Author

Heather Loeb

For decades I've struggled with major depressive disorder, generalized anxiety disorder, avoidant personality disorder, dysthymia and an eating disorder. I pen my misadventures here, but you can also find my column in the Corpus Christi Caller-Times (caller.com). Thanks for reading and for your support.

So Much Weight

by Heather Loeb
written by Heather Loeb

We all know that depression is a huge weight to carry but do you know what else is heavy? Actual body fat and I’ve got a surplus right now. I mean it. I’ve gained 20lbs in the past two months and it ain’t pretty.

At first, the weight started to just creep up, then I ignored the scale, ate Whataburger everyday and threw caution to the wind (and chocolate in my mouth).

I am so uncomfortable. My back is hurting again – it hasn’t hurt since my breast reduction last year. None of my clothes fit me right and I’m just disappointed with myself. I feel embarrassed and judged by strangers and those I love. I don’t know why.

There’s nothing like getting depressed about your weight while you’re actually depressed. I know some depressed folk who won’t take medication, effective medication, because one of the side effects is weight gain. The struggle is real. And for me, compulsive eating is a coping mechanism so this happens quite often. I eat my feelings and as it turns out I have a lot of feelings. Sometimes eating is the only joy I have in my joy as sad as that sounds. Also, if eating a certain meal felt good one time, I often go back to the meal to recreate feeling good. Even if it doesn’t work the second time, I still go back for more. I’m not a fast learner.

I know what I need to do to be healthy; it’s just hard when I can barely take a shower. But if I can drive my ass to Whataburger, I can drive to the gym, right? We’ll see.

There’s a 5K coming up in November I want to do, so I want to start running again. Along with eating healthier, I’ll make that my goal and maybe I can get these awful extra pounds off.

See below when I felt sexy and hot and a picture I took Saturday and felt blah.

 

 

I know I’m still beautiful and all that, blah blah, but I’m just so uncomfortable – did I mention that? In the picture on the left, I felt so sexy and wore cute clothes all the time. On the right, I feel like a hot mess – like fat girl in a little coat. I hope y’all are old enough to get that reference.

I’m going to shut up about it now.

So here I am going up a hill, depression/anxiety riding my back with the added bonus of 20 extra pounds.

I’m already sweating.

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Endorphins and Sandcastles

by Heather Loeb
written by Heather Loeb

58384722_10103529967079724_4680691183503015936_oYesterday I was feeling good enough to drag my family to the beach. This may sound simple but I had to prepare snacks, drinks, load up the car with chairs, bring towels, lather up my kids in sunscreen, bring the beach toys, etc. It was like a Navy Seals mission for someone like me.

But I had fun. We built sandcastles and swam in the ocean. We lost toys that I told them not to bring in the ocean. I had a very good day. I felt happy and with all the sad days I write about on here, I must celebrate the good ones here, too. They are few and far between but I have noticed I’m coming across more and more. Ketamine infusions? God answering my prayers?

Who knows but I’m taking it.

Stay in the light, my friends.

 

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Treatment Resistant Depression

by Heather Loeb
written by Heather Loeb

As I’ve mentioned in 389,432 of my other blogs, I have treatment resistant depression (TRD). It may sound like its not curable, but by definition it means one is non responsive to at least two antidepressants for a period of time. It also is characterized by extreme sadness, sleep disturbances, low energy, suicidal ideation and suicidal attempts.

TRD is experienced by 45 percent of patients with a major depressive disorder. That’s just crazy to me. It contributes to nearly one-third of patients attempting suicide in their lifetime, a rate more than double that of their treatment responsive peers, according to this article by Psychiatry Advisors.

While psychiatrists cannot pinpoint why some are treatment resistant, researchers have seen correlations in certain populations who are more vulnerable than others. For instance, women and senior citizens. Individuals who have had severe or recurring bouts of depression also appear to be more susceptible, according to Johnson and Johnson’s website on health.

What I found most interesting is other medical illnesses can play a part in TRD. The article states that thyroid disease and chronic pain (I have both thyroid disease and chronic migraines) makes you a greater risk for treatment resistant depression. Mind blown.

Other factors include substance abuse and eating and sleep disorders. I also suffer from compulsive eating and insomnia. I should donate my body to science when I die.

So, what happens with you’re treatment resistance and your meds don’t work? We do have options. We can go on the highest dosages of our meds – IF YOU’RE DOCTOR THINKS THAT IS RIGHT FOR YOU – or there are non-drug therapies which I’ve mentioned in the past, such as transcranial magnetic stimulation, ketamine infusions and ECT, which helps reverse symptoms of TRD.

