Category:

Depression

Exhaustion

by Heather Loeb
written by Heather Loeb

You know when you wake up and you’re in a good mood? You don’t even have to think about it, you just have a good day…

I don’t.

If I wake up in a good mood, which is rare, I have to constantly monitor my emotions to keep myself in a good mood. My therapist pointed out to me that (most) other people just have emotions but I have to manage mine. And it’s exhausting. I think that’s why I have to compulsively eat, compulsively shop or take something, like an anxiety pill, just to feel ok. Anything throughout my day could set me off or unnerve me and I’m always on alert. It leaves me feeling so depleted all the time, and along with my depression, I’m just so worn out.

I’ll tell you a story that isn’t the best example but it’s the only thing I can think of right now. My husband told my daughter that she could get a new kitten. I wasn’t on board at first, as we have three older cats now. I finally got on board and I went to look at some kittens alone last week. I was excited. I was having a great day and almost felt manic, which when I look back, I probably just felt like a “normal person.” Even my husband commented on what a good mood I was in. Back to the kittens. I found one that I liked and called my husband. I thought we could bring the kitten home and surprise the kids. I thought wrong. My husband said no – that we would have to wait until we got back from out of town. We’re leaving for a week after the kids get out of school.

I was crushed. I immediately felt depressed. All the happiness that was running through my veins turned cold and I couldn’t stop crying. I knew this wasn’t over the kitten, I didn’t even like it that much. It took me a few hours to realize that I was scared and disappointed because the feeling of happiness could be gone just like that. That I’m so fragile. I had stopped managing my emotions.

Again, that was last week and I haven’t felt that great since. It’ll come back, I’m sure. I hope. And if it does, I can’t let my guard down for a second.

I’m tired just thinking about it.

Stay in the light, my friends.

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Emotional Eating

by Heather Loeb
written by Heather Loeb

Update: I’m doing very well with my intermittent fasting but wanted to talk about emotional eating and what drives it.

Somewhere inside me, there’s a void. I don’t know what it is, I don’t know where it is – I just know that when I want or need to fill it I do two things: eat or shop. I’m always doing one or the other (or both) – a compulsion is always present. Mainly, emotional eating. As I mentioned in my Weight Gain blog, it’s the only part of my day that I feel happy, but that’s just it – it’s not real happiness and it brings on more guilt than anything.

I talked to my therapist about this today. I have a great life. I have everything I need and want: a great family, nice house, awesome kids and a wonderful husband. Where is this void coming from?

I honestly don’t know.

I’ll tell you what I do know. When I binge or compulsive eat, the food will be bad for me and obviously I will eat too much of it. Sometimes, I’ll do it in private when the kids are at school or when David is asleep. I’ll even eat in my car if I think my housekeeper is at the house. I guess I don’t want them to judge me. I don’t want them to know I’m going to eat half or an entire pizza to feel good for maybe 15 minutes, if that, feel guilty but then do it all over again the next day.

This isn’t just eating unhealthy occasionally and gaining a few pounds. As I mentioned in my other blog, this is gaining 20lbs in two months. This is eating until I feel sick and uncomfortable. This is terrible.

And it’s usually comfort I seek when I’m eating. I make excuses like “oh, I had a long day” or “the kids were driving me nuts today.” I’ve got to realize that’s going to happen all the time. That’s life. I have to deal without food making it “better.”

But it’s not really the kids misbehaving or having long days that drives me to emotionally eat – it’s that emptiness inside. Where is it coming from? I just can’t figure it out.

I don’t hate myself. I don’t want to sabotage myself. I don’t lack self-awareness. But I don’t have the answers either.

I’m not asking for a psychoanalysis either, folks. Just getting it out there, because if your keep it inside it stays a secret and bounds you.

 

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Fasting as Fast as I Can Go

by Heather Loeb
written by Heather Loeb

So, a lot of you responded to my weight gain blog. Tons of you reached out and said you were in the same boat, which is nice to hear that I’m not alone but it also means maybe I should share some of my weight loss journey, which shouldn’t be too depressing. One would hope.

Yesterday, I started a intermittent fasting plan. Basically I eat three meals a day but only between certain hours. I can eat between 6 a.m. and 2 p.m. and that’s it. I can have water and tea anytime, but mainly tons of water Now, I want to be clear that I don’t consider this a diet but making healthy life changes. I do not think fasting is sustainable for the rest of my life but I do hope it will encourage me to make healthier choices and help me gain momentum to start losing weight. Also, I’m not advocating fasting. Check with your doctor before your start any diet changes or exercise plan. You’ve been put on notice.

Anywho, I made it through the day better than I thought. I accidentally skipped my third meal because I read the plan wrong but I wasn’t that hungry during dinner time and David graciously didn’t eat in front of me, so there’s that. I also didn’t have any Diet Coke SO THERE’S THAT, TOO. I’m been trying to quit for years and even though it’s been one day it feels like years.

I want to document this journey with pics, so below you’ll find pictures of what I started at and I’ll post updates throughout this process. I also won’t be a liar and tell you I’m perfect. If I make mistakes while trying to make these life changes, I’ll ‘fess up. There’s no “cheating”, this is all a learning process. I’ll even tell you the numbers on the scale.

Yesterday, it was 187. I’m 5’7”, making my BMI 29.3, which is considered Overweight on the charts.

 

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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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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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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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