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major depressive disorder

Ketamine/Spravato

Spravato: Treatments 1 & 2

by Heather Loeb
written by Heather Loeb

This past week I completed my first two treatments of Spravato. What’s that, you say? It’s a nasal spray with esketamine (very much like ketamine) that helps with depression and a host of other things, such as migraines – at least for me.

imgresMy first treatment did not go well. First of all, I HATE things going up my nose. Second, it gave my a horrible taste in the back of my throat and I got a little nauseated. I also didn’t dissociate, which is one of the biggest side effects of the drug. Under the FDA’s rules I had to stay there for two hours, so I was hoping for a little dissociation, otherwise it’s just boring. So, it had no affect on me besides being a little sick to my stomach and then I was bored for two hours. Plus when I got home, I got a huge migraine and for the next two days and had to see my neurologist to get a Nubain injection for my migraines to go away. Maybe it was just a coincidence but I was annoyed and didn’t want to go for the second treatment. It had been awhile since I’d had a migraine.

But to my delight, the second treatment went well. I got the hang of putting the nasal mist up my nose, got used to the nasty taste in my throat and this time they gave me Zofran for the nausea. I still didn’t dissociate but I was tired enough to take an almost two hour nap, so the visit passed rather quickly. Can’t say the same for my husband who has to stay there the whole time and give me a ride home. FDA rules again. He can’t leave the whole two hours while I’m receiving treatment.

I don’t feel a whole lot better, and since it’s hardly affecting me, my doctor is going to bump me up to the big girl dose next week, which is about 84mg of esketamine. When I go to get the ketamine infusions at the clinic via IV, I’m receiving 100mg, plus they give me a benzo in the IV – I don’t know why they do that. So, maybe the larger dosage will help me more.

Don’t get me wrong, it wasn’t a complete failure. I do feel better after the second one but I’m still dealing with symptoms of depression. But I don’t feel as blah as I have been.

I’m supposed to go three times to the clinic next week to get the larger dose, so we’ll see how that goes.

As far as my weight loss and journey to get healthy, I haven’t even been on the scale. I’ve been eating poorly and drinking Diet Coke again. My depression just hit hard this week and the week before. I think. I can’t remember last week. I’ll get back on track and keep you guys updated. Thanks for the support.

Stay well, my friends.

 

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Lake House Trip and Update on Life

by Heather Loeb
written by Heather Loeb

Let me start by saying the lake house was a lot of fun. I learned to play corn hole and I learned that I wasn’t very good at corn hole – my sis in law replaced me pretty fast as her partner but I still had a blast playing. The best part of the trip was watching the kids have such a good time. They went swimming, riding on the mule, jet skiing, and playing with a bubble machine. The lake house is truly magical for them. There’s nothing like spending time with your cousins and I’m so glad they have that.

All of that was briefly interrupted by a stomach bug. It started with my niece, then my mother, my nephew, sister in law, my daughter, me, my husband, my aunt and my brother caught the tail end. It was pretty awful for the adults but the kids bounced back rather quickly. I was in a lot of pain, really dizzy and couldn’t eat for days. In fact, I lost 5 pounds which I was really excited about. If you’re going through so much unpleasantness, let’s say, you need some kind of award.

BUT GUESS WHAT. I seemed to have gained it all back despite not eating much since. My stomach is still a little queasy, so I really haven’t partaken in a good meal. I’m very disappointed but oh well. So….

Starting weight: 187
Current weight: 179

Now that I’m back home with my own food, I’m sure I’ll be able to eat my healthy meals and continue to lose some but I’ve been saying that for a couple of weeks now. It’s starting to piss me off.

Also, I feel off the wagon on the Diet Coke front. My parents have no shortage of Diet Coke and it’s in every fridge in the house and lake house. It practically poured itself down my throat, so I’ll have to start over with that. It’ll be easier because I don’t have any here. So, I tell myself.

That’s about all – I did see my psychiatrist while I was up in the Dallas area. She was happy with my meds, even though I told her some days I wake up and say to myself “is this as good as it’s ever going to get?” and she seemed to say yes, it might be. She said for me, depression is a life-long illness and I might never get better but someday I could get to a better place. That depressed me, because I used to see butterflies and rainbows most days. Now I’m lucky to see some moths flying around a light bulb. Not to say I’m totally unhappy with my life. My life is great as far as my family, friends and how fortunate I am. I just miss feeling happy most of the time. Now I feel like I’m just getting by and that’s surviving, not living.

