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electroconvulsive therapy

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Half Glass Full

by Heather Loeb

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Preface: A few weeks ago I fell into a depressive episode, the first since leaving The Menninger Clinic 5 years ago. During that 6-week stay, my medicine was changed, I did intensive therapy, took classes and started electroconvulsive therapy treatments. In the past couple of weeks, I’ve been irritable, fatigued, had a loss of appetite, had problems showering, been sleeping more, etc. A week ago I started a new medication that’s used off-label for treatment-resistant depression. It has been a very difficult time for me. 

I’ve been on my new medication for about a week now. I’ve read that it can start working as soon as a week, but won’t be completely effective until about 6 – 8 weeks. But the past two days have been good, and I feel excited and hopeful about what may come.

Earlier this week was challenging. I had two commitments at NAMI that I thought I could handle but at last minute (day before) I panicked, had an anxiety attack and knew I couldn’t make it. I didn’t know what to do until it just came to me — “I should ask for help.” You might think that should be an automatic thought, but I had never asked my friends at NAMI to help like me like that. I’ve asked one or two for help, but never said I was flailing and needed help now.

So I asked.

Within minutes, my NAMI commitments were covered, and grateful tears streamed down my face. I received supporting and kind texts telling me to rest and take care of myself.

The next day one of the Leadership Team members came to do a “wellness check.” She’s a dear friend and gently told me we needed to get organized when it came to covering my future events and presentations. I told her my original plan was not to do those things and focus on what I could do at home. Meetings and presentations are very overwhelming to me right now, and I certainly wanted help with that. So we made a plan, and I felt so relieved. Before I would put meetings or presentations on my calendar, thinking I’d be okay by then, but then I’d have anxiety attacks when it came time to go. This would prevent us from scrambling the day before or day of and prevent a lot of stress.

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I talked to most of the Leadership Team, and everybody has been so supportive. They want me well in time to go to the big NAMI Texas Conference Nov. 7 to Nov. 10. That gives me about a month. I feel like I can handle that, and that will give my medicine more time to work.

Even though I’ve had a couple good days this week, I’m still struggling with fatigue and taking showers. I also got on the scale today just to check, not thinking there’d be a big change, and I’ve lost 6 pounds since this depressive episode started. I’ve noticed it has been harder to eat, but I didn’t realize it was that bad. My doctor told me to stop losing weight, but I’m thinking he’d be understanding with everything that’s going on (maybe). So now I have one more thing to worry about, but I guess it’s better than me binge eating.

In other, positive news, I’m not napping so much during the day, even on the weekends. I’m gearing up to start walking on the treadmill in the mornings. I bought new workout clothes and (read Isla) updated my playlist (all Taylor Swift). I feel optimistic about taking care of myself, but I don’t want too excited because I know fatigue and apathy can take over anytime. But I want to stay positive. If I can just get 20 minutes of walking in each day, that’ll help stifle the depression big time. Oh, and I plan on going outside for some sunshine, too.

I’m going to do everything I’m able to get better. I just gotta strike while the iron’s hot. And it’s warming up.

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I’m Happy, Y’all

by Heather Loeb

If you happened to read my blog last night, you learned that I was feeling sad. Well, when I awoke this morning, I was feeing pretty good. That’s the thing about negative emotions (at least in my case) — they’re fleeting. My baseline, ever since leaving the psychiatric hospital, is good. Then pretty good, great, happy then amazing. But I don’t stay sad for long, and if I do, that means there’s something wrong, i.e. I need an extra therapy appointment, medicine change, Ketamine treatment, ECT, etc. It’s a simple barometer for me.

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But you know what?? It’s ok to be sad. You can sit with your feelings and explore them. Just don’t move in with them. Sit with them, then let them go. Meditation helps. Don’t feel bad when you you feel a negative emotion. You’re feeling them for a reason, and ignoring them is not the way to go, trust me. Although this is my process, and if you have a better one, I honor and respect that.

My favorite part of yesterday’s blog was the positivity at the end. It was faint, but it was there.

 

Right now I countdown the hours until I can take a nap or go to bed. I do my best during the hours I’m awake, but tears crowd my eyes knowing I might wake up tomorrow feeling the same way, even though I pray so hard it doesn’t, and I envision a happy day.

