Category:

Depression

Q&A With My Psychiatrist

by Heather Loeb
written by Heather Loeb

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.
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Fragile Psyche

Fragile Psyche

by Heather Loeb
written by Heather Loeb

Edit: This post was originally slated to run Sunday, April 19.

Fragile Psyche

COVID-19 is driving me crazy.

I am desperately missing my life of mediocrity. I realize that everybody’s lives have been turned upside down but I’m wading through some uncomfortable feelings that are starting to challenge my mental wellness.

I want to preface this post by saying it’s Sunday, and I always get the “Sunday Night Blues,” but it’s even worse knowing my kids will be spending all their waking hours with me and I’ll have little to no break.

I don’t mean to sound ungrateful or whiny; I know there are lots of families who can’t stay safely at home, away from the virus, but it’s just so trying right now. I needed a lot of mental breaks before all this chaos and that was with the kids being at school from 9 a.m. to 2 p.m. I was able to cope (for the most part) because I had time to decompress. But now looking at the week ahead the every day mundane tasks I have to complete in order for all of us to function seems insurmountable.

These uncomfortable emotions also are challenging my treatment plan — the plan I have outlined that helps me stay on track mentally. Instead of using my healthy coping skills, I want to turn to my bad habits, which caused my breakdown (last summer) in the first place. This includes: overeating, over spending, not sticking to a sleep schedule and wanting to abuse my meds (which is hard because I don’t have anything to abuse anymore).

I don’t know why I would want to fall back on these negative behaviors, especially when I’ve worked so hard to get where I am. I guess sometimes it feels good to be “bad” but the thing is, I’ve seen the endgame to that. I know where it leads you.

I know it’s ok not to feel ok right now, so that’s what I’m repeating to myself. Tomorrow’s a new day and I plan on reviewing my Self Care 101 list, which is abbreviated here:

  • Get good sleep
  • Know and accept limits
  • Eat healthy foods
  • Decompress throughout the day
  • Feed spiritual sel
  • Remember to love myself

If I just go back to the basics I know my fragile psyche will recover. And getting all this out has actually helped, too.

Ultimately, I need to make good decisions and take each day hour by hour. That’s what I need to do to survive right now.

If you have some self-care tips you’d like to share, drop them in the comments. Thanks for reading. Stay in the light.

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Heather Loeb, Creator of Unruly Neurons

ECT and Me

by Heather Loeb
written by Heather Loeb

I’ve talked a lot recently about my six-week stay at the Menninger Clinic but haven’t really discussed why my stay there was so helpful – doing (electroconvulsive therapy) ECT treatments.

Over the years I was told to try ECT because of my treatment-resistant depression, meaning none of the meds I tried (and I tried a lot) worked well. ECT always scared me and I think it scares a lot of people. I imagine a lot of people associate it as being “shock therapy,” a very primitive form of today’s ECT from the 1900s. But I was doing so poorly by the time I got to Menninger, I prayed that I was a candidate and it worked. Turns out I was and it did.

I did my initial (or index) treatments at Menninger. I did treatments about three times a week until I left the hospital. Each treatment began with memory and cognitive testing. After that came the actual treatment. The nurses would place electrodes on my head, which would provide an electric stimulus to my brain, inducing a seizure. It was then my brain’s job to shut off the seizure, and I was told the shorter the seizure the better. I had monitors for my heart function, blood pressure and pulse, as well.

After everything was in place it was time for the anesthesia. They would administer it, insert a bite guard into my mouth and place an oxygen mask over my face and nose. I’d fall asleep, have the seizure and be awake in about 15-20 minutes.

At first I had awful migraines after the treatments and would have to stay in bed, but now I get a minor headache, some neck pain and fatigue. Not so bad, considering.

As I mentioned earlier, I did my initial treatments at the Menninger Clinic but then switched to a facility in San Antonio, Laurel Ridge Treatment Center after I done at Menninger. Unfortunately, there are no doctors who perform ECT in Corpus Christi, where I live. Both facilities are very good but different. Whereas Menninger might see a handful of patients – if that – a day, Laurel Ridge sees much more and they’re very efficient getting people in and out.

Sometimes I panic before a treatment, although I don’t know why. Nothing scary has ever happened to me but I do get very nervous beforehand. The nurses/doctors can’t give me anything to relax because most meds in that category prolong the seizures. Regardless of my panic, I still get treatments when I’m feeling down.

If you are contemplating ECT, feel free to contact me and I’ll answer any questions. I know it can be scary and intimidating but the treatments are very safe. It has been, by far, the most effective treatment for my treatment-resistant Major Depressive Disorder, Generalized Anxiety Disorder and Avoidant Personality Disorder. I’m happier and have more energy now.

One thing I will mention is memory loss. This is normal and usually occurs around the time of treatment, so you might not remember getting to the hospital or recent conversations. In my case – and this is just me – I have lost memories from years ago and short-term as well. You can read my memory loss blog here.

