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major depressive disorder

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Sometimes it feels like I eat, sleep and breathe my mental disorders. My depression is all consuming — how do I feel today? How about now? Am I anxious? Will I have a panic attack today? Will I have suicidal thoughts?

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In order to maintain my mental health, I have to adhere to a strict routine, and any interruption — big or small — to that routine can cause me to fall into a depressive episode. It’s like I’m walking on a tight rope, and it’s a lot to deal with, to say the least.

I don’t mean to complain, only to emphasize that it’s a lot just to keep me feeling OK and functioning at the most basic of levels. As hard as it is for me, it’s has to be even harder for David.

I imagine him each day gauging what mood I’m in, how fragile I am at the moment and whether he has to come home early to help me with the kids, because I’m overwhelmed. It happens every week. Some of you will say it’s his job as my husband, that he’s not fighting mental illness, but he is.

He is right alongside me every day, battling depression, anxiety and my binge eating disorder. He takes me to doctors appointments, to get ECTs in San Antonio every four to six weeks and he’s there advocating for me and picking up the slack. And there’s a lot of it.

Even in the midst of being suicidal, abusing my meds and self harming, his love has never wavered. I don’t mean to make him out to be perfect, but he has been there for me and the kids through the worst of my depression.

He is living this disease just as much as I am.

Nobody ever talks about how spouses/significant others struggle with this — the other side of depression. Often, they play the role of caregiver, and even if it’s necessary, it’s not sexy. Nothing about depression is. Spouses should be recognized for their sacrifices and struggle, too.

The truth is David must be weary. I know I am. But everything he does is to support me and literally keep me alive and functioning. How tiring that must be, because I live in a dark place. My brain is not my friend, often telling me I should die. It’s so dark sometimes I feel blind, lost in despair and destined to suffer.

But then there’s David, with enough light for the both of us.

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This past week was very stressful and anxiety-inducing. On Tuesday, the day of the election, I was a ball of nerves and after putting the kids to bed, I glued my eyes to the TV to watch the returns.

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I was shocked. I thought it would be a landslide for Joe Biden. For a while, it wasn’t looking good and I flashbacked to four years ago as Trump won the presidency. I cried. I cried, and I lashed out at my parents and brother, who voted for Trump. I remember feeling so much disappointment because it felt like hate had prevailed over love. I watched over the past four years as Trump erased what I considered progress. It felt like evil had trumped (get it?) good.

As the election dragged on, I felt so disappointed there were still so many people who supported Trump, for whatever reason. I had resigned myself to four more years of disappointment.

And then, the mail-in ballots started to favor Biden, and Trump’s lead in battleground states dissipated. It felt like a miracle.

Yesterday, news outlets called the election in favor of Biden/Harris, and the two spoke that night. I listened to their speeches, and I cried happy tears. I’m happy that my kids get to see a woman as VP. I’m so happy for little girls of color who now have someone who looks like them in one of the highest offices in this nation. I’m happy that Biden mentioned LGBTQ+ people in his speech. I’m happy for progress.

Some negative comments have been made on Facebook about a Biden/Harris picture I posted, including one comment my aunt left that said, “Disgusting” but I don’t care. There’s no home for negativity in my heart, and if others want to live that way, that’s fine by me.

Love always wins.

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I’m struggling.

Recently, I blogged about gaining 15 pounds (thanks, COVID) and how discouraged I was. I know it’s not the end of the world, but I ruminate about each pound every day. It makes me feel ugly and unworthy. I try to make healthier choices, but I get dismayed any time I veer off my healthy course.

And then another part of me takes over, and I’m empowered. I tell myself that I’m beautiful no matter what. That I need to learn to love myself despite what the scale says.

I’m battling low self-esteem and an eating disorder (Binge Eating Disorder). A year ago I had the gastric sleeve surgery, hoping it would physically limit the amount of food I could eat, but I didn’t resolve my issues with my eating disorder, and I pushed the limits of my smaller stomach, eating so much that it was hard to breathe, not to mention painful.