But you know, even on a sad day like today, it’s still a million times better than when I was in my worst depressive episode. That’s what I need to remember.

And all of a sudden, things are lookin better. And they look like they’re coming up Heather Loeb.

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That makes me smile, something I’ve done all day.

Eventually, it all comes up Heather Ann Loeb. It’s good to be me.

 

 

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Good Vibes

by Heather Loeb
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It has been 14 weeks since my last ECT (electroconvulsive therapy), a milestone for sure. That’s the longest I’ve been able to go since 2019, after leaving a psychiatric hospital for depression and anxiety.

It makes me so happy because, frankly, I hate them. I developed a phobia to anesthesia last year and have panic attacks before treatment. For those who don’t know, ECT entails going under anesthesia then doctors induce a seizure. It’s usually a short seizure and they give me a muscle relaxant so I’m not thrashing around. The seizure sort of resets my brain. Doctors aren’t sure why or how exactly it works, but it’s very beneficial to people like me who have treatment-resistant depression.

I thought since it has been awhile since my last treatment that my memory would start coming back, but there are still huge chunks of my memory I can’t recall. It’s common for people to experience retrograde amnesia, but usually memories return.

Not only can I not remember things from the past but also it affects my short-term memory. I can’t always retain new information. It’s especially hard to follow recipes or instructions on how to do something. Now I need assistance from my husband when I’m cooking.

It’s also embarrassing.

I’ll meet someone and not remember we met. Or I’ve forgotten people who I knew. People come up to me all the time and ask how David is or the kids, and most of the time I just can’t place them so I try to hide it. Hopefully they can’t see it in my face.

Still, even with the memory loss, it’s one million times better than being where I was. I was so lost and unhealthy, relying on binge eating, abusing my medication, cutting and shopping to distract me from my pain. I was suicidal all the time. Somehow I was able to take care of the kids, but my health suffered greatly. The kids sucked up everything I had. I don’t regret going to the mental hospital at all.

I wrote about ECT and losing my memory for a mental health site, The Mighty, and some people — a lot of people — thought it was so horrible that I was risking my memories. They couldn’t comprehend it, but one of the best things about my memory loss is that I don’t remember all the ugly, dark parts of my illness before I went to the hospital. It’s a blessing, actually. What I do remember is so awful and sad. There’s no part of me that wants to relive that at all.

So while my memory (what’s left of it) is terrible and it can be embarrassing, I’m so fucking grateful for where I am. For my support system, all my friends and family members who stepped up and completely support me. For being able to find joy in the little things. For being able to enjoy watching my kids grow up. For laughing until tears come to my eyes. For the growth that I’ve seen in the past three years. I’m just so grateful. I’d do it all again if I had to in order to feel as good as I’m feeling now.

I know there’s always a possibility of a depressive episode recurring, but that’s why I’m doing the difficult work of confronting my demons and putting into place healthy habits. I have to walk a fine line in order to be healthy, and sometimes that can be annoying, but it’s so worth it.

For anyone struggling with their mental health, I see you. I pray you don’t give up, and I have to tell you that it gets better. It gets sooo good.

There’s great divinity in finding the light where it is dark. And I hope you find the light.

You can do it. I clawed my way back from hell, and I’ll keep fighting to stay where I am, every single day.

Thank you to all my loved ones (and even strangers) who have been rooting me on all this time. It’s a beautiful thing to receive that kind of support.

And I love you all.

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TW: suicide, suicidal ideations, depression
Please know that while I am experiencing suicidal ideation, I have no plan, and I am completely safe.

This Thursday I’ll be the main speaker at the Suicide Prevention Coalition of the Coastal Bend’s Suicide Prevention Symposium. Say that five times fast. Last week I wrote my speech, and I’ve been practicing it, but there’s something really bothering me. I centered my speech around a time two years ago when I was suicidal after having a fight with my husband over the phone. It was a harrowing experience and shortly after that I went to a psychiatric hospital for six weeks.

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I had a wonderful experience at the hospital. And I tend to think of my time as pre-psychiatric hospital and post-psychiatric hospital. Only I’ve been dealing with suicidal ideation this past week. I blogged about how my last ECT didn’t help me, it made me worse, but I wasn’t expecting to grapple with these morose and very frustrating thoughts again. Am I going backwards?