Having said that, I would still recommend ECT to anyone who is suffering with depression. It really changed my life at a time I wasn’t sure if I’d make it much longer.

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Disorderly Personality

by Heather Loeb
written by Heather Loeb

In 2019 I entered an inpatient program at the Menninger Clinic in Houston. I was having some issues to say the least, including suicidal ideation, severe depression and I was mis-using some of my medication. I guess the better word would be abusing.

Going into the program I had already been diagnosed with Major Depressive Disorder (MDD) and generalized anxiety disorder (GAD). After six weeks of intensive testing, therapy and meetings with doctors, I was able to return home, but I had a new diagnosis to my already growing list – Avoidant Personality Disorder. I had never heard of it and I didn’t know anyone else with a personality disorder so I was feeling like a “legit” crazy person, if there ever was such a thing.

I’d spent years being diagnosed with depression, dysthemia, an anxiety disorder and I was even misdiagnosed as Bipolar II. I knew next to nothing about Avoidant Personality Disorder (AVPD) but I soon learned. It’s a disorder characterized by social discomfort and avoidance of interpersonal contact. According to the Mayo Clinic, someone who has AVPD avoids intimate and social contact with others.

When I read this, I thought, “Wow, this is me.” I think it’s apparent to those who know me well know I’m no extrovert. And while I do have friends, it is rare for me to be around a lot of people and not at all uncommon for me to cancel plans (usually due to anxiety). But as I continued reading, something struck a nerve. My paperwork stated that people with this condition may be extremely shy, fear ridicule and be overly concerned with looking foolish. That they – I – could have an inferiority complex. Yes, I’m sensitive and don’t respond to rejection well but isn’t that everybody?

Apparently not.

As I continued learning, I read that these folks have low self esteem and here’s the kicker – it’s common for people to avoid work, social and school activities for fear of rejection. I was constantly missing school and later work. And it always caused problems.

According to WebMD, a person with Avoidant Personality Disorder may be afraid to speak up for fear of saying the wrong thing, blushing, stammering or otherwise getting embarrassed. That they may also spend a great deal of time anxiously studying those around for signs of approval or rejection.

I know my diagnosis doesn’t define me, so I try not to get upset when I revisit my paperwork. But sometimes I do get upset and that’s ok. Yes, I have “mental problems” but who doesn’t?

But it is important to me not to be “extremely shy” and so scared of rejection. It’s more important to me because my children are watching me, and I would hate for either of them to be painfully shy, to miss out on things only to create a world of isolation and loneliness.

So, I’m (trying) to step up. Kids’ birthday parties? We’re there. Encouraging my children to say hi to others, even adults? Yes. Teaching them to be confident and strong? We’re working on that, too.

No parent wants their children to repeat their mistakes but I hope both my children pick up on some of my attributes that weren’t in my Menninger paperwork – my empathy, resilience, creativity and generosity (that I already see blossoming in my oldest).

Again, my diagnosis does not define me and how I live my life. If anything, it helps me live life more fully and with having more empathy. And that’s ok with me.

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Uncategorized

When the Darkness Comes

by Heather Loeb
written by Heather Loeb

I can feel it coming. My body feels weighted down, I’m irritable and even more sensitive, which is saying a lot. It’s sort of like PMS but it’s more than being moody and there’s no relief in a few days. Sometimes I just want to die.

I can remind myself how lucky and privileged I am, who I need to live for but the pain is deep and distorts everything I know to be true. It’s a scary feeling and I hate feeling out of control. Despite having a safety plan (a plan of action for when or if you’re suicidal), I don’t feel safe. There have been times I have called the National Suicide Prevention Hotline and tried to use the chat feature but there were more than 70 people also waiting for help and support. I could have called the hotline but I resigned myself to sleep.

Things looked better in the morning but it was still creepily dark in my head. I didn’t want to get out of bed but had to take the kids to school. I couldn’t shower. I couldn’t brush my teeth. I forced myself to take my pills and retreated to the comfort of my bed.

After a couple of (weepy) days, I did feel the fog lift but it took awhile to return to “normal.” That’s the scary part of depression – one of them, anyway. You can do everything right – take your pills, see your doctors, see your therapist, put real pants on and shower but depression will find you.

So will anxiety. My depression and anxiety go hand and hand. Mine makes me obsess about the weirdest things – things that have happened years ago, hypothetical tragedies that could happen to friends/family, bad things happening. Sometimes there are no thoughts behind it. It’s just there, a heavy weight on my chest making it hard to breathe.

Since going to the Menninger Clinic these symptoms have gotten better but not all together gone. When I can muster the strength to combat my overwhelming sadness and panic, there are things I can do to help.