Now, I can’t stop bingeing. I feel like I always need a treat, something to escape into, but I can’t figure out why I feel the need to escape so frequently. Maybe from stress of the pandemic? And my “treats” often turn into a punishment because I eat so much, too much for my stomach to hold. Too much shame to derive any pleasure in the binge. So, maybe it’s all punishment — for what, I don’t know.

It definitely doesn’t feel good, aside from the initial pleasure of the food hitting my palate, but it never lasts. It’s temporary, but the shame and pain from doing it is often permanent.

And then, in between binges, I stare into the mirror and try to love and appreciate my body, which has birthed two amazing kids. I breastfed them, sustained them with this body. I live here, in this 180-pound body that holds all my essence and what makes me me. I reject the idea that I’m ugly, fat and less than. I’m a child of God and wonderfully made. I’m just as beautiful outside as I am inside, and my light shines regardless of my weight. My worth is not tied to my weight.

But I get lost navigating the conflicting messages these two polar-opposite sides of me are sending. And for some reason, it’s easier to believe the negative ones: I’m ugly, I’m a fat ass, people are judging me, nobody loves me because I’m fat, etc. But I do feel like the other side of me’s voice is growing louder. It’s not a distant whispering anymore — she’s getting stronger, and I pray that she continues to do so, because I’m weary from fighting this division inside me. I wonder why everything has to be so hard. Isn’t having Major Depressive Disorder, General Anxiety Disorder and Avoidant Personality Disorder enough? Why are there so many things wrong with me? Maybe I don’t need to pull at that thread, but I’d really like not to collect any more diagnoses.

I want to find a balance where I can eat healthy, occasionally indulge and truly appreciate my body. I don’t want to tiptoe around the house anymore, thinking my footsteps are too heavy sounding.

I want normalcy. I don’t mean to complain and whine — I know that I’m the only one in charge of what food goes in my mouth. But it’s still so hard, and not just for me — about 30 million people have an eating disorder in the U.S., according to U.S. News and World Report. That roughly 20 million women and 10 million men. That’s a huge number, and eating disorders, like mental disorders, are often unreported so you can expect those numbers to be a little higher.

A lot of those people also suffer from a mental disorder. The National Association of Anorexia Nervosa and Associated Disorders reports that 33 to 50 percent of people with anorexia also have a mood disorder. I don’t have numbers of what percentage of people with Binge Eating Disorder have a mood disorder, but I’m confident I’m not the only one.

Another alarming statistic is that 26 percent of people with an eating disorder attempt suicide. It’s beyond hard to have an eating disorder — you can’t give up food like an alcoholic can give up alcohol (Do not get me wrong. Battling any addiction is very difficult. I do not mean to imply otherwise). You have to fight your brain while learning new methods on how to nourish your body in a healthy way (such as intuitive eating or mindfully eating). It’s hard as hell for me to break old habits when it comes to food, but I know I need to do it if I want to be around for my family and friends later in life. Having an eating disorder is so hard on the body and mind. With everything else I’m battling, my body could use a respite.

I know a lot of us are in the same boat when it comes to weight gain during the pandemic. I don’t have any pointers because I’m still learning, but I do want to say be patient with your body. Give yourself some grace. Try to love the body you’re in, because you’re not getting another one. Weight can come off, and maybe it’s OK if it doesn’t.

You are not your eating disorder.

I hope y’all stay well and in the light.

If you are struggling with an eating disorder, please reach out to your doctor or visit the National Eating Disorders Association website. They also have a crisis text line — just text NEDA to 741741.

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I’ve been feeling pretty great lately, which is a bit unusual, but hey, I’ll certainly take it. When I feel this good I tend to treat myself better, I’m more productive and generally in a good mood.

But I’ve noticed, even with these good moods, there’s still a part, albeit a small part, of me that looks for ways to be unhealthy. For example, I’ll get the urge to overeat, even when I’m not hungry. I’ll think, “What pills can I take to feel good?” even though I have no such pills. Images of cutting myself will appear, even though I surely don’t want to do that.

I’m aware that it’s happening and I know it’s 100-percent my lying ass brain spreading more lies. It’s just a malfunction. It’s not really real, but emotions are energy in motion, and I can’t let these awful thoughts fester in my head.