It’s a “depressing” reminder that I won’t ever be cured, no matter the strides I make with my mental health. A depressive episode could strike any time, and it feels like I don’t have any control over it. I’ve been doing everything right — I go to therapy, I’m consistent with my medications, I’ve been exercising, I practice self-care, but this time it didn’t matter. And the one thing that I know helps — an ECT — has made things worse.

So what now?

Well, for starters, I fall back on what I know to be true: my ECTs usually help me, this pain and discomfort is temporary, the suicidal thoughts are just thoughts — they are NOT fact and my support system is strong and available. My goal is to schedule an ECT for next Monday and go into Survival Mode until then. I’ll be OK.

My priority this week is to do a great job at the symposium. And to get through the week in as little pain as possible. Maybe having these thoughts will help tell me story and serve as a reminder that even a seemingly strong and successful person can still have suicidal thoughts. It’s important to know because more than half of people who die by suicide have no history of a mental disorder. And because of that, it’s important to openly talk about suicide and remove the stigma associated with it. Also, I used to think that suicidal thoughts were something that you could control, but mine are intrusive thoughts, popping in and out of my mind throughout the day. I can’t control them anymore than I can the weather, and I think people need to understand that, too.

I don’t know why this is happening to me again (and again), and it certainly feels unfair, but if a single person is helped in some way by hearing me speak or reading my blogs, then maybe it’s worth it. Because I know I’ll be OK. I’m strong, I’ve been here before, and my life is just too good not to fight for.

It just sucks in the meantime.

If you are having suicidal thoughts, please call the National Suicide Prevention Lifeline at 1-800-273-8255. If you are in immediate danger of harming yourself, please go to the nearest emergency room. Please do what you need to do to stay safe and healthy. You are not alone, and you are not a burden.

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Yesterday I blogged about my ECT not being as effective as in the past, but today I’m feeling a little better. I’ve been productive, cleaning and organizing various parts of the house , so that’s something. I’m trying not to be negative about the situation, but sometimes it’s hard to get past “it’s not fair!” especially when I try so hard to maintain my mental health. So hard.

It’s all I ever think about sometimes, and despite my habits in the past, I haven’t done anything to sabotage it (such as missing my meds, not going to therapy, etc). Nearly every one of my actions is to ensure I’m healthy as possible, so it’s very offensive when my ECTs don’t echo that. OK, I’ve stewed enough about it.

This coming week is a big one — I’m the main speaker at the Suicide Prevention Symposium put on by the Suicide Prevention Coalition of the Coastal Bend. I’m very excited and a lot nervous, but I wrote my speech last week so I should be good to go after practicing it 800 times before Thursday night.

I’m going to take the next couple of days and decide if I need another ECT next week. I’m hoping I’ll inexplicably bounce back. Any good vibes you want to send, please do. I hope you all have an amazing Labor Day weekend and week to follow.

Stay in the light.

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I am so frustrated, y’all. Two weeks ago I went to get an ECT treatment because I could feel depression trying to set in, so we drove two hours to San Antonio, and I actually had a very nice treatment, I didn’t get too upset, and I felt calm before going under anesthesia.

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But now, I feel worse than I did before getting the ECT. I hate that. It doesn’t happen all the time, but there has been at least one other treatment that made me feel worse afterward. And at the risk of sounding like a child, it’s not fair!

I hate getting ECTs, but the whole experience was so nice this past time. So why do I feel worse? My fuse is so short, I’m very irritable, doing even small things takes a lot of effort, and I just want to binge every meal. I’m worked hard to lose 19 pounds, and I’d hate, hate, hate it to go backwards. I’ve made strides in my recovery from binge eating, and I’m just so scared I’m going to lose my momentum and progress that I’ve made. And I don’t want to be the mom that yells and has a short fuse. That’s no fun for anyone.

The only thing I can think to do is just get another ECT. Only I can’t next week because I have the Suicide Prevention Symposium and I’m the main speaker on Thursday night. I guess I could go that Friday, and it’d be OK.

I wonder if other ECT patients notice such huge differences between treatments or if this is just me because my brain is special. I’m getting tired of having a special brain. It should be studied after I die for sure. I went a whole four months without needing a treatment, so it’s bothers me A LOT that now I can’t even go three weeks.

