Mental Illness on the Front Lines

A dear friend texted me the other day, and after chatting a bit, I asked how she was doing. She’s an ER nurse in Florida, so I was concerned. Florida, if you don’t already know, is a hotspot for coronavirus and the governor is incompetent, in my opinion. This was her reply: 

It’s bizarre and sad. The first wave was mainly elderly folks from nursing homes mixed with regular people; some very sick, some not. In the beginning we had a tent outside where we tested people with minor symptoms, when it declined they took it down. The numbers we saw in the beginning don’t even compare to now. Every room with a door has a COVID patient. Four units have been converted and they’re full. Our governor was actually at the hospital today talking about how everything is fine. It’s not fine. This new wave is younger, mainly Hispanic; people who are low income and work either illegally or in cramped factories, they live in multi generation homes, so they all get sick. I feel relatively safe though, we have enough PPE. It’s just crazy. The saddest part is nursing home patients; they literally haven’t seen their families for months, even if they don’t have it, if they come from somewhere that has people who are positive, no visitors. I try to find beauty and love in tragedy when I can. 

Her response broke my heart. I’ve read that it’s bad but to have my sweet friend recount the chaos and horror just shook me. Can you imagine what first responders, nurses and doctors feel being bombarded with sick patients who can’t see their family and those who die? A local friend who is a doctor said her friends cry in their cars after working a shift because there are so many codes. 

Unfortunately, there is no where you can go to escape the pandemic, the divisiveness that’s occurring or the uncertainty. Corpus Christi is especially bad and has made national news, for all the wrong reasons. We have more cases than the larger cities (Dallas, Houston, Austin) per capita. Since March, 85 babies have tested positive for COVID-19. 

My Florida friend also told me that she had to start taking antidepressants because of stress and trauma of it all. Thankfully, the meds are helping and I’m so glad she reached out for help, but I couldn’t help but think of Dr. Lorna Breen, the ER doctor in New York who killed herself. She had no history of depression, other mental illness or suicidal ideation, according to her father. I can’t say for sure why she killed herself but I imagine the weight of so many people getting sick and dying was too heavy. Not only were people dying, but at that time, medical providers in New York struggled with a shortage of personal protective equipment. Dr. Breen also contracted the coronavirus before her death. 

The trauma of everything she faced every day could’ve changed her brain. Trauma has a way of doing that – just think about our vets who suffer with PTSD and depression. Trauma can also cause feelings of despair, and right now, who isn’t in despair? A 2013 study done by researchers at the University of Liverpool showed that traumatic life events are the single biggest cause of anxiety and depression, followed by a family history of mental illness and income and education levels.

It’s enough that our front lines workers have to worry about contracting coronavirus, but it can be just as bad developing depression (or other mental illness). Both diseases are ravaging and both can kill. I don’t really know what I can do to help these heroes other than bring awareness to mental health and the consequences of untreated mental illness. It’s overwhelming and I hope lawmakers will keep all of this in mind, because make no mistake, this will be a real problem — one that can’t be ignored. America’s supposed to be the greatest country in the world — so what does it say if we don’t take care of those who take care of us? It’s happened before.

After texting me about the chaos and death that surrounded my friend, she left me with this: “It’s so unfair that what should be an exciting time is tainted by all this but find the joy in it, too.” 

My friend is so strong and has such a good heart. She’s doing God’s work and she is more than worth protecting and taking care of.

G, if you’re reading, I love you and cherish our friendship. I’m so proud of you. Just keep swimming, my love.

If you know somebody struggling with mental illness or suicidal ideation, please direct them to the National Suicide Prevention Lifeline at 1-800-273-8255.

To learn more about depression, please visit the National Institute of Mental Health.

Q&A With My Psychiatrist

I have a really great psychiatrist, Dr. Neysa Johnson in Southlake, and she was gracious enough to answer some questions for me about depression and treatment plans so I could share with you. 

If you have depression, will you always have depression?
You will not always feel depressed, but depression, unfortunately, is a recurring illness.  If you have an episode of depression, you have about a 50% chance of it coming back.

What kinds of things do you recommend as part of a treatment plan, i.e. meds, therapy, etc?
A treatment plan should be well rounded, and usually includes both medications and therapy, as well as self-care like good nutrition, exercise, and sleep.

After starting a treatment plan, how long does it take to feel better?
It partly depends on the treatment, but for most antidepressants that are used to treat depression or anxiety, it can take up to 6-8 weeks to feel the full benefit of treatment, but a lot of people start feeling better in 2-3 weeks.