If I do, unhealthy behaviors take control and with them come intrusive, unhealthy thoughts. My control over these thoughts and behaviors loosens, and just like that, I’m in a dark, ugly place that I can’t find my way out of. It’s like being in a deep hole and my depression is just too heavy, weighing me down and preventing me from climbing out.

It’s a slippery slope, a dangerous one for me, given that I can become suicidal very quickly.

I have to take inventory of my emotions constantly to prevent this. I have to be fully aware of how I feel and avoid switching to autopilot where I might miss something. I have to be so diligent so I can avoid that hole. And honestly, it’s exhausting and feels like sometimes it’s too much or not worth doing. Before I’d try to figure out why I was having these thoughts and ask what it meant, but like I said, it’s just a malfunction. I need to stop wasting time wondering why and just dismiss the thoughts. They’re not worth thinking.

I must release the energy that fuels these damaging thoughts and refocus if in a productive way, channeling it into exercise and writing, etc.

A self care check list is helpful to have so I can stay on top of the things I need to do to prevent self destruction. Just thinking about all the work I have to do to stay healthy is daunting and tiring. But I have to do it if I want to be happy. This past week has made me realize how much I’ve missed being happy — singing at the top of my lungs in the car and shower, truly enjoying spending time with my kids, reading for pleasure, writing my ass off and exercising. Medicine, ECT and therapy just aren’t enough to maintain my good mood and healthy behaviors. I have to put in the work at it, just like anything else. Sometimes it bothers me that other people don’t have to work as hard at life.

But I don’t do happy-go-lucky — I physically can’t. Happiness, for me, is hard work. It’s sticking to a strict schedule, taking an assortment of pills daily, going to therapy, keeping a close eye on my emotions and lots of prayerThere’s nothing lucky about it. 

I do have to work hard, but the payout is so, so good and that’s what I need to remember. What is the point in having an amazing life if you can’t enjoy it? Why do I spend so much time self-sabotaging? Again, with the “why?”

I’m going to work at my life like it’s my damn job and like it pays, because it is and it does.

It pays so much.

This is the Self Care Checklist that I created. It’s super simple; feel free to download:

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I’ve been seeing my therapist for about 10 years. I love her. She truly helps me and makes my life better. If you don’t go to therapy, I highly recommend it. She helps me work out my problems, listens when I just want to vent, and gently helps me realize when I’m exhibiting not-so-healthy behaviors. I trust her judgement and appreciate her very much.

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Therapy is beneficial, even if you aren’t depressed.

She’s given me some sound advice over the past decade, so I thought I’d share my favorite tidbits here.

You can’t let anxiety prevent you from taking care of yourself.” I have a habit of making things bigger in my head, then worrying about it, which can prevent me from doing what I need to be mentally and physically healthy. Anxiety is such a monster and you can’t let it win.

You’re not the black sheep, you’re different.” My political leanings and general philosophies on life tend to be very different from my immediate family and for years I’ve thought of myself as the black sheep, which has a negative connotation. For me it’s important that I don’t use this because it can make the metaphorical divide larger in my head.

It’s not personal.” This is pretty common advice but advice that I need to hear constantly. I get these ideas in my head that someone doesn’t like me or is mad at me and there’s really nothing to back that up.

You don’t have the ability to understand some things, like why people are mean, and that’s OK.” Too many times have I sat across from my therapist upset at something bad that happened or someone was cruel. She’s right, though. I don’t have hate in my heart, I’m kind and a generous person. I don’t need to know why something bad happened and I’m just fine not being able to understand.

It’s not about you.” This goes along with “it’s not personal” and is important for me to remember, because again, I can make a mountain out of a molehill pretty quickly. My therapist says if I think there’s conflict or somethings not right in one of my relationships, just tell him you’re there for them. Ask if they’re OK. But don’t obsess because it’s just not about you.

You grew. You turned the light on. You embraced your life, and that’s scary to some people.” Sometimes you outgrow a relationship, but that’s OK. Some people will do things to keep you small because they’re afraid of growth and change but never make yourself smaller for others.

Don’t take criticism from someone you wouldn’t take advice from.” This is by far my favorite piece of advice. I would get caught up in something someone said about my life and get so upset, but repeating this comforts me and gives me clarity. We all have people who can be toxic at times but this quote frees you from caring about their toxic or hurtful opinion.