  • I take my anxiety pills
  • I get under my weighted blanket
  • I listen to guided mediations or favorite music
  • Write

But if you’re in a scary situation that you can’t get control of, please call the National Suicidal Prevention hotline at 1-800-273-8255 or call your city/county’s mental health resources to see what’s available to you. And you can always call your primary physician. There is help out there and I know sometimes you don’t feel you need help but that’s just the depression talking. People care.

I’d you’d like to list your positive coping skills, please feel free to in the comments.

Stay in the light, my friends.

 

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Self Care Isn't Selfish
Uncategorized

The Struggle is Real

by Heather Loeb
written by Heather Loeb

“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.

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My Mother

by Heather Loeb
written by Heather Loeb

My mom is cut from a different cloth. Even from a young age, she has always done what she needed to do. At 19, her father died. She didn’t hesitate to help my Mema with the younger kids. She took a job right after high school so she could help pay bills. My mother had seven siblings but the two older siblings were married and were starting families, so she helped take care of the younger five. Still to this day she helps her siblings, financially or otherwise because that’s who she is – a caretaker.

Skipping years ahead, she got married and helped my dad and his brother open a business. She was the first employee and she excelled at it, even though it probably wasn’t her greatest passion. Still she learned everything about truck accessories for heavy duty trucks and continued to work that job for years. After some personnel issues, my mom and dad decided to open a second store, this one with my older brother at the helm. It too was a success and it still didn’t bother her talking shop about truck bumpers, wheels and other accessories. Like I said, she always did what she needed to do.

I can’t speak for my brother but I’m sure he would agree – she would do anything for us. In middle school when I developed migraines, that at times were uncontrollable and debilitating, she became my advocate. She navigated a new world of medicine and therapies and triggers. Fragrances were a trigger so she stopped wearing perfume and bought special soaps.

Years later I finally told her I had depression – bad depression. This was not her field of expertise and although she was probably really scared, she learned the ropes and how to help me calm down during a depressive episode.

When I had kids my depression worsened. Some days I couldn’t find my way out of the overwhelming sadness. I would often want to harm myself. My mom, who had never experienced mental illness herself, dug deeper and supported me the best way she knew how. It must’ve broken her heart when I became suicidal and needed intensive intervention. I stayed at a psychiatric treatment center for 6 long weeks. But she was there, helping take care of my children, visiting me and encouraging me once again.

As I’ve now stabilized, I think about the calls I made to her crying, suicidal. Her love, strength and endurance has never wavered and she just listened, not knowing how to help her daughter stop being suicidal. I firmly believe she was meant to be my mom, to help someone who struggled daily with invisible demons. Someone who wasn’t cut from that seemingly magical cloth. But I have learned from her, too. My bouts with depression have taught me strength, most importantly, compassion. My mom has been my advocate, leading me to be an advocate for those who suffer from depression and anxiety. Maybe to those who haven’t had support and are afraid of speaking out because of the stigma surrounding mental illness. Maybe I’m more like my mom than I think. At least I’d like to think so.

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I don’t do math.

by Heather Loeb
written by Heather Loeb

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.

 

 

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Safe Haven

by Heather Loeb
written by Heather Loeb

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.

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Remembering

by Heather Loeb
written by Heather Loeb

As y’all are all well aware, it’s been weeks since we started self-quarantining and though I feel stretched thin by homeschooling and being with the kids 24/7, I have discovered an advantage I have – my ECT treatments (for depression/anxiety) and the holes that they left in my memory.

I once read that (usually) people who suffer from ECT memory loss only lose memories around the time of treatment. That hasn’t been my case. My treatments have erased memories from years ago. I’ve forgotten people. I often have no idea how I’ve met my friends on my Facebook page. It’s been embarrassing and frustrating and that’s why I considered it such a burden in my life.

Until now.

To maintain even a modicum of sanity, I have turned to my favorite books, TV shows and movies. I picked up my favorite book last week (Summer Sisters, Judy Blume) and although I did remember most of it, there were delicious new details that I consumed – they felt new anyway. I was also able to watch one of my fave shows again. This time I couldn’t remember plots and characters. I have to admit, it was nice watching like it was the first time. I cried during the series finale, probably much like the first time I watched. Everything is new again.

I began to think – my memory loss isn’t such a bad thing. It was then I realized I could apply this thinking in other aspects of my life. Mainly, with the children. Being home with them all day reminded me of when they were babies. The days were long and hard then, too. And yes, they’re older now but I can rediscover parts of my babies that I otherwise might have forgotten.

Isla’s laugh.

Eli’s all consuming love for his Weerows.

How bright and tender hearted they are.

I’m memorizing their faces, gestures and little quirks that make them who they are – (hopefully) better versions of me and my husband. This time I’m documenting it all. I hope they remember the games we played during this time, the pictures we drew and stories we read.

I don’t know how my brain chooses to keep or erase memories. I’m sure some might want to forget these past few weeks forever, as thousands are dying and sick. And while I’m ok with blocking that out, I will remember that it was a privilege staying home with my family.

That I’ll never forget.

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