treatment resistant depression

99123330_10104257334010564_1018913027413508096_nYesterday, I went to the dentist to replace some old fillings. No big deal — except that it was. I got in the chair and the dental assistant put the nitrous mask over my nose. I started to feel intense anxiety. I think it reminded me of my ECT treatments, which give me a ton of anxiety. I grabbed the mask off my nose and tried to calm down but I had lost control. My heart was pounding and I started to shake. I lay back down and the dentist started to numb my mouth but as soon as he put instruments in my mouth, I couldn’t breathe. I felt like I was in danger, as silly as that sounds. By then, it was decided I would come back another day and I left with my numb mouth and all.

I am prone to panic attacks, so I have a lot of coping mechanisms I use – not just for acute incidences like at the dentist but also for times I can’t go to therapy every week and now for a pandemic!

It’s hard to distract yourself when you’re in the throes of an attack or in a depressive episode, and I’m not perfect. For almost every healthy coping skill I have on file, I also have an unhealthy one. When I don’t use the healthy mechanisms, I definitely pay the price emotionally, and even physically.

Here’s what works for me, whether I’m stressed or having an attack:

  • Practice deep breathing – When you do deep breathing exercises you increase the supply of oxygen to your brain and it stimulates the parasympathetic system, which promotes a state of calmness, according to
  • Watch Friends bloopers on YouTube – This is one of my fave ways to relax because as soon as I start watching, I’m cracking up and my brain has managed to think about something else. I highly recommend laughing your stress and anxiety away
  • Sing my favorite songs – I sing a lot. The kids are constantly telling me to stop but it makes me feel good. It’s something that I do regularly to improve my mood but probably not something that can stop a panic attack in its tracks
  • Take VERY hot baths – I like to turn the heat up as much as possible to where the only thing I can feel is the hot water. It’s also therapeutic for me to have a good cry while the water is running
  • Write – Again, blogging really helps maintain my mood but it isn’t something I would be inclined to do when I’m panicking
  • Get a massage – This is my favorite thing to do to keep me de-stressed but unfortunately, I haven’t been able to get one because of the coronavirus
  • Get under a weighted blanket – says the weighted blankets help ground your body by pushing it downwards and has a deeply calming effect. The blankets also stimulate deep pressure touch, a type of therapy that uses hands-on pressure to reduce chronic stress and high levels of anxiety
  • Sew – I really have to concentrate to sew, so I tend to leave my troubles behind while working on a project
  • Read – Reading is awesome and you can get lost in a completely different world
  • Pray – It helps me to pray, especially when I’m feeling completely out of control
  • Go to therapy – This probably should go at the top of this list. Talking to my therapist helps me sort my thoughts and she provides practical solutions to some of my often-illogical behavior
  • Get my nails done or do them myself – My friend Meredith and I have a saying — “Everything is always better with painted nails.” Solid philosophy

Those aren’t all the coping skills I’ve employed but my favorite ones that have proven beneficial. Now, for the unhealthy mechanisms. I DO NOT recommend you try to deal with panic, stress, anxiety or depression with these but I know they are very common. While I aspire to nix those from my list some day, I understand that it’s hard to break these habits and behaviors.

  • Overeat or binge on healthy foods – Depending on the situation, I purposely overeat until I’m uncomfortable or in pain. More rarely, I binge on unhealthy foods like candy and LOTS of carbs. I do love my carbs but I had gastric sleeve surgery last year, so it’s REALLY not in my best interest to eat them. (If you have unhealthy eating habits, check out my cousin’s Facebook page. She’s a licensed nutritionist and has great ideas about intuitive eating)
  • Compulsively shop – Sometimes, I just feel the need to shop. It’s fine if I need something and need to buy it for the house or kids, but I’ve had times where I’ll spend hundreds of dollars on stuff we don’t necessarily need. And it makes me feel terribly guilty. That’s the thing with unhealthy coping skills, they only feel good for a little while
  • Blow off appointments – When I’m dealing with a lot I feel like I need to retreat into my home and be alone, which is fine some of the time but at other times, I really need to go to therapy or my doctor. There have even been times I blow off the not-so-important appointments like getting my hair done or a massage appointment but I’m still being inconsiderate but not going and wasting others’ time. I feel guilty about this, as well
  • Abuse my medications – I don’t do this anymore but there was a time that I would take too many of my anxiety pills because I just didn’t want to feel, well…anything. I would also take too many pain pills, pushing the limits of what was safe. This is a serious problem, and for some people, it’s a deadly problem. If you abuse your medication and need help stopping, please contact your doctor

Having depression and anxiety is hard. They both can take over almost every aspect of your life and make it even harder. While I implore you to find coping mechanisms that work for you, I think I would be doing a disservice if I didn’t mention that things such as talk therapy, medication and a good doctor can drastically improve your life. Sometimes we need to arm ourselves with more than coping skills, and that’s OK. Whatever your plight, I hope you find peace with it and thrive.

If you are suicidal, please call the Suicidal Lifeline Hotline at 1-800-273-8255 or visit their website at to use the chat function. Stay in the light.


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I write a lot about having depression and reaching out to get support but it has come to my attention that when I’m the one struggling I don’t reach out often. Maybe to my mom, husband and best friend but with everyone else I put on a happy face while inside it feels like I’m dying. I think it’s important I talk about the dark while I’m in it.

