium because I did not want to be addicted, or dependent and because I hear so much negative press about people on these medications.

He told me that many psychiatrists would say there is a population of people where the risks of dependency and addiction have to be weighed against those people's debilitating symptoms. He said for me taking a small amount of Valium seemed to relieve me so much of so many symptoms of my anxiety. It appeared to him that my continuing to take Valium was the right choice for me (He said it better and much more coherently than that).

I expressed my feelings that some of my memory and word finding problems, and perhaps some of my balance problems were associated with taking a benzodiazepine. He told me that is possible and perhaps likely. Unfortunately the alternative for me is irritability, inability to sleep, extreme anxiety and the return of depressive symptoms. I decided I would go back on the Valium dose I was on. He seemed to think that was a good idea.

I know I build up a tolerance for Valium. It seems to stop working after a period of time. At that point I need a small increase in my dosage. I also know I have really bad withdrawal effects every time I go off it, which I need to do every once in a while for a period of time to offset the tolerance. However, I also know I am far more functioning and able to enjoy life when I take Valium.

I really worry that one day something might happen to Dr. X. and I will need to get a new pdoc, and they will not understand this dynamic the way Dr. X. does. They will think I am drug seeking if I ask for Valium, or think I am an addict, when in reality I wonder if there are some of us for whom benzodiazepines are a much needed supplement to the other medications we take.

What is the difference between a medication that is needed to maintain balance in a person's life, and a medication that the person is addicted to. I do not really understand where I fit in or to which category I belong. Dr. X says I am not an addict, nor am I drug seeking when I ask for Valium. I have to trust and believe he is right.

A Conversation Between Me and My Dad

Me: Hi Dad, guess what? I bought a new car. (I've been driving and old 1986 minivan for years...love it, but it's time has come...well, did come years ago)

Dad: Hell, you never listened to your father's advice. Why in the hell would you buy a new car? (sort of joking I think)

Me: The same vehicles, but 3 years older, are only $3000.000 less and have no warranty, it made way more sense to buy new, plus I have never owned a new car. I just wanted a new car.

Dad: What else are you up to?

Me: (really excited)..oh, I applied for and got the volunteer position to teach 3 half day printmaking workshops to teens in the summer.

Dad: What kind of teens are they.

Me: Teens coming to the Art Clubhouse. Teen with mental illnesses.

Dad: Oh, you mean not real teens?

Me: (in my head...WTF?) (Out loud)They are REAL teens, what is that supposed to mean? They just have illnesses too.

Dad: Why the hell aren't you getting a real job, one that pays? Why the hell would you volunteer when you could be working for money.

Me: Well, I'm only volunteering to teach 3 hours a week and it's in a rehabilitative and supportive environment. I am trying to get better.

Dad: Well if you can volunteer to work you can get a real job.

Me: (wishing I'd never called, and wondering WHY I always contact him with the delusion that someday he will actually be proud of how hard I try, and wondering where I could get a job that allowed me to work just 3 hours a week and where I could feed myself and pay the rent) Dad, I am still not well. I cannot work right now. I am slowly trying to get better so I can work.

Dad: What you need is a real job. You have been doing that volunteer stuff for a long time now.

Me: (thinking yes...I've been managing a few hours a week for the last 1.5 years, but just recently began to feel safe doing that or even well enough to do that....and besides that, what I do in my volunteer work now is far more "real", much more meaningful and important than anything I have done work wise in my past). I am not ready to work yet Dad. I'm trying to get well and volunteering in this supportive environment is a safe way for me to work towards that.

Dad: Hrmfft. (Translation: you are so lame)

Me: (Hanging up from a call I initiated and entered feeling excited and proud of myself; and hanging up from the call feeling dejected, rejected, diminished, ashamed)

...bye Dad. I love you.

Dad: yup, bye. (click)

My Depression is Returning

Even as I was answering the question, "How do I manage my depression"? I could feel my mood slipping. In my session last week I was frustrated that my creativity seems to have disappeared. The ability to paint, which seemed so innate, and was pouring out of me, is gone.

After talking with Dr. X about this, and him being supportive and suggesting it hadn't disappeared I came home and tried to paint. Leaving my appointments and trying to do what I tell my pdoc I cannot do is a common occurrence with me. Something about telling him I can't do something challenges myself to try.

So I tried, and nothing worked. I tried again the next day, and the outcome was pure frustration. I tried again the next day and I became angry and annoyed that something that seemed so easy a few weeks ago was so complicated and irritating now. I tried playing my guitar twice yesterday too, but again it ended in me feeling annoyed and angry that I could not get such a simple lesson. I had my blues lesson today and for the first hour I was awkward. My fingers and brain wouldn't connect. Simple rhythms would come and then suddenly disappear. My brain feels like a sieve; a sieve that only pours out things I want to learn, or things I want to do, things I want to retain, but instead on that holds in all the garbage I want to rid myself of; a clogged up and broken sieve.

