Tag:

Depression

Fight Like Hell

by Heather Loeb

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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Dr. Lorna Breen. Photo from Ny Times

A couple weeks ago a well-liked ER doctor at a Manhattan hospital killed herself. Dr. Lorna Breen, the medical director of the emergency department at New York-Presbyterian Allen Hospital, had been reportedly working long hours and on the front lines fighting the coronavirus. She was 49 years old. Her father, also a doctor, said Dr. Breen had no history of mental illness or depression, but sometimes that doesn’t matter. Dealing with trauma, be it a one-time situation or an ongoing ordeal, can lead to depression and I imagine that was the case for Dr. Breen. She saw hundreds, if not more, of people suffering. People who couldn’t be with their loved ones during their final moments. Just thinking about how scary it must be for those dying alone makes me so overwhelmingly sad – not just for those dying but their loved ones who couldn’t say goodbye. Couldn’t tell their loved ones, “I love you,” or pray with them.

As of April 7, there had been 59 patient deaths at Dr. Breen’s hospital, according to an internal hospital document.

New York continues to be a hot spot for COVID-19, with 333,000 people infected and more than 21,000 dead. The weight of those numbers is so heavy, it hurts my heart. And I feel a combination of compassion and pain for nurses, doctors, first responders and others who are fighting this battle that has no end in sight. These people are heroes. They continue to fight a losing battle with not enough personal protective equipment and other life-saving medical supplies.

Everything I just mentioned can have a huge toll on anyone, and sometimes traumatic events can actually change your brain and can cause depression. 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.

According to the National Institutes of Health, some depression can be situational and with life changes, medications and therapy, it can be manageable. Other times, depression, anxiety or PTSD can be life-long problems.

What’s scary to me is that Dr. Breen’s depression (I’m assuming it was depression brought on by severe trauma) came on fast. There wasn’t much time to prepare for COVID-19, as fast as New York was hit. I’m sure priorities were treating sick patients, providing PPE to health care workers among numerous other jobs that had to get done. Which means, there was no time for Dr. Breen to get help. She felt she was best needed at the hospital and no doubt she helped hundreds of people and supported everyone in the ER Department, even after contracting COVID-19 herself.

Dr. Breen was no doubt a hero and dying by suicide doesn’t change that. It just emphasizes the need for better mental health care, more support for those struggling and more understanding from the public, who still support the stigma of mental illness and depression.

Look for these symptoms of trauma-induced depression:

  • Extreme sadness
  • Frequent crying
  • Feelings of loss
  • Emotional numbness
  • Disillusionment
  • Loss of appetite
  • Difficulty sleeping
  • Recurring memories/flashbacks
  • Nightmares about the traumatic event
  • Social withdrawal

If you know somebody struggling, 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.

 

 

 

 

 

 

 

 

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Bad Day

by Heather Loeb

For the past few weeks I have (mostly) been rocking the quarantine by staying on top of school work, baking, cooking more, sewing and I even learned to make bread. Good bread. I kept repeating myself, “When is this period of productivity going to crash down on me?” Because it always does, and today was that day. This whole week, actually. I stopped home schooling the kids, my sleep schedule is messed up, I haven’t done anything but lie on the couch and have a migraine.

I know everyone has bad days but why does something so good get taken away from me, just like that? Why can’t I go a long time being productive and happy?

I don’t mean to whine because there are people out there who have it so much worse and I want to remember that. I’m just sad. I’m in mourning of the me that got so much done, the me I was so proud of myself. It hurts to say this but I don’t know which one is the real me, the baseline Heather. I’d like to say the productive, happy one is but I’m better acquainted with this Heather – the one who feels buried beneath judgment, worthlessness, hopelessness and inadequacy.

I want to tell myself that it’s just hormones and/or only anxiety, and if I know anything, it’s that anxiety is a big, fat liar. It can take over your brain, meld your thoughts with those of the devil. And it feels so real. So, so real.

I know I’ll pull out of this little funk in time but I’m so afraid I won’t get back to the point where I was doing all the things I love, not just loafing on the couch wishing it would happen again. I waste so much of my life waiting for the good to come. But most of the time I’m too tired to breathe. So I just wait some more.