Now, I don’t want to dissuade anyone from getting ECTs. They are life changing, and I’ll never regret getting them, even the ones that seemed to make me worse. They have made my life so much better — I’m light years away from where I was after I was hospitalized at Menninger. So if you have treatment-resistant depression and no other therapies have seemed to work, I’d highly recommend trying ECT. It has the highest success rate when compared to other therapies and is not as scary as I sometimes (by accident) make it sound.

That being said, I’m going to schedule another one and show myself some compassion. I’ll treat myself with kid gloves and do what I need to do to take care of me and my family until I can get back on that table. Because that’s the ultimate goal right — to be the best version of myself. And I’ll keep going until I get there.

That’s the version of Heather I want to experience, one that doesn’t give up and does anything and everything for herself and her family.

Maybe the last ECT wasn’t so bad after all. But I want better for myself, and that’s OK. After the past four months, I’ve seen my potential and all I was able to accomplish, so I know it’s in there. I guess I just have to try harder to shake it loose.

Here’s to good seizures and strong medication.

To learn more about ECT treatments for depression (or other mental condition) go to the Mayo Clinic here or feel free to email me at heatherannloeb@gmail.com

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Sentenced to Life

by Heather Loeb

Please note that this was written two weeks ago and I feel better.

Last week I had a much needed ECT. When I awoke from the short procedure, I felt strange. Usually, I have a terrible migraine, I’m confused and fatigued, but this time I was alert, I knew what had just happened and there was no sign of a migraine. Good, right?

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During the two-hour drive home, I kept thinking that it was amazing that I didn’t feel like crap. I looked over the papers the hospital gave me and saw that I had a short, 42-second seizure, which is good — the shorter, the better. But something was bothering me.

It’s now been several days since the ECT. I don’t feel as different as I’d like. I don’t have much energy, I’m not as optimistic as usual and at times I’m just sad. I hate to say it, but I don’t think this treatment worked. It’s happened before — the ECT leaves me feeling no different or actually worse, but it’s rare. It scares me, because getting treatments is the main part of my treatment plan. I rely on them to feel better.

This is just a very sad reminder that I’ve been sentenced to life with major depression/anxiety, and there is no cure. I’m treatment resistant, meaning most medications won’t help. Therapy, ECTs and behavioral modification are the only things keeping me from slipping back into a depressive episode. And I’ve worked too hard to go back.

I don’t mean to be gloomy. Maybe it’ll take a week before I feel better. Maybe I’ll have to work harder on self-care and turning to healthy coping mechanisms. I hope to hell I don’t, but maybe I’ll need another ECT before the next one scheduled in eight weeks. Maybe that one will work.

It’s just hard not to feel betrayed right now. I hate getting ECTs, but I continue to get them because I know they help make me a better mom, wife and friend…they usually help, anyway. But this time was different — I feel bamboozled. I went to all that trouble for what? To still feel out of gas and like there’s nothing to look forward to? I hate my brain! Even if I do (most) everything right, my efforts are thwarted. It just doesn’t matter, my brain’s gonna do what my brain’s gonna do. And that, my friends, is depressing in itself.

I’ll give it a few more days. I’ll do my best, practice self-care, go to therapy. I’ll drudge on, but I have a feeling I’ll be making another trip to San Antonio sooner than expected. And that’s OK, if the next time works.

But what in the hell will I do if it doesn’t?

I can’t really entertain that thought, because it’s so suffocating. I feel the urge to stomp my foot like a child and scream, “It’s not fair!” Because it sure the fuck isn’t.

It’s just not fair.

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I’ve had a lot of questions about ECT (electroconvulsive therapy) lately, so I thought I’d talk about it more today.

I’ve been doing ECT treatments since 2019, after I stayed at the Menninger Clinic for six weeks. My doctors all agreed that I was treatment-resistant, meaning most depression medications would be ineffective in helping me, and ECT has a high success rate.

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I’ve had about 30 treatments, and I can honestly say they have changed my life for the better. I have more energy, more patience, I’m not sad as often, and I’m able to function pretty well for a girl with no serotonin, lol.

I now do my treatments at the Laurel Ridge Treatment Center in San Antonio; there are no doctors who do them in Corpus Christi where I live.