My mood is slipping, and I'm scared the depression is sinking back into me. I am obsessing about my mouth movements (this is how the thoughts go...and they are rapid and circular and seem like they will never stop):

"Oh God I have Tardive Dyskinesia, but what if I go to the neurologist and he doesn't see the movements, so many of the movements are inside my mouth, my tongue is pushing in a weird way inside my mouth, my lips are pursing, and it feels like my lips are really tight together, my teeth are tapping, and grinding and clenching, but the only external notification of this is a tiny movement by my temples which is covered by my hair, My cheeks and lips are making strange movements every once in a while, my eyebrows are going up every so often, my toes are wiggling annoyingly but maybe I am just so conscious that I have a problem that I am making it happen, I feel it, but what if I'm just making it happen by thinking about it so much, what if the neurologist thinks I'm faking it, what if he doesn't believe me, what if he doesn't see what I'm seeing and feeling, what if he says nothing is going on, but I know something is going on, and I'm scared it will get worse, but what if no one see it, or believes me, what if it really isn't there and I'm imagining it (not consciously, but subconsciously), I have had so many times when I have felt physically ill, or like something is wrong and it often turns out to be nothing, what if I'm just a hypochondriac, but what if it's real, and what if it is permanent, and what if it gets worse, Oh God, I have TD....etc., etc."

This is what was going through my head all day yesterday, and it is back again today. The thoughts are obsessive, and relentless. On top of this the 4-8 bars of repetitive music is starting to come back into my head; the same beat/section of a song, over and over and over.

I'm not sleeping well again. I am irritable. I am feeling much more anxious. I do not want to see people. I have avoided the art clubhouse. I feel depressed again.

Oh God, please do not let my depression return .

Managing my Depression Getting Through the Toughest Days

In a previous post I welcomed my 5000th visitor to ask me a question, or suggest a topic for a post. Deepblue being my 5000th visitor posed the question/s:

"I guess the question I'd have to ask is: what has been the most helpful thing you have done to help manage your depression? or, how do you get through your
toughest days? I guess you can answer either of those".

I am not sure how long Deepblue has been following my blog, or what s/he knows about my situation. I have had Major Depressive Episodes (MDE) since I was 17 or 18. I always managed to pull out of them either on my own, or with a small amount of counselling, until I was 31 or 32 (I'm now 42). At that time I sought long term counselling (2 years/once a week), and then I was referred to an outpatient Cognitive Behavioural Training (CBT) group and then a group therapy program, both of which did not help me at all. I had tried CBT in therapy when my MDE's were mild to moderate, but this time my depression was become far worse than ever before. For about a year my MDE went into remission on it's own (with some residual symptoms...not sleeping, irritable, fatigue).

In the summer of 2001 I became despondent and requested more help from my family Dr. She referred me to the Mood Disorders Clinic and on October 3, 2001 I met my pdoc. He invited me to become his patient. I knew as soon as I began talking with him, that were a perfect match. I agreed and began seeing him for therapy and a search for medications. He and I have worked for 6.5 years to try to help me manage my symptoms and my depression. It has been a brutal and tough journey. No medications worked for me; and I tried almost everything you can think of (more than 35 different medications in total, either alone or in combination with other medications) Part of the problem was that not only do I have MDD, I also have anxiety and OCD problems. I think this makes my depression harder to treat.

Back to your first question: " What has been the most helpful thing you have done to help manage your depression?

Until the last month or two, I would not even say I was managing my depression. I was literally trying to "Survive my Depression". There have been a few things:

1) The first most helpful thing I did was find a pdoc that I could receive both therapy and medication advice from. A pdoc who was supportive, authentic, available, hopeful, intelligent, and who I connected with on a personal level. There were weeks and weeks where all that kept me going were thoughts that "I have an appointment in three days. I can survive until then".

In some of my worst moments I would visualize myself laying on the floor in Dr. X's office (no I have never really laid on his floor). The thought of just being near his calming presence helped me calm down.

I never have told Dr. X. this, but one day he left a message on my voicemail at work asking me to call him. I never erased that message until the day I left work. Whenever I was so stressed out I wanted to kill myself in the staff washroom, instead, I would go to my phone, pull up the phone message, listen to his voice, maybe repeat it a few time and something about his voice magically helped me survive...I know it's weird...but it helped

2. Medication that worked is the second thing.

Years of therapy and support helped me survive and try to get going and begin to "live with my depression", but as soon as I found a medication that helped, I was suddenly able to make a huge transition. Suddenly my anxiety dissipated, I lost most of (not all) my fear of people. I wanted to leave the house (vs.having to force myself out of the house), I wanted to see people, I wanted to experience new things. I felt hope. I saw the possibilities. I became more motivated. I began sleeping better. My mood lifted.