You’re very concerned with how [someone] treats you. Muster enough concern on how you treat you.” I love this. I do expend a lot of energy on others, but I’m learning to focus my energy on me and I can see the positive changes.

(If you have a toxic person in your life.) “You can admit that they’re toxic. It doesn’t mean you don’t love them. You can be grateful for what they’ve given you and be aware of their behavior at the same time.

You love everybody and everything but you don’t love yourself. You have to love yourself.

If you didn’t have struggles, you wouldn’t have strength.” So, so true.

You don’t have to stay where you are. Find the sun, like a plant. Twist however you need in order to find it.” This is also one of my favorite quotes of hers. When I’m going through a depressive episode, these words remind me that there is still good, I just have to twist and grow to get to it.

Be aware. Awareness doesn’t equal change, but it leads to change.” This is a reminder to avoid switching to autopilot in life. A lot of us go through our days without really being aware of our surroundings, our emotions and others.

A person’s worth is measured by how they treat the most vulnerable population.” While this isn’t advice, it’s important to remember. Be kind to others, especially those who aren’t as fortunate as you.

My therapist has said so many other important things that have helped me and shaped me. One of the things that I hate most about depression is how it slows my thinking, jumbles my thoughts and it can be hard to have clarity about what’s going on around me. I’m not the only one — scientists have discovered that there are physical changes in a depressed person’s brain, such as brain shrinkage. It can also cause structural and connective changes. Between that and my ECT treatments, I can get overwhelmed with my thoughts and emotions easily, so I’m glad I have an outlet that helps me sort through my messy — or unruly, I suppose — brain.

I can’t recommend therapy enough, even if you aren’t depressed.

Stay in the light, friends.

To learn more about depression visit the National Alliance on Mental Health website.

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Real Me vs. Depressed Me

by Heather Loeb

This past two weeks have been amazing. My demeanor has changed. My mood has lifted. And I’m able to do things that were near impossible before. The ECT treatment I had two weeks ago must have been a good one. I’ve seen a glimpse of my authentic self, who wants so badly to be set free from wherever she goes when a depressive episode hits. Before this past ECT, I was suicidal. I was unbelievably sad and anxious. I thought I was doing OK but I can see now that I wasn’t.

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I didn’t recognize this feeling of joy and happiness, and I can’t tell you the last time I felt it either. I’m more familiar with “Depressed Me,” a slower, sadder, less efficient version of me, riddled with depression symptoms, who seems to be the reigning champion of my brain. But now that I am feeling happy and I see the “Real Me,” I’m going to fight tooth and nail for it. I refuse to go down without a fight. How I’m feeling and what I’m able to do right now — that’s worth fighting for.

In the mornings, I don’t immediately feel weighed down and already exhausted before even starting my day. I have energy and am excited about the day. The chores and tasks I absolutely have to get done don’t seem so taxing and annoying. Showering is now relaxing and not a daunting chore I’d put off for days (yes, days!). I don’t feel the need to stuff with my face with food that I don’t want or need, which is a battle for most everyone. I’m more cheerful and attentive to my kids. The Real Me is kind of a badass.

I could name so many more examples. I don’t know if it was the last ECT. I don’t know if it was a new medication I started the same day as my last ECT. I don’t know how long this will last, but again, I gotta make hay while the sun shines. And I have to fight.

Fighting looks like me not solely depending on my medication and ECT treatments. It means exercising, going to bed early, eating healthily, keeping a strict routine and reaching out the minute I feel like things are slipping. It sounds like a lot, or maybe it doesn’t, but I’m done with my rebellious, depressed part of me that refuses to comply with even the simplest of instructions.

When I’m not handicapped by severe depression, I’m so powerful. I radiate love and happiness. My writing flows onto paper, because my words are powerful, too. I utilize my limitless ability to care for my loved ones. I’m able to reach my full potential, instead of being a shadow or fraction of my true self. Like the phoenix, I am rising and there’s not a whole lot that can stop me.