When I arrive at the treatment center, I fill out paperwork on how I’ve been feeling and whether I’ve been suicidal. I talik to the nurses and PA, discuss the depression symptoms I’ve experiencing then they move me to a bed. A nurse then puts in an IV and they give me medication for nausea, just in case. Next, they wheel my bed into the treatment room where an anesthesiologist, a doctor and nurse are waiting. They attach electrodes to my forehead and temple, then add a blood pressure cuff and pulse oximeter. Usually at this time, my blood pressure gets higher and my pulse races because I’m scared, even though I have no reason to be.

The docs chat with me for a bit and then they put me under anesthesia. After I’m out, they put a bite guard in my mouth and give me the oxygen mask. The nurse starts up the ECT machine which will send electric pulses to my brain, triggering a brief seizure. They also give me a muscle relaxant, so I’m not moving a whole lot. Once the seizure is started, they wait for my brain to stop it. My brain works hard to stop it as fast as it can, but sometimes the docs have to administer medication to stop it. The shorter the seizure, the better the outcome I usually have. This past ECT I had a 42-second seizure but I’ve also had ones that last up to a minute or longer.

After the seizure, I’m sent to a recovery area. It usually takes about 20 to 30 minutes for me to wake up. After I’m looked over by the nurses, I’m free to go home. I usually have a killer headache, so I get something to eat, take my migraine meds and sleep on the way back to Corpus Christi.

I can see how reading this would surprise some people — one person described it as barbaric after I explained the treatments, but it is not barbaric. For someone like me, it’s life-saving, and even though I don’t like getting them done, I’m grateful for treatments.

ECT helps as many as 80-85 percent of patients who receive it and is the most effective treatment option for those who are treatment-resistant.

Most people have an initial course of ECT then do maintenance treatments every now and then. I haven’t gotten to the point where I don’t need them, so I go every four to eight weeks. I’m working on stretching out the treatments, and maybe one day I won’t need as many.

I hope I haven’t shocked you — haha, get it? If you’d like to know more, please leave a comment on email me heatherannloeb@gmail.com

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Low Battery Mode

by Heather Loeb

Note: I wrote this blog a couple weeks ago and have since had an ECT treatment.

It started yesterday — irritability, moodiness and the urge to overeat. I attributed it to lack of sleep; Eli had woken up at 3 a.m. and hadn’t gone back to bed, which meant I didn’t go back to bed. I thought if I just get some good sleep I’d be fine, but this morning, I could feel it — thick fog around my brain, heavy weight on my shoulders, more irritability and wanting to just go back to bed.

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I thought, “Great, I’ll have to get another ECT before I’m ready.” I’m trying to go at least eight weeks without one. I was totally preparing to power down to my Low Battery Mode when I thought to myself that I should get on the treadmill and spur some endorphins. It was the first time I’d ever worked out for my mental health and not to lose weight. I didn’t stay on the treadmill long (my kids drained my Air Pod batteries) but I instantly felt better, not all the way better but better. Not bad for a girl with no serotonin.

I still have the urge to binge and to get in bed for the better part of the day. That’s where my Low Battery Mode comes in, like I talked about on my Spoon Theory post. I only have so much energy, even when I’m not feeling depressed. Unfortunately, that means I’ll have to depend on my husband more and housekeeper. I say unfortunately because my husband already has a lot on his plate and I never want to be a burden. So, I’ll ask for help when I need it. I’ll take more breaks than usual. I’ll force myself to drink more water and back off the Diet Cokes. I’ll get a pedicure. I might even take a (short) nap. I’ll do what I have to do to feel better, because I HATE getting ECTs. It should be a last resort on my treatment plan, not just a quick fix. I hate feeling like I’m waving a white flag in defeat to my depression. I want to fight, I have to fight it. I just can’t let it win. And if it turns out that I do really need an ECT, I’ll concede because that’s what’s best for my family and me. But I still want to fight. I’ll have to fight my brain and not give into unhealthy coping mechanisms that seem so much easier to do than healthy ones.