I think the only non-drug therapy I haven’t mentioned in detail is ECT (electro-convulsant therapy), which is effective to 70-80 percent of patients. This is not to be confused of electroshock therapy, poorly portrayed in movies and TV. ECT uses general anesthesia intentionally triggering a quick seizure. It’s meant to reverse symptoms of mental health problems and as of now is the best treatment for depression.

So, as of now I’ve definitely more than two antidepressants/antipychotics: Doxepin, Zoloft, Prozac, Lexapro, Wellbutrin, Abilify, Rexulti, Saphris and Seroquel. For me, that’s a lot. I’m also tried Lamictal as a mood stabilizer.

I’ve also tried TMS (transcranial magnetic stimulation), ketamine infusions and I’m about to try the Spravato nasal spray which is based on ketamine.

Here’s to my people who are treatment resistant. You’re not alone and hopefully there will be better alternatives in the future.

One thing I forgot, there’s also a genetic test you can take that can tell you which antidepressants will work better for you. It’s called the cytochrome P450 (CYP450) test. Ask your doctor if this is an option for you.

Stay well. Stay in the light.

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Picking a Good Psychiatrist

by Heather Loeb
written by Heather Loeb

I briefly touched on this before but when I had postpartum and post-weaning depression, my then doctor was the wrong one to see. He said I couldn’t take Zoloft while I was breastfeeding (wrong) and had no suggestions when I was suffering post-weaning depression. I decided I would not see a man again. I didn’t mean this to be a sexist choice, just a personal preference. Obviously, this one doctor wasn’t up to date on current practices.

Even before postpartum care, he only saw me for about 15 minutes each time, which made me feel rushed and that he didn’t care. He had put me on a couple of different antidepressants, neither seemed to work, so he just kept me on them stating those were my only options and adding some anxiety and sleeping pills to the mix. So, I thought there were no other pills I could take. Wellbutrin XL and Zoloft were it for me. He didn’t even recommend therapy, which I was doing anyway.

Luckily I found a doctor that specialized in women’s mental health issues. Unfortunately, she’s in Southlake (Dallas/Fort Worth metroplex), so I travel up there once in a while to see her face-to-face and the rest of the time we have phone visits. She even has an email address that patients have access to.  I don’t ever feel rushed and our conversations are as long as I need them to be. I feel that she really listens.

I thought I’d offer some tips when looking for a new doc. So, when considering a psychiatrist, first ask for referrals from other doctors or friends first. It’s also imperative you do research online to view the doctors’ credentials, years of experience, what they specialize in and read reviews other patients have left. And, of course check if the doctors take your insurance. This goes for therapists, too.

And don’t be afraid to just try the doctors out. You don’t have to commit.. When it’s time for your visit, consider how they make you feel – are they listening, do you feel safe, are they rushing you, etc. This is an interview for them – not you. It’s a very personal decision and you have to be your own advocate.

Another important thing that falls on you is to be a good patient. Be honest with the doctor or therapist. If you’ve had trauma in your past, tell them. If you’ve abused certain meds, tell them. They need to know every medication you’ve taken and are taking. If you’re not honest with them, they can’t help you to the best of their ability.

Hope this helps.

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When I Hit Rock Bottom

by Heather Loeb
written by Heather Loeb

About two years ago, I felt great. I was taking two HIIT (high intensity interval training) classes a week and when I wasn’t doing that I was training to run a 5K, a feat for me because I hate running. I felt so strong, so energetic and proud of myself. I was doing hard things, things I didn’t think I could do. I was a role model to my kids.

In June 2017 I ran the 5K. I was happy. A couple weeks later I started to feel bad. I wasn’t sick but I started to lose momentum with my workouts. Things that were once easy or doable became hard. Waking up in the morning was hard. I didn’t know what was going on. I knew I had depression but I was doing so well. It had been well over a year since I had Eli, it couldn’t be postpartum depression – I was over that.

I took whatever energy I could muster and put it toward the kids, which meant I suffered more. Showers seemed near impossible. I stopped working out. I just wasn’t myself.

In October, I hit rock bottom. I had suicidal thoughts. I was crying at every little thing. I felt anxious all the time and my marriage was suffering. Thankfully, my mother in law was helping with the kids.