I would not say the medication was a miracle, because I had been working so hard on setting up a foundation to begin with, but suddenly, along with medications that worked, my foundation became like rich soil feeding growing plants and I was finally able to grow and blossom very quickly.

I have to say, the bloom has fallen off my plant a bit lately, but I still feel like I am strongly supported by the medications. I think in the beginning, when the medications first helped my mind was so blown that I actually could feel okay, that I ran with it above any of my expectations. Now I feel more like I have a long way to go to get well, but the medicine will help me get there.

3. Build and Create a life that has meaning and purpose. I have always been angst ridden about my life. Except for the time I was in my third and fourth years of university, and doing EXACTLY what I thought mattered, and exactly what supported my feeling that I was doing something meaningful and purposeful, I have always had a sense that I am wasting my life; that I will die and my life will have been meaningless.

I am really interested in existential psychology, because it speaks to this exact thing. So Dr. X. and I have worked really hard to help me slowly build a life full of meaning and purpose. It began slowly, but initially I thought, maybe if I give back to the world somehow I would feel better about my existence. So I began volunteering to walk dogs at the local SPCA. It was a start. I felt that no matter how depressed I was being around a dog would help me, and it was a flexible, drop in when you can situation, so days I couldn't leave the house, or even my bed, I didn't have to.

I realized I needed something more meaningful than walking dogs, so the next year I volunteered for our city's Shakespeare festival. This time I had to commit to one shift a week. That scared the hell out of me. It meant even if I was sick I had to go. It came with many therapeutic moments. I worked with people who either did not have a mental illness, or were not "out" about it. I struggled. My medication and medication changes made it difficult for me to think straight sometimes. I felt really self conscious. I was terrified. I did it anyways, and I got through the first season. The second season was less difficult, except I became so severely depressed part way through the season that I left, thinking I was going in for ECT. Even though I had to leave it helped build my confidence to try something even more challenging.

I began volunteering at the Art Clubhouse for people with severe and persistent mental illnesses. I took classes there, and eventually I began volunteering to apprentice classes with an O.T. and now I am volunteering to teach classes there. This all during the period before my medications worked.

It was hell, but I also loved it. It was hard to manage my responsibilities when I was so sick, but the structure really helped me leave the house, get out of bed, relearn to communicate with people, learn to lessen my social anxiety by exposing myself to more and more social situations: meetings, classes, and teaching. A structure to depend on, and one that was meaningful, and purposeful to me, helped me live with my severe depression.

4. Writing in this blog

For lots of reasons. First I have met some really interesting and caring people in the blog community. I feel like I able to be so open and honest here. It feels purposeful to me. I really hope that people who come here and are struggling with mental illness see what I write and realize they are not alone. I never want to provide false hope, because so many times I have written about feeling completely hopeless, but I know for me there is something about knowing I belong to a shared human experience that lessens my load. I hope that is what I help people with; providing a sense that we are not alone in this world, or in this battle.

The last question you ask is: "how do you get through your toughest days?"

I wrote a post a while ago titled: "Coping Strategies for Treatment Resistant Depression (TRD)"

probably provides my most comprehensive answer to this question. Honestly, some days I just cling to my life; curl up in a ball and just get through the obsessive suicidal thoughts, plans and urges. Those thoughts always pass eventually, and they always come back too, but I try really hard to just get through each tough moment as it comes and try to not think it will always be this way. Ant then there is always the thought...."three more days until I see Dr. X." I can last three days. I can manage knowing I have his support.

Deepblue is my 5000th visitor

Deepblue asked "How do I know if I'm the 5000th visitor?

You are, by the way. (is that your question? or do you want to ask another question, or suggest a topic for me to write about?...I'm open to another question...

Deepblue I know you are my 5000th visitor because you left a post on my blog at 10:53 and my 5000th visitor viewed my blog at that time (the "sitemeter" icon on the sidebar of my blog is free and it gives me simple statistics about how people find my blog (i.e. what they used in google that made my blog show up, times of visits, #'s of visits to my site per day etc.) It is really great because I can see what interests people and think about that when I write. I think you can click on the icon and it will give you a summary of what it tracks.

It says it tracks location, but it must track the city and then maybe your internet provider's address, because I looked up myself and it is nowhere near where I live. When I first saw "sitemeter" on someone's site I was worried about what kind of information it had about me...but having downloaded it to my site and viewing my own information that it tracks I feel pretty confident that my privacy is still protected.