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7th grade photo

I remember it like it was yesterday, which is a feat because I don’t remember anything from all my ECT treatments. I was in the nurse’s office having left my 7th grade computer class. The nurse, who had seen me several times that month, called my mom from her office. I couldn’t hear everything but I did catch this, “Your daughter is in the nurse’s office again. I believe she has school phobia.” Little did I know that was the first “diagnosis” I would receive in the years to come. And there have been many.

The 7th grade was a difficult one for me and looking back I can see the first signs of an anxiety disorder and depression – extreme sadness, intrusive thoughts, and of course, anxiety. I thought it was normal to feel that way so I never thought to tell anyone about these symptoms. I can remember being scared, and it is scary to experience those thoughts and emotions, especially at the age of 12 or 13. My anxiety included being worried about dying, scared my family would die and I got nervous and agitated about school, fretting about projects due, homework and tests. Some of that is normal but what I remember is the sense of dread that went along with it. Every Sunday night (read my Sunday Night blues blog here) I would get anxious and my stomach would hurt. On top of that, I developed a phobia of thunderstorms. I began obsessively watching The Weather Channel, checking the radar and barometric pressure for signs of storms even when it was nothing but blue skies outside. When the weather did get bad I would experience more stomachaches and stress.

I also remember intrusive thoughts interrupting my daily life. I constantly prayed to God that my family or I would not die because my brain was telling me it was going to happen. There were milder thoughts like, “You’re a loser. Nobody likes you.” Thoughts that still plague me, even at 36 years old.

A lot still plagues me, including intrusive thoughts, anxiety and depression (I was diagnosed as having Major Depressive Disorder in my 30s). Even though it’s been more than 20 years, I still battle all of this every day. I might not be depressed every minute of every day, but it is a fight. Sometimes, a very hard fight. I still feel like that little girl, worried and anxious, trying to quell her thoughts. Only now I’ve traded little girl worries for big girl worries but at least I have support and a treatment plan.

It saddens me when I think of the kids struggling now – the ones who can’t verbalize their pain. According to the National Institute of Mental Health (NIMH), about 3.2 million 12- to 17-year-olds have had at least one major depressive episode (A depressive episode is characterized by low mood and other symptoms of depression that lasts for two weeks or more. Some episodes can last weeks to months). NIMH also says that depression in teens is on the rise.

If I could go back and tell myself it would be ok, that it would get better, I would in a heartbeat. More importantly, I would tell myself to come clean to my parents about the anxiety and dark emotions I was feeling so I could receive the help I needed.

It is my hope by blogging about my experience others will realize this can happen to anyone, at any time. I had a wonderful childhood and amazing, supportive parents. I always felt I had everything that I needed. Still, depression struck. It doesn’t discriminate, doesn’t care who you are and apparently, it doesn’t care how old you are either. Such a cruel disease.

That’s why support from family and friends is so important, especially for kids and young adults. If one of your loved ones is struggling, please reach out. Do research about depression and anxiety and educate others who might still buy into the stigma surrounding depression.

Here are some things to look for when it comes to adolescent depression:

  • Irritability and moodiness
  • Abnormal sleeping habits
  • Isolation, especially from adults and family members
  • Low energy

Something to note about depression in teens is that symptoms vary by age but also by gender. According to a study published in the Journal of Family Medicine and Primary Care, girls report feelings of sadness, guilt, worthlessness, punishment, tiredness, low energy, where as boys report irritability, depression and suicidal thoughts.

According to the CDC, only 20% of youth suffering from a mental health disorder receive treatment. That means 80% or 12 million youth are undertreated or not treated at all.

There are more alarming stats but I’m going to stop here for now. I know all the aforementioned symptoms may sound like “normal” teenage behavior but hopefully this blog and the studies I mentioned earlier will give you insight into teen depression and encourage you to support a loved one if you see them flailing.

Depression is difficult and ravaging for adults, let alone kids and teenagers. Let’s focus on supporting and taking care of each other. Thanks for reading.

Stay in the light.

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Q&A With My Psychiatrist

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

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

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

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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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

“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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