It started a couple weeks ago. I wasn’t being honest with myself about how things were going. I happen to have a therapy appointment and one with my psychiatrist that week so I let it all hang out. It felt good to come clean and it was decided I would get an ECT treatment ASAP. I scheduled it for next Friday so in the meantime I made an impromptu visit to my parents’ lake house. The kids were dying to get out of the house and I figured it would do me good as well. While the kids had a blast, I didn’t fare as well. I can remember one night eating steak with my parents and I was staring at the bright pink steak knife that cut the steak so well. I wondered how it would feel down my arms. Later, I told my mom to just hide the knives.

I decided to chat on the suicide lifeline messaging system. The lady was asking my history and as I told her that I had major depressive disorder, anxiety, I’ve done ECTs, been to a psychiatric facility, etc. She the said, “Wow, you’re a fighter.” Though I know it’s the truth, it’s not something I’ve heard a lot through my life. I’ve heard I’m lazy, that I’m basically useless, but not a fighter.

But I fight everyday. For my kids, my husband, my family, my amazing friends who support me no matter how depressed I am or how unwashed my hair is. And I know sometimes I’ll fall back on the idea that being mentally ill makes you weak, but I can’t stress enough how that’s total and utter bullshit. And then I’ll remember that I’m a Phoenix rising from the ashes, that I’ll regenerate and will continue to be born again. Because I’m a fighter and I will continue to fight like hell, even though it sucks, even though it’s hard, even though it tires my soul. If anything, I need to show my children that there are many ways to be strong. And that it’s ok if you’re different than others. It’s even ok if you need to go to a mental health hospital. And that self care is a necessity and doesn’t make you selfish. I’ve tried pouring from an empty cup and it got me nowhere (technically it got me to the mental hospital) so even though my journey is a messy one, my kids can still appreciate it one day. I hope.

If you need help, I highly recommend either calling the National Suicide Lifeline or using their chat function. Call them at 1-800-273-8255

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The other day my doctor suggested a couple of Ketamine infusions to do until I can do ECT. I didn’t think much of this because I’ve done several ketamine infusions in the past and they didn’t do much for me, but I learned the clinic that I was going to in Corpus was doing the infusions wrong, or perhaps not in the ideal way. Let’s put it that way.

At the old clinic they were adding benzos (Ativan, Valium) to the ketamine, which actually lowers the efficacy of the ketamine. I didn’t know that until I got to Menninger. Also, the other clinic’s protocol was to give everyone 100mg/hour no matter what. Here, they go by weight. I was skeptical of that at first but now I see why.

When you do 100 mg per hour, rather when I do 100 mg per hour, I feel like I’m in a black hole. There’s a lot of dissociation and I just feel drugged up and then I’m tired for the rest of the day. When I tried ketamine at the clinic, it was almost a religious experience. It was the most calming, most relaxing, therapeutic experience I’ve EVER had. I felt happy – and I haven’t felt happy in a loooong time.

It was amazing. Now, this infusion lasted just 40 minutes but I’ve already noticed a shift in my behavior. I made some jokes with some of the patients and staff here. I cleaned up my room and generally my mood is a bit better. I still have depression, of course, but it did provide a respite from the constant pain I’m in.

This makes me hopeful. I’m scheduled to have another ketamine treatment Monday and then later in the week, I’m due to start ECT. I’m not expecting my life to change but I’ll take any improvement from my current state. Some days it’s just so hard to breathe and it’s so exhausting to be a wife, mother, daughter, friend, etc. It’s just painful. Everything is painful, so relief is all I want. I want to be there for everyone. I want to smile and laugh – just live in something other than this awful darkness. I know I have to work on my therapy, too, and believe me I am. Everyday here is emotionally draining and I don’t think I’ve gone a day without crying, but that’s okay. I’m just trying to get to the other side.

I hope I see ya’ll there soon.

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Since I’ve been blogging, I’ve gotten a lot of feedback from friends, family and strangers. Most of it is really positive – some have thanked my for being so blunt and open about mental illness and they don’t feel so alone. I’ve also had others tell me that I’m “not doing it right.” I’m not praying hard enough, I focus too much on the negative, or this is something I’m doing to myself.

This is part of the stigma I’m trying to fix.

And I don’t have to defend myself. I know I’m one of the hardest working people when it comes to my mental health. Depression is NOT something I do to myself subconsciously. Nobody wants this. Nobody.

Don’t let anybody tell you that you’re not trying hard enough, or you’re doing this to yourself. Don’t think you can just pray this away (prayer does help but you know what I mean). Don’t let anyone think you are a lesser person because you have this disease. Those people obviously haven’t struggled the way we have, and good for them – they are very fortunate.

But you can try every treatment, pill, therapy, alternative medicine, meditation, etc., and you will still have this disease. Do you know why? Because your brain is not the same as everyone else’s. You have unruly neurons. It’s just chemical and it’s not your fault. Especially if you are treatment resistant, it’s not fair.

It’s still not your fault.

So the next time someone says pull yourself up by the bootstraps or think positively (I know you are), just remember that you are working hard. And forgot those other people who obviously are ignorance to the intricacies of depression and anxiety and how it affects you.

Just keep swimming, friends.

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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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