Here are some examples of what the Real Me versus the Depressed Me are like:

The Real Me exercises, reaches out to friends, eats healthy foods, writes/blogs, goes outside, puts the TV remote down, reads for pleasure, sings all day (to the point where her family complains), cooks, bakes, showers, brushes her teeth, laughs loudly, plays with her kids even more, styles her hair, gets massages (or goes to any self-care appointment).

Depressed Me sleeps more, watches TV until having to get the kids, endlessly scrolls social media, gets in bed until she absolutely has to move, doesn’t shower, blows off doctors appointments, gives into sadness/anxiety, doesn’t smile as much, has a short fuse, is impatient and more.

Depressed Me goes to sleep at night because she can’t stand to be awake one second longer than she has to. She’s judgmental and mean about her appearance and body.

The Real Me looks forward to the future but enjoys the present.

I’m certainly enjoying right now, and although I’m cautious about the future, my outlook is finally optimistic.

As I’m writing this, I’m hoping that you don’t get the wrong idea about Depressed Me. While I would love not to experience depression and anxiety, I respect Depressed Me. She fights hard and doesn’t give into her suicidal thoughts. She’s a fighter. She’s scrappy. She has grit, and without her efforts, the Real Me wouldn’t appreciate what it’s like to be happy.

For that, I’m grateful.

To learn more about major depression and signs of depression, visit the National Alliance on Mental Illness website.

If you or a loved one is experiencing suicidal thoughts, please call the Suicide Prevention Lifeline at 1-800-273-8255 or visit the website here.

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Another Day of Self Loathing

by Heather Loeb

I’ve had some pretty good days recently, but like everybody else, I’ve had some not-so-great ones, too. Like today.

It started the minute I woke up. I could feel the dark cloud hanging over my head. My fuse was already short. I didn’t feel the surge of energy I’ve had lately, and all my limbs felt extremely heavy.

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I gave into the children’s request to get donuts, even though it was a school day. As soon as I finished my bag of donut holes, I knew that the day was going to steamroll me. And I let it.

The donuts didn’t satisfy me like I thought they would, nor did they give me a pick me up. They just reminded me of my recent weight gain and all the other poor decisions I’ve made. The self loathing was on full blast now.

I wanted energy, so I chugged Diet Cokes until my stomach hurt. The only thing I got in return was more self loathing. I was supposed to quit Diet Coke last year but didn’t last a month or two. Sigh.

By the time I got the kids dropped off, my blood was boiling. I recoiled when people would speak to me, and after I did a little writing, I retreated to the couch where I turned the TV on. I had been craving alone time all week but I felt restless and unsatisfied.

For some reason, I decided to order a pizza, even though I didn’t really want it. I felt terrible, mentally and physically, after just one slice. I tried to scrub my bad decisions and terrible mood off in the shower, to no avail.

I tried to rally before picking up the kids but even my Adderall* was no match for my mood. I went through the motions of the rest of the day, trying not to snap at my family.

I put Eli down (David’s with Isla) and I have some time to myself again. Literally, all I can think about is getting donuts tomorrow despite just recounting my shitty day, which began with seemingly innocent donut holes. Sometimes I really am a glutton for punishment.

Thank God I have an ECT on Monday. I hope they can reset my short-circuiting brain and help me forget this feeling — like I’m drowning in a sea of self hatred. And there’s nobody to save me. Therein lies the problem with depression — sometimes we’re our own captors, fueled by a faulty brain, sure — but I’m the one holding my head under right now.

I have actual plans in place for these types of days, such as a self-care checklist, but it’s so much easier to give way to the “Depressed Me” — or is it?

Monday can’t come soon enough. Because of the ECT and because the donut store is closed.

Download my self-care checklist below:

*I take Adderall, prescribed by my psychiatrist, to help get me moving when my extreme fatigue and dysthymia is bogging me down. Always consult your doctor before trying a new medication and never take medicine that is not prescribed to you.

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Trigger Warning: Suicide, Suicidal Ideation, Death by Suicide

Preface: I don’t pretend to know what others go through during a depressive episode or why someone would want to die by suicide. These are solely my opinions, based on my experiences.

This is not an easy topic, nor is it a comfortable one to discuss, but that’s why we need to talk about it. The stigma surrounding depression and suicide leaves people feeling they can’t talk about it, and the silence is deadly. And so heartbreaking.