During a school break, we took the kids up to my parents’ house. I had also made an appointment with a new psychiatrist who specialized in women’s mental health in Southlake. My then current pyschiatrist wasn’t cutting it. While my parents’ and the kids were at my parents’ lake house, my husband and I got into a huge fight and I just lost it. I was sobbing uncontrollably and suicidal. This next part is hard – I knew where some hydocodone was and I had a plan to take some but I didn’t want my mom to find my body. I called my best friend and she urged me to go to the ER.

I waiting for hours at the ER for them to transfer me to a psychiatric hospital. Around midnight, hours after I’d arrived, I was taken by ambulance to a psych ward at another hospital. I was there two and a half days. The psychiatrist there was a total dick. He wouldn’t release me until he “talked to my husband about my illness” and didn’t listen to anything I said. Because I had an appointment with the psychiatrist in Southlake, he ended up letting me go after talking to my husband of course.

When I met with Dr. Johnson, I saw the light at the end of the tunnel. She diagnosed me with Major Depressive Disorder, PMDD, generalized anxiety disorder and social anxiety. My old doctors just said I was depressed and never spent more than 15 minutes with me. Dr. Johnson spent more than an hour talking to me. She put me on medications I had never heard of, that my doctors never mentioned, and I left the office crying tears of happiness.

I did get better, I’m better than I was that awful October but I’m treatment resistant, so medication can only go so far for me. That’s why I try alternative treatments like TMS, ketamine infusions and soon the ketamine nasal spray. Right now, I’m definitely not suicidal but I have to struggle though days, some more than others.

If you’re suicidal, please go to the nearest ER or tell your doctor – any doctor. There is help and it does get better. You can also call the suicide hotline at 1-800-273-8255. Someone is there 24 hours a day to help you.

Thanks for listening. This blog was a hard one to write.

 

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Oops

by Heather Loeb
written by Heather Loeb

Oh, hey. It’s been since September since I last blogged. My apologies. It’s been a hard few months since. First, I was busy with the holidays and since the beginning of the year I’ve been depressed and haven’t felt like talking despite everyone’s urging to do so.

That’s the thing about depression, even when you need to talk the most you feel like you just can’t do it. I can say that I’ve been going to therapy on a regular basis but my meds have stayed the same despite me feeling like crap. Because I’m treatment resistant, there’s really nowhere to go from here medicine wise. My psychiatrist has suggested ECT but I’m just not ready for that. Yet.

I have been getting ketamine infusions which helps with my moods. It doesn’t last very long but thankfully we have the money to get them. I don’t know what I would do if we couldn’t afford it. If you’re poor and have MDD, you’re screwed. My medicine alone costs hundreds of dollars. So wrong.

IMG_2079My therapist and I started Dialectical Behavior Therapy. Basically, you identify your negative behaviors and teach yourself positive behaviors. Seems like common sense but it’s really helpful when all you’ve been doing your whole life is practicing negative coping skills. So far, so good. I’m working in a workbook, which I would recommend to anyone.

I’m also going to try the new ketamine-based nasal spray, Spravato. It was approved by the FDA in March. The doc that did my TMS treatments called and wants me to be her first patient. You have to be in the office and monitored for two hours after receiving the spray and I think you go twice a week for six weeks at first. I hate stuff going up my nose so we’ll see how this goes down. Waiting on insurance to clear my first, of course. It’s always insurance.

That’s my update for now. I’ll try to be more consistent with everything and I’ll definitely keep you updated on the Spravato.

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TMS: Session 24

by Heather Loeb
written by Heather Loeb

So it’s been awhile since I last updated my blog, my bad. I’ve also missed a couple of sessions of my TMS but am on session 24 and I’m feeling really good. It’s really helping – I have more energy, I no longer feel hopeless or depressed all day, and little chores that seemed impossible no longer do. I have 11 sessions of TMS to go.

I can’t wait to finish up in October, I should be feeling way better by then.

In other news, I stopped taking the Trintellix because it was just too expensive and went back to Zoloft. I haven’t noticed any changes – if anything, I’m doing better but it’s hard to tell because the TMS is so effective now.

I know this a short update but I don’t really have anything to report other than I’m doing great. Thanks for reading!

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The Impossible Task

by Heather Loeb
written by Heather Loeb

Recently I saw a Tweet talking about depression commercials and how they don’t mention how hard it is to do certain things – Impossible Tasks. This really hit me hard because when I’m very depressed there are chores and very easy tasks that I need to get done that seem impossible. Like, I might die if I have to do it. And not a lot of people understand it.

For instance, when I’m really down showering seems so hard. It seems insurmountable to get in the shower, wash my hair, then get out of the shower and do my hair. And shave my legs. Kinda gross, right? I don’t go long periods without showering but I dread when I have to do it. This is my impossible task.