How will I know if I’m getting better?
I tell people that they will begin to feel more like themselves.  Treatment doesn’t change your personality or who you are, but it gets you back to your baseline.  You may not notice things at first, sometimes others notice changes before you do.

What kind of lifestyle changes will help my depression/diagnosis?
Managing sleep, nutrition and exercise can definitely affect your depression.

What’s the best thing to do in a crisis?
Self-care is really important.  Keeping a regular sleep schedule and getting enough sleep and eating nutritional meals on a regular basis are very important.  Exercise is really vital to stress relief, and finding a way to exercise even if you are in ‘shelter in place’ is essential. Emotionally, sharing your feelings and fears with others is very helpful to knowing you are not alone in how you might be feeling.  Reaching out for treatment may be needed in a crisis; and if you already have a mental health condition, keeping in touch with your treatment providers can help a lot.

How many patients do you see?
I see up to 13 patients a day for follow ups, less than that if I am seeing a new patient.

How long have you been practicing?
I have been in practice for 13 years, private practice for 10 years.

What are your credentials?
I have my M.D. from UTMB Galveston, and I did my residency at UT Southwestern in Dallas in Psychiatry.  I am board-certified in Psychiatry.

If you could tell your patients anything what would it be?
To be open with me about how they are feeling and if they are having any side effects from treatment so we can decide if we need to make changes.

I think the question that resonates most with me is, “If you have depression, will you always have it?” I (and so many others) work hard daily to stave off depression and it’s tough to see that I’ll probably always have it – and that it might come back. Right now, my depression isn’t terrible; I’m pretty high functioning, but it seriously exhausts me going through all the daily tasks I have to do in order to make sure I’m ok. Not great, just functioning. Just ok. I think that’s why it’s so important to focus on a treatment plan, stick to a healthy routine and I’m glad Dr. Johnson mentioned sleep, good nutrition and exercise as cornerstones to a treatment plan. 

Also, I’m glad she talked about self care during a crisis. Self care is always important but now that most of us are in isolation, it should be a priority. Honestly, being at home and not able to do much is just fine for me; however, dealing with the kids all day is exhausting, both mentally and physically. I can see how others being at home, away from friends and family would be tough and the urge to reach out might not be there. 

I know it’s hard right now but every storm runs out of rain, right? Take care of yourselves.

For more information on depression and other mental illnesses, please check out the American Psychiatric Association’s website. 

And as always, if you are feeling suicidal, you can call  the National Suicide Prevention hotline at 1-800-273-8255 or chat online with someone here.

The Struggle is Real

“Do I stay up, relax and watch trash TV or do I go to bed at a decent hour?” For weeks I’ve been having this internal debate and I know I can’t be the only one. I used to go to bed at 9 pm (in the good old days) because I need A LOT of sleep but now I blow past that 9 pm mark knowing that I’ll likely regret it but I also know I need “me time.”

Surely I’m not alone in this. Especially now because the coronavirus is holding us all hostage. Don’t get me wrong, I do like being around my children but after 8-12 hours of their incessant arguing, watching freaking Peppa Pig and wanting to climb on me and whatever else, I’ve just had it. I’m touched out. I want to be on the couch, watching my shows and not asked to do one single thing, even by my husband. I don’t even like the cats on me until after I’ve chilled for an hour. It’s too much. And I know y’all feel me. At least I hope you do otherwise I need to up my meds, lol.

My usual self-care routine includes massages, getting my nails done, reading and napping. I would also go to therapy. But none of that is plausible now and I think it’s ok to mourn that. It’s ok not to enjoy every second with your kids, because this shit is hard even when you do have outlets and self-care rituals.

Staying home with the kids right now is one of the hardest things I’ve done. My 3-year-old wakes up at 5 am every morning, which means I’m up. He’s clingier than usual, most likely from the uncertainty of life, which he can probably sense from us adults. But despite his 5 am wake calls, I’ll still probably go to bed late because that’s the only alone time I’ll have all day. The only time I can eat the kids’ cupcakes. The only time nobody is shouting, “Mommy!”

This precious time to myself has become a ritual and until the schools open back up, I’ll just be exhausted and crazy looking because frankly, I’d rather have bad TV and cupcakes.

If you’d like to share your self-care rituals, please do so in the comments.

I don’t do math.