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September is Suicide Prevention Awareness Month

I think about Kate Spade‘s and Robin William’s suicides from years ago, and while most everybody was shocked, I really wasn’t surprised. In my opinion, the people who work the hardest, the most passionate and genuine, are the ones who struggle the most. I know it was hard for people to understand and I’m sure very scary that two such successful people could lose a battle to a little-understood enemy, that they could leave their seemingly happy lives and family, but it happens every day. Depression is an invisible illness that can completely devastate you, yet so many stay quiet because society as a whole doesn’t seem to want to understand. (Read about the history behind the stigma of mental illness here.)

It’s obvious that depression is misunderstood. It’s hard for people to understand that someone can make jokes and be depressed. Or that a person can be suicidal yet appear fine, even fully functional. Depression sufferers are good at hiding pain. I hid mine for years because I felt judged and ashamed. I felt like I was weaker than everybody else but that was the stigma talking.

I don’t get it. Is it ignorance or is society so fragile that people can’t handle knowing others are suffering so much? It’s 2020 — shouln’t we be more evolved, more enlightened?

It doesn’t matter why the stigma is there, it needs to end. In 2018 (the latest stats I could find) there were more than 48,000 recorded suicides, according to the CDC’s National Center for Health Statistics. On average, the annual U.S. suicide rate increased 24-percent between 1999 and 2014, from 10.5 to 13.0 suicides per 100,000, the highest rate recorded in 28 years.

Those numbers are from two years ago and have increased, no doubt. I imagine they will significantly increase this year due to coronavirus and the resulting problems, such as increased number of depressed persons from job loss, trauma, health concerns, etc.

But I digress. I’ve been suicidal more times than I can count. I haven’t talked about it a lot, but I should, especially since it’s Suicide Prevention Awareness month. The only way to normalize depression and suicide is to talk about it and help educate, so here I go.

My mind goes to a time where I was staying at my parents’ house. My parents had taken my two young kids to their lake house. My husband (who was back in Corpus) and I had gotten into a fight, I don’t even remember what it was about, but I remember how alone I felt, so out of control. I had experienced bad postpartum depression a year before and it just lingered and worsened.

That night I was so sad, I could feel it in my bones. I was exhausted and it truly felt like I’d be unhappy forever. That argument sent me over the edge and all I could think about was I’d be better off dead, but I didn’t want to leave my babies. I didn’t want my mom to find me dead.

I ended up driving myself to the ER and was then sent to an acute behavioral hospital for two days.

Tears are streaming down my face as I write this. It’s painful to think about. I love my family more than anything and I don’t ever want to do anything to hurt them. Unfortunately, I’ll probably have more suicidal thoughts, but I don’t want to die. My brain is such a liar. Such a con artist, making me believe I’m not worth being alive. That my family doesn’t want me. It is my heart that saves me, helps me see through the bullshit. And that’s all it is, except it feels so real, and I completely understand how people could succumb to those big feelings and end their lives.

The people who die by suicide — they aren’t selfish, they were just sick and their illness just so happens to take over their brain. I think they just wanted to be free of the pain. Depression makes you hurt all over, and of course, the pain you feel mentally is pure anguish. It’s exhausting living with all that. I get it.

I feel like suicide could happen to anyone under the right circumstances. That’s why we need to eradicate the stigma and support those in need of mental health services.

Lives literally depend on it.

Risk Factors for Suicide Ideation and/or Attempts

  • Family history of suicide or child neglect
  • Previous suicide attempts
  • History of mental disorders, especially clinic depression
  • History of alcohol and substance abuse
  • Feelings of hopelessness
  • Isolation, a feeling of being cut off from other people
  • Physical illness
  • Barriers to accessing mental health treatment

Read more about risk factors on the CDC website.

Warning Signs of Suicidal Ideation and Behavior

  • Talking about wanting to die or kill themselves
  • Looking for a way to kill themselves (like researching how to buy a gun)
  • Talking about feeling hopeless or being in unbearable pain
  • Increasing the use of alcohol and drugs
  • Acting anxious or agitated
  • Withdrawing or isolating themselves
  • Extreme mood swings

Read more about warning signs and how you can help here.