Why does it seem so hard? I have no idea. But I’m thinking that everyone with depression has at least one task like that.

My husband and best friend don’t understand. It can take less than 20 minutes to shower. They ask, “why don’t you just get it over with?” But still, it’s not that easy. Even brushing my teeth seems hard sometimes. I swear I’m not disgusting or smelly, I’m just keeping it real. 

But going back to what the Tweet was talking about – they don’t mention things like that on the commercials. They talk about sadness and losing interest in things you used to enjoy, which does happen, but I feel the commercials miss a mark when they don’t talk about the other stuff: anxiety attacks, social anxiety, not wanting to leave the house, lying in bed for days, etc. I guess they only have so much time for the ad, but I think it adds to others’ perception that depression is “just sadness” or losing interest in things or being lazy. That doesn’t sound so bad, but there are dozens of symptoms that come along with depression, especially treatment resistant depression and major depressive disorder.

I’d really like to know your Impossible Tasks. Leave a comment and we can chat.

Thanks for reading.

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The Other Side

by Heather Loeb
written by Heather Loeb

I have a new respect for my husband. And any other partner of someone who has depression and anxiety. I’ve realized these past few months – a year, maybe – couldn’t have been easy for husband. I’ve gone from almost manic happy to severely depressed and hospitalized; I’ve told him I don’t feel well almost everyday; and he’s the one who helps me when my anxiety attacks come, which they do often. It’s got to be hard on the other side. We might not be suffering the same way but I imagine it’s a struggle to see his other half down and out.

DSC01340He’s so patient and sympathetic. I truly picked a good one. But it’s not always perfect, sometimes we fight about my depression. Sometimes it’s too much for him to bear all the responsibility while his wife can barely get in the shower and brush her teeth. That’s an accomplishment some days. Who else is with me?

So, I’m wondering…does every married couple or relationship suffer if one has depression/anxiety? Tell me, friends.

On another note, Rosh Hashanah begins tonight. For those who don’t know, Rosh Hashanah is the Jewish New Year. It’s a chance to start over, reflect over the past year and then prepare to apologize to those who you have wronged (Yom Kippur).  I of course plan on apologizing to my husband but I owe myself a big apology too. I haven’t taken care of myself, I’ve put others’ needs in front of mine (kinda hard not to do when you have kids) and I haven’t shown up for myself. I break promises to myself all the time. But now I’d like to change all that.

I sometimes rely way too much on my meds and therapy to slough through my depression and that’s fine but I want to make an effort, when I can, to really meet all my needs, stop talking negatively to myself and practice self care. I know that will help immensely in my marriage. After all, you can’t pour from an empty cup. I want to be better for me and my family and I believe self care is the first step to that goal.

So, here’s to the new year. L’shana tov, friends.

Update on TMS: I’ve had 14 treatments and I’ve started to notice little things that are better. Around the 20th treatment is when I’m supposed to notice major changes and I’m looking forward to that.

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Body Back

by Heather Loeb
written by Heather Loeb

Today is the first day I’m doing Body Back, a Fit4Mom HIIT class that is intense, hard and invigorating once you’re finished. It really transforms you – physically and mentally. I’ve done Body Back before and I lost 6inches and 9 pounds. It’s no joke. But I’m scared to go today. I’ve gotten so use to my unhealthy lifestyle that I’ve been really comfortable and I know I’m about to be VERY uncomfortable. I need that. I need to get uncomfortable and start living a healthy lifestyle. No more overeating, downing Diet Coke every hour and being sedentary, My husband has lost 70 pounds and I’ve gained almost 10. More importantly, I need to show my kids how to be healthy and I need to be around to watch them grow up and be there for my husband.

I’m also scared because this session will be different than any of the other sessions and I hate change, lol. You see how badly I need to do this.

When I made a list of hard things I’ve ever done (to prove to myself how strong and mentally tough I am) Body Back was definitely on the list. You’re not just working out, you’re pushing through mental blocks and challenging your body to go harder, faster, better, stronger. Once you get through the class though, you get about 15 minutes to meditate and reflect on what you’ve accomplished and it feels so good.

I just need to remember that I’ve done this before. I’ve run a 5K. I’ve given birth to two large babies. I’ve fought depression and suicidal thoughts for years and haven’t given up. I’ve done some hard things.

So I can do this, right? I guess I don’t really have a choice. I have to start living a healthy lifestyle.

So, here’s to burpees, squats and sweat.

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