Sorry to leave on such a negative note but that’s how it is sometimes.

Stay well, my friends.

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Kids

Parenting with Depression

by Heather Loeb
written by Heather Loeb

I don’t talk about this much because I don’t want to come across as a bad mom but parenting with depression is hard. It can be real hard. Depression depletes your energy, at least it does mine, and what little I have left goes to the kids, I know – you can’t pour with an empty cup and all that. But what little energy I have, I have to spend it on feeding, bathing, dressing, and reading to the kids. And of course, getting them to school and back.

View More: http://jenniferstewartphotography.pass.us/loebfamily2018Luckily for me, the kids go to preschool for most of the day and I can go to therapy, take time for myself or take a nap before they come home. When they do get home, I get anxious what do with them and just want to lie down. YouTube is watched a lot around here when I’m going through a really bad depressive episode. That’s not something I’m proud of. My mother-in-law helps A LOT, which makes me feel guilty, and I feel like I rely on her too much. And I’m just talking about the depression, I haven’t even touched on my migraines and their frequency.

Because the kids take up so much energy, my showers get missed, I don’t cook dinner for my husband and me, and my house is a disaster. It’s so overwhelming and I feel like a failure on both the mom and the wife front. Then comes more guilt, followed by more anxiety.

Have you ever seen Bad Moms? I can related to one of the characters – Kristen Bell’s character. She happily describes a scene where she’s in the car alone and she gets hit by a car or a truck and has to go to the hospital a long time and basically everyone has to wait on her. Now, I’m not wishing to die here, people. But that scene is funny because a lot of moms can relate to that, whether they admit to it.

View More: http://jenniferstewartphotography.pass.us/loebfamily2018Parenting is so hard and it’s even harder with depression. I guess that’s why I love going to my mom’s house because she helps me with the kids and sometimes I don’t have to lift a finger. She cooks all the meals, helps with bath time or even just does it herself. As a grandma, she likes it. I hope.

I know intellectually I’m a good mom. I’m the first person they see in the morning and I’m the last person they see at night. I make them breakfast, pack their lunches and sort of put dinner together. I read to both every night. And I tell them I love them every single day. They are loved and they are taken care of. I know they can see I love them through my actions.

It sounds like I’m trying to convince you but I guess it’s me I’m trying to convince. There will always be this feeling that I’m not enough.

But depression is a liar.

Anxiety is a liar.

My brain just has to come to terms with that.

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Exhaustion

by Heather Loeb
written by Heather Loeb

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

I don’t.

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

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

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

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

I’m tired just thinking about it.

Stay in the light, my friends.

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When I Hit Rock Bottom

by Heather Loeb
written by Heather Loeb

About two years ago, I felt great. I was taking two HIIT (high intensity interval training) classes a week and when I wasn’t doing that I was training to run a 5K, a feat for me because I hate running. I felt so strong, so energetic and proud of myself. I was doing hard things, things I didn’t think I could do. I was a role model to my kids.

In June 2017 I ran the 5K. I was happy. A couple weeks later I started to feel bad. I wasn’t sick but I started to lose momentum with my workouts. Things that were once easy or doable became hard. Waking up in the morning was hard. I didn’t know what was going on. I knew I had depression but I was doing so well. It had been well over a year since I had Eli, it couldn’t be postpartum depression – I was over that.

I took whatever energy I could muster and put it toward the kids, which meant I suffered more. Showers seemed near impossible. I stopped working out. I just wasn’t myself.

In October, I hit rock bottom. I had suicidal thoughts. I was crying at every little thing. I felt anxious all the time and my marriage was suffering. Thankfully, my mother in law was helping with the kids.

During a school break, we took the kids up to my parents’ house. I had also made an appointment with a new psychiatrist who specialized in women’s mental health in Southlake. My then current pyschiatrist wasn’t cutting it. While my parents’ and the kids were at my parents’ lake house, my husband and I got into a huge fight and I just lost it. I was sobbing uncontrollably and suicidal. This next part is hard – I knew where some hydocodone was and I had a plan to take some but I didn’t want my mom to find my body. I called my best friend and she urged me to go to the ER.