I want everyone to know that I respect your privacy and only use the sitemeter to make my blog more interesting.

P.S. my visits are not tracked as part of the volume of visitors. You can set it to either include you, or not. Idid not include myself as it would skew the #'s.

5000 visitor? Ask me a question.

It is June 7th/08 10:33 PST and the next visitor is my 5000th visitor. If you are that person...ask me a question and I will provide a post about it.

I Just Want The Old Me Back

I have been so frustrated, despite my recent mood lift. You would think I would be happy that my mood has been consistently better for much of each day, but that is not the case.

As my mood remains better, my expectations of myself increase. I feel I should be able to do what I did when I was well; things like work, and read, and remember things, and not have difficulty doing simple tasks. I feel I should be fully functioning, now that I have felt better for a while, but that is not the case either.

I still cannot read. I used to be one to have 5-6 books on the go at any given time. I could leave a book for months and pick up where I left off, remembering the plot, characters and themes from what I had read previously. This seemed like a simple, everyday thing to me.

Now I pick up a book, read a chapter, and sometimes, even while reading that chapter get confused, because I cannot remember who is who, or what is going on. I often read and re-read the same paragraph or pages over again because I get lost and cannot figure out where I got off track.

If I read a chapter and put the book down for a couple days and then pick it up again I cannot remember what happened in the previous chapter/chapters, so I become disheartened and feel stupid and lose the desire to keep trying the book.

It is not just reading. I watch a movie, and a week later I cannot remember the most of the plot line. I remember I liked it, or hated it, but cannot remember what it was about. I have been taking blues guitar lessons. Years ago I played the guitar and all through grade school and high school I was a percussionist. I understand (or thought I did) rhythms. The first guitar lesson I got home to practice and I could not remember the simple blues shuffle pattern. I went to the next class and we practiced all class and then came home and again I could not remember the simple pattern. The third lesson I recorded it. True to form I came home and could not remember the pattern, but this time I had a reminder to help me.

I feel so stupid, when before I felt like I was very intelligent. It is like I have lost big chunks of memory, or ability to store memories, or ability to learn new things. I always thought when my mood lifted these would all come back to me.

Dr. X. and I discussed this today. He said part of the difficulties may be made worse by the way I am placing negative labels on what is happening. The more negatively I see myself, the more I live up to my own expectations (those are my words, not his...he was much more eloquent). For example, by calling these things "simple", and then seeing myself unable to do them, I become frustrated that I cannot do "simple" things.

He said the rehabilitation process can take a while and, like someone being rehabilitated to walk again, it can be very frustrating to not just be able to walk like you did before. I guess I thought when my mood was better I would magically become my old self; the self that never really had to try very hard to succeed at anything I tried.

Prozac and Bruxism or Tardive Dyskinesia, or both?

I am exhausted right now. It is the "witching hour", that wicked two hours everyday where someone sprinkles a magic potion over me and I fall into a deep sleep, like sleeping beauty. Hey, Where's my prince?

I get so tired everyday at this time that I feel sick, literally. The tiredness isn't "sleepy" tired, it's fatigued, "burnout" tired. So I will lay down and even though I'm not sleepy tired, will fall asleep for a few hours. I am trying hard to be okay with this. To accept that outside these few hours my mood is definitely better; so what if the trade of is a few hours extra of tiredness. At least I do not feel like this all day, like I do when I am depressed.

I am also having "mouth movement problems". At first my pdoc said it was bruxism, then three or four weeks ago he seemed to be really concerned about how my mouth was moving and took me off the Dexedrine as he said it was making the movement worse.

Last week he said they were not as bad as the previous week, but the night before I saw him I took extra Valium and two muscle relaxants because I had such a sore next from my teeth clenching and grinding. I got a bit mad at him, because I felt he was brushing off my concerns about Prozac and tardive dyskinesia. However, he told me he was aware Prozac has been seen to cause TD and he was concerned too.

Anyways, He suggested I see a neurologist to rule TD out. I told him I would like to see if it subsides over time first. In the mean time I want to come off Valium, because I think it is masking the movements. So I began cutting back slowly and already the movements are getting worse and I am not sleeping well. Argh!

I definately have Prozac induced bruxism; and I am increasingly certain I have TD as well. I have videotaped myself while I am involved in an activity (playing guitar, working on the computer) and the weird mouth movements are definitely there. Every once in a while my mouth makes really strange movements. This is freaking me out, I do not want to look strange to other people. What do I do if it is TD? When my current medication mix is the first thing to ever help me?