Last night, I wanted pizza for dinner. We don’t usually eat pizza, we usually cook or get takeout from Asian restaurants. But I wanted pizza. I thought that it would just be a treat because I had a bad day and sometimes you just have to treat yourself. But when you’re dealing with an eating disorder, it’s a slippery slope. And I sure did slip. I purposely ate too much and then binged on my kids’ candy stash. I felt so sick, and despite feeling so badly, I still planned on getting donuts in the morning before dropping off the kids at school.

It’s the instant gratification that I’m always seeking. I hate being uncomfortable, so I turn to my bad habits for that temporary release.

But today is a new day. Instead of feeling overwhelmed and anxious about my mood, I actually feel optimistic. I didn’t just say, “Fuck this day!” and give myself carte blanche to binge, etc. I made myself get on the treadmill. I made myself sweat and think about how much better I would feel afterward. And that, my friends, is progress. It’s a huge step for me. I KNOW what to do to stay healthy, I blog about it all the time, but honestly this is one of the first times I’ve actually taken my own advice. It’s hard when your brain is telling you to do the opposite, but I did it. I won a battle against my obstinate brain.

I might still have to power down a bit, but that’s OK. It’s self-care. It’s a survival mechanism, a healthy one.

So, I’ll keep on fighting and surviving — it’s what I do best.

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I Hate My Brain

by Heather Loeb

Ever have a long day and think to yourself you deserve a treat? So you get ice cream and start to feel better? That sounds normal to me. My problem is that I think I deserve a treat multiple times a day. I constantly want to feel good. To feel happy. I compulsively eat to get that high and, enjoy that “treat.” Then I feel sick. After I’ve recovered, I look for another treat, forgetting how sick I felt earlier. It’s a vicious cycle.

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I do this a lot but especially when the kids are away at my mother-in-law’s. I tell myself that I need to relax, enjoy the quiet and that I need to feel good. Last night, even after I had a big dinner, I sat there thinking of what I could eat that would make me feel good. And I even tried many things, despite being uncomfortably full already. M&Ms didn’t work. Neither did peanut butter crackers, ice cream or SweeTARTS.

But there is nothing I can eat that will make me truly happy.

Now, I’m trying to give myself a break because I am in need of an ECT treatment, which is scheduled for Friday. Usually the week before treatment I run out of gas, and I try to cope however I can. BUT this doesn’t just happen in the weeks leading up to treatment. This happens all the time, even when I’ve just had an ECT.

So I pose this question, “Why do I feel the need to be happy all the time?” Honestly, that question was asked by my therapist last week. She following up with, “Can’t we sit with other emotions? Nobody is happy every minute of the day.”

And she’s right. We don’t need to be happy every minute. I think my problem is that I HATE being uncomfortable, so I’ll do anything to push those negative emotions aside. Emotions like anxiety, stress, anger or sadness. It’s clearly not working for me to ignore these problems, and even if overeating has helped in the past, it sure as hell is not working now.

This may sound strange, but I think I need to acknowledge and honor whatever feelings I’m having. Maybe I need to grab my journal whenever I’m feeling negative emotion, talk about what’s going on and then release that feeling. I don’t know.

All I know if that I need to stop coping by bingeing. It’s made me gain a bunch of weight and really, aren’t I just eating my emotions?

Sometimes I really hate my brain, which I hold responsible for my debilitating-at-times depression and anxiety. I hate that it doesn’t respond to other treatments. I hate that my mental health is so precarious, and I resent that I have to be so careful as to not disturb it. I hate that happiness seems so fleeting at times. I’m not a big fan of my eating disorder either.

I don’t like to say hate; It forces a dichotomy with the idea that I should love and respect myself. I’m trying really hard to love myself, even almost 30 pounds heavier and a handful of mental disorders. But I feel betrayed by my brain. I know I need to reconcile those ideas. I know there is more benefit in loving all of me. I’ll get there. Despite everything that my brain has thrown at me, I’ve only become stronger. Take that, asshole.

And there are times that I think God made me this way because He thought I could handle it. I can, and I will. I remember this quote: “Your talent is God’s gift to you. What you do with it is your gift back to God.” I don’t mean to sound haughty, but maybe He knew I would use my voice and (hopefully) help others through my writing. That’s why I can’t stop blogging so much about mental health; there are so many who feel alone and haven’t found their voice yet. I certainly don’t mind lending mine in the meantime.

I guess my brain is just as much a blessing as a curse.

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