I waiting for hours at the ER for them to transfer me to a psychiatric hospital. Around midnight, hours after I’d arrived, I was taken by ambulance to a psych ward at another hospital. I was there two and a half days. The psychiatrist there was a total dick. He wouldn’t release me until he “talked to my husband about my illness” and didn’t listen to anything I said. Because I had an appointment with the psychiatrist in Southlake, he ended up letting me go after talking to my husband of course.

When I met with Dr. Johnson, I saw the light at the end of the tunnel. She diagnosed me with Major Depressive Disorder, PMDD, generalized anxiety disorder and social anxiety. My old doctors just said I was depressed and never spent more than 15 minutes with me. Dr. Johnson spent more than an hour talking to me. She put me on medications I had never heard of, that my doctors never mentioned, and I left the office crying tears of happiness.

I did get better, I’m better than I was that awful October but I’m treatment resistant, so medication can only go so far for me. That’s why I try alternative treatments like TMS, ketamine infusions and soon the ketamine nasal spray. Right now, I’m definitely not suicidal but I have to struggle though days, some more than others.

If you’re suicidal, please go to the nearest ER or tell your doctor – any doctor. There is help and it does get better. You can also call the suicide hotline at 1-800-273-8255. Someone is there 24 hours a day to help you.

Thanks for listening. This blog was a hard one to write.

 

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Oops

by Heather Loeb
written by Heather Loeb

Oh, hey. It’s been since September since I last blogged. My apologies. It’s been a hard few months since. First, I was busy with the holidays and since the beginning of the year I’ve been depressed and haven’t felt like talking despite everyone’s urging to do so.

That’s the thing about depression, even when you need to talk the most you feel like you just can’t do it. I can say that I’ve been going to therapy on a regular basis but my meds have stayed the same despite me feeling like crap. Because I’m treatment resistant, there’s really nowhere to go from here medicine wise. My psychiatrist has suggested ECT but I’m just not ready for that. Yet.

I have been getting ketamine infusions which helps with my moods. It doesn’t last very long but thankfully we have the money to get them. I don’t know what I would do if we couldn’t afford it. If you’re poor and have MDD, you’re screwed. My medicine alone costs hundreds of dollars. So wrong.

IMG_2079My therapist and I started Dialectical Behavior Therapy. Basically, you identify your negative behaviors and teach yourself positive behaviors. Seems like common sense but it’s really helpful when all you’ve been doing your whole life is practicing negative coping skills. So far, so good. I’m working in a workbook, which I would recommend to anyone.

I’m also going to try the new ketamine-based nasal spray, Spravato. It was approved by the FDA in March. The doc that did my TMS treatments called and wants me to be her first patient. You have to be in the office and monitored for two hours after receiving the spray and I think you go twice a week for six weeks at first. I hate stuff going up my nose so we’ll see how this goes down. Waiting on insurance to clear my first, of course. It’s always insurance.

That’s my update for now. I’ll try to be more consistent with everything and I’ll definitely keep you updated on the Spravato.

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The Impossible Task

by Heather Loeb
written by Heather Loeb

Recently I saw a Tweet talking about depression commercials and how they don’t mention how hard it is to do certain things – Impossible Tasks. This really hit me hard because when I’m very depressed there are chores and very easy tasks that I need to get done that seem impossible. Like, I might die if I have to do it. And not a lot of people understand it.

For instance, when I’m really down showering seems so hard. It seems insurmountable to get in the shower, wash my hair, then get out of the shower and do my hair. And shave my legs. Kinda gross, right? I don’t go long periods without showering but I dread when I have to do it. This is my impossible task.

Why does it seem so hard? I have no idea. But I’m thinking that everyone with depression has at least one task like that.

My husband and best friend don’t understand. It can take less than 20 minutes to shower. They ask, “why don’t you just get it over with?” But still, it’s not that easy. Even brushing my teeth seems hard sometimes. I swear I’m not disgusting or smelly, I’m just keeping it real. 

But going back to what the Tweet was talking about – they don’t mention things like that on the commercials. They talk about sadness and losing interest in things you used to enjoy, which does happen, but I feel the commercials miss a mark when they don’t talk about the other stuff: anxiety attacks, social anxiety, not wanting to leave the house, lying in bed for days, etc. I guess they only have so much time for the ad, but I think it adds to others’ perception that depression is “just sadness” or losing interest in things or being lazy. That doesn’t sound so bad, but there are dozens of symptoms that come along with depression, especially treatment resistant depression and major depressive disorder.

I’d really like to know your Impossible Tasks. Leave a comment and we can chat.