If you or a loved one is struggling with suicidal ideation, please seek immediately. You can call the Suicide Prevention Lifeline at 1-800-273-TALK (8255).

There are better days ahead. Stay in the light, my friends.

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The stigma of depression can cause deep-seated shame.

I’ve suffered with depression for a long time, which means I’ve also suffered through ignorant, and sometimes just mean, comments. I realize some people may have good intentions but it still can sting. The stigma of depression is still very much alive and comments like the ones below may be why some people suffer in silence. But they shouldn’t have to. Depression is one of the most common mental illnesses, affecting 15 to 20 percent of people. It’s scary, debilitating and seriously misunderstood, but it doesn’t have to be.

I’m hoping through my blogs I’ll help chip away at the stigma. Below are some of the most common things I hear.

1. You need to get out more — get some fresh air and sunshine. Breaking down this comment is kind of hard because fresh air and sunshine are beneficial, BUT they alone will not cure depression. When this has been said to me I usually am so depressed that getting out of bed wears me out for the day and even thinking about expending more energy stresses me out.

2. It could be worse. It’s not like people with depression don’t have perspective, but this comment can really alienate people. Nobody is saying their struggle is harder, but when you’re in the throes of a depressive episode it feels terrible and lonely. A comment like this is insulting and trivializing.

3. You’re just being lazy. No depressed person I know is lazy, and even if they were, laziness doesn’t cause depression. But depression can cause extreme fatigue and deplete energy levels.

4. It’s all in your head. This is another comment that I think trivializes depression. Depression isn’t made up. It’s a very real medical condition where there are actual changes in the brain and it impacts physical health as well. Read more on how it affects the brain and body here.

5. You wouldn’t be depressed if you exercise. This is another tricky one because exercise is crucial to a person’s health, but again, I’ve been in situations where I was lucky to even shower, let alone do anything more strenuous. Only recently have I realized that exercise will help maintain my mood, so I’m working very hard to incorporate it into my daily routine. BUT even if I do exercise I will still be depressed. I will still need medications and talk therapy.

6. What do you have to be depressed about? I struggle with this personally because I feel so fortunate to have what I have, and it does make me feel very guilty; however, this is the stigma talking. Depression doesn’t care who you are or what you have. It can affect anyone but it doesn’t mean someone is not grateful for what they have. This is very hard to hear from others.

7. Just think positively. I hate hearing this so much. Thinking positively is not the reason I have depression. It’s not like I think negative thoughts all the time, but I am realistic about my disease and how to maintain it. Positive thinking never hurt anyone, but some may be incapable of putting things in perspective during a depressive episode. No matter how many happy thoughts you think, you can’t think this disease away.

8. Snap out of it! This is simple — nobody can just snap out of depression. This is mean, in my opinion, and people shouldn’t have to hear this.

9. But you seem fine. At times, I can be very high functioning. I also can laugh and joke around. In my case, I’m not depressed every single minute of every single day, so it may come off like I’m fine, but I’ll be saddled with depression for the rest of my life. And that’s OK.

10. Happiness is a choice. Another bullshit comment. This is offensive. The idea that people are choosing to be so devastatingly sad or suicidal is so ignorant. Please don’t say this to others.

I don’t want anyone to think that I’m discouraging you from reaching out to someone who suffers with depression. You should. Here are some ideas on what to say that (likely) won’t hurt them.

1. How are you feeling? Someone with depression may not want to talk about it, but this is a good way to get them to open up.

2. How’s your day going? Another good way to check in without being intrusive.

3. I’m coming over. In my experience, I will tell my friends I’m fine even when I’m struggling because I don’t want to be a burden. Some of my friends have learned to just show up.

4. I’m here if you need me. It always feels good to hear this. I know my friends and family are always there for me, and they give me space when I need it, but this is still comforting and supportive.

5. What can we do? This is very supportive and makes me feel like I’m not in the dark hole of depression alone.

I hope this helps, and I hope you will join me in trying to end the deadly stigma surrounding depression. Stay in the light, friends.

If you or a loved one are suicidal, please call the Suicide Prevention Lifeline at 1-800-273-8255.