This week I have made sure that my oldest (who is in pre-k) is doing some kind of work. Last week was such a shitshow and probably the week before that. But guess what? I can’t remember. I’m proud of us for doing some of the work provided by her teachers and also doing ABCmouse. I’m also proud of us for not getting into a knife fight with each other, but that could still happen, especially since this week’s worksheets involve fractions and a bit of math.

Anyone who knows me well can attest to my hatred of and subpar skills in math. I failed math courses in junior high and high school. Amazingly, I did fine in college but I think I took “Math for Liberal Arts Majors,” so there’s that. I know that I am not a dumb person but I just can’t do math problems. The numbers get scrambled in my head and even on paper I invert them. I wish I could blame my ECT treatments for my stubborn and forgetful brain when it comes to math but those treatments came decades later.

When I had children, I can clearly remember telling my husband, who is a literal genius, that he would have to help the kids with their math homework. And even though this is just the most basic preschool math in the homeschool packets, I still start sweating and stammering while I’m trying to give instructions to my poor daughter. She’d tell me how to do it and I’d get flustered because how would I know if she were right? Lol. Nothing makes you feel like a bigger moron than being confused over your kid’s homework.

What also doesn’t help is my daughter’s attention span (or lack thereof). She has no interest in doing worksheets and I can’t say I blame her. I can’t imagine how she feels – her impatient, non-math knowing mom trying to teach her when she wants to go outside or play with dolls or get on the iPad. Or stick a pencil through her eye, lol.

But the truth is that I’m lucky to be able to teach her during these times, and though she might deny it, she’s lucky too. To have a parent who has time to devote to her work. We are a privileged family, and in addition to math, I also hope she learns how good she has it and is appreciative.

I make light of the this situation because I’m hopeful it will be over in a few months. I’m hopeful she’ll enter Kindergarten and do great. I’m also hopeful her teachers can correct any wrongdoing on my part.

But she’ll be fine. I’ll be fine (so long as I never have to do math).

We will all be fine. Our children will thrive and be stronger for what they’re having to endure. They will probably learn more about love, strength, community and generosity – along with other things you don’t always find in a textbook. And to me, that’s most important to learn.

 

 

Safe Haven

As soon as the coronavirus started rapidly spreading, I started to panic. I panicked even more when, while the kids and I were at my mom’s house for Spring Break, the schools across the state starting closing. When lines wrapped around grocery stores. When my husband started to worry about business. What really bothered me the most is that I had to be with the kids at home 24/7 with virtually no breaks. I wasn’t trying to be selfish but I was worried about my fickle mental health. I tried to put a brave face on but no matter how hard I tried, the uncertainty and chaos had already sneaked inside their little lives.

The first things I noticed were changes in Eli. Usually, when I put him to bed I could sing him a song, tell him goodnight and he’d be out by 6:30 pm. When we returned to our home, Eli was afraid of the dark and wouldn’t go to bed without me. Then he started waking during the night. Now he’s up around 5:30 am, despite having an alarm clock that lets him know when he can get out of bed.

And that’s not all. Eli has started to hit – he’ll hit his sister, me and even his dad. One time he hit me so hard he knocked my glasses off and I spanked him. I cried so hard after that. We don’t even believe in spanking but I was at a loss. It was after that I started thinking – this virus has wreaked havoc on all our lives. It’s stressful no matter who you are or what you do. I know how stressful and anxiety-inducing it is for me but I hadn’t really thought about how this situation affects our children.

These sweet children are experiencing something that not even parents have been through. They’re out of routine. They miss their teachers and friends. Older ones are worried about high school graduation and and lamenting the fact they likely won’t return to their school. Some kids are experiencing death of their loved ones without ever having said goodbye. It’s depressing to think about but it is the reality of many. These are dark times.

No matter how old your children are, they’re still kids (or young adults). We all have to dig deep and find the resolve to create a safe place – to be their safe place. I’m not saying never share what’s going on in the world with them but if they do act out, and I’m guessing many will, we have to let them fall apart and put them back together again.

As a mom with depression who has “vacationed” at a psychiatric facility, I’ve seen very dark times. I’ve been scared. But nothing scares me more than thinking my children could get lost in the “dark” – the uncertainty and depressing road the weary world is traveling right now. So, of course I’ll stick to my mental wellness plan and I’ll take care of myself. Because I have to. I will protect my tender-hearted babies from the dark until my dying days.