Thanks for reading.

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The Other Side

by Heather Loeb
written by Heather Loeb

I have a new respect for my husband. And any other partner of someone who has depression and anxiety. I’ve realized these past few months – a year, maybe – couldn’t have been easy for husband. I’ve gone from almost manic happy to severely depressed and hospitalized; I’ve told him I don’t feel well almost everyday; and he’s the one who helps me when my anxiety attacks come, which they do often. It’s got to be hard on the other side. We might not be suffering the same way but I imagine it’s a struggle to see his other half down and out.

DSC01340He’s so patient and sympathetic. I truly picked a good one. But it’s not always perfect, sometimes we fight about my depression. Sometimes it’s too much for him to bear all the responsibility while his wife can barely get in the shower and brush her teeth. That’s an accomplishment some days. Who else is with me?

So, I’m wondering…does every married couple or relationship suffer if one has depression/anxiety? Tell me, friends.

On another note, Rosh Hashanah begins tonight. For those who don’t know, Rosh Hashanah is the Jewish New Year. It’s a chance to start over, reflect over the past year and then prepare to apologize to those who you have wronged (Yom Kippur).  I of course plan on apologizing to my husband but I owe myself a big apology too. I haven’t taken care of myself, I’ve put others’ needs in front of mine (kinda hard not to do when you have kids) and I haven’t shown up for myself. I break promises to myself all the time. But now I’d like to change all that.

I sometimes rely way too much on my meds and therapy to slough through my depression and that’s fine but I want to make an effort, when I can, to really meet all my needs, stop talking negatively to myself and practice self care. I know that will help immensely in my marriage. After all, you can’t pour from an empty cup. I want to be better for me and my family and I believe self care is the first step to that goal.

So, here’s to the new year. L’shana tov, friends.

Update on TMS: I’ve had 14 treatments and I’ve started to notice little things that are better. Around the 20th treatment is when I’m supposed to notice major changes and I’m looking forward to that.

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Day 2 of TMS: Anatomical Variance

by Heather Loeb
written by Heather Loeb

I went back for the second TMS treatment yesterday so they could remap my brain and try to find that exact spot on my cortex where the magnet would be most effective. They searched and the searched and called corporate (Neurostar). Then the doc had an idea of moving the magnetic device back farther than it was or should be. It worked! My hand and eye were twitching, which is a sign they’re on the right spot.

The doctor then proceeded to tell me I have an anatomical variance – my brain isn’t the same as others so it was harder to find the right spot. Again, my brain is a real asshole and I’ve always known it was different but I didn’t think it was THAT different.

Anyway, once the found the right spot the treatment was started, lasting about 20 minutes again and this time it was less painful/uncomfortable. I can definitely make it thought 34 more sessions. Also, I didn’t get a migraine which is a huge plus. Hopefully, I wont have to worry about that in the next several weeks.

I’m not supposed to feel better until about 2.5 weeks in but I already feel better. Placebo affect, I guess, but I’ll take it. I’m still overeating (way too much) and getting anxious at night but I’m working hard to set goals for myself that will make me healthier.

Enter the Harbor Half. I signed up to do a 5k in November, one of the biggest runs in the city. I figure this is the best goal I can make right now because it forces me to train, fuel my body properly and gives me an exact date, or deadline I should say. I’m excited. I ran my first 5k last year but then stopped running so getting back into shape is going to be tough. I can do it though. I’ve done it before and I’m ready to get uncomfortable to make some major changes in my life.

That’s all for now. Thanks for reading.

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Day 1: TMS

by Heather Loeb
written by Heather Loeb

So, day 1 of TMS (transcranial magnetic stimulation) did not go according to plan. Since it was my first visit, the treatment operator and doctor had to adjust the magnet exactly right so it would stimulate a certain part of my brain. They figure this out by sending a signal to your brain and seeing if your hand or fingers twitch. They had a hard time finding the right spot but eventually they were happy with where it was and began treatment.

It was weird. Everyone says it’s like a woodpecker pecking your brain and that’s exactly how it felt. The magnet was placed near my temple so it made my eye twitch and water. The treatment lasted only 20 minutes long, and the good thing is that I didn’t get a migraine, thank god. It’s not exactly painful but it is uncomfortable and I have 35 treatments to go (I’ll go Monday-Friday).

So I’m thinking, “this isn’t so bad” but then I got a call from the doc later that night saying she wasn’t happy with the