Learn what to do if your loved one is in immediate danger of hurting themselves.

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heatherandeli-1-1132729

I breastfed Isla for eight months before I started showing signs of depression again. Pregnancy hormones and breastfeeding gave me a temporary boost, but I could feel the darkness try to creep back in. My doctor (wrongly) told me I couldn’t breastfeed and take antidepressants, so I stopped. (Some antidepressants are safe to take while breastfeeding. Read more here and always consult your doctor if you need medication).

heatherandeli-1-1132729
Heather and Eli, 2016

I weaned Isla somewhat abruptly and started my meds, expecting to immediately feel better, but Zoloft was no match for my hormones. I cried all the time. I had suicidal thoughts. I felt out of control and that scared me. I had experienced depression before but not on that level.

After talking to other moms and doing research, I discovered I had post weaning depression, something I’d never heard of, but it’s real. When you stop breastfeeding you experience a drop in prolactin and oxytocin levels, according to Parents.com. Prolactin, needed for milk production, causes calmness and a sense of well-being. Oxytocin, needed for milk ejection, increases relaxation, lowers stress levels and lowers blood pressure.

It’s no wonder that my hormones caused such a violent reaction when I abruptly stopped breastfeeding. I turned back to my doctor but he wouldn’t acknowledge that post weaning depression was real. I got the impression he didn’t deal with pregnant or postpartum patients at all. Later he labeled me “treatment resistant”, which felt like he was giving up on me. So, I gave up on him and found a new psychiatrist — a woman.

I received inadequate postpartum mental healthcare. I’m hardly the only one who has experienced this, which got me thinking — I was able to afford new medication ($300!) to combat my depression. I was able to find a new doctor, even though she lives in the DFW metroplex (near my parents’ house) and doesn’t accept insurance. She charges $125 per hour. I was able to get the help I needed, but there are women who aren’t as lucky, especially women of color. There’s a huge disparity when it comes to the risk of experiencing postpartum health issues. This is likely due to the fact black women are more likely to have traumatic births and other complications, such as maternal hemorrhaging. Read more about that here. Also, black women are less likely to reach out, most likely due to the stigma associated with mental illnesses.

Nationally, postpartum depression affects 1 in 8 women. New mothers of color have rates of postpartum depression close to 38% compared to the 13 to 19% rate all of new mothers, according to the Psychology Benefits Society.

A disproportionate number of women of color are not even screened for depression and don’t receive the services and treatment they need. Up to 60% of women of color don’t receive any services at all. That’s crazy! Proper screening of women of color during pregnancy and postpartum is known to reduce the symptoms of depression, yet there’s still this great disparity.

There’s also this — there are documented racial and ethnic differences in perceptions and treatment experiences of low-income women of color vs. white women, including limited access to health care, a disconnection with providers, lack of access to providers that look like them and unavailability of culturally/linguistically appropriate services, Psychology Benefits Society says.

A study questioned new mothers of color about what they needed in order to access screening and treatment and it shows mothers of coloring lack the following:

  • Access to information and resources
  • Access to services (insurance coverage, transportation, childcare services, etc.)
  • Flexibility when making appointments and flexibility when finding a doctor
  • Community-based support services

This is not OK. All those numbers are probably much higher in reality than what’s being reported. Again, the stigma keeps women of color from reporting and reaching out. It is still common for people — no matter what their background — to view depression as a weakness. New moms could also fear people thinking they aren’t fit as a mother if they are experiencing depression. That was a huge concern of mine.

I’m not trying to make this about me, but I can’t help but think what if I didn’t have the means and flexibility that I do to receive quality mental health care?

What I experienced with postpartum and post weaning depression was not good, and to be honest, it was dangerous (not for my kids, just me) because of my suicidal thoughts. I could have easily killed myself but my support system and options for healthcare saved me.

But there are others who need saving. All women need quality healthcare, and closing the gap between treatment of mothers of color and white mothers should be a priority. It should’ve already happened. The U.S. is supposed to be “best country in the world” but it ranks among the last compared to other first-world countries in terms of healthcare. I love my country, but it’s not the best if the majority of women are receiving little to no healthcare postpartum or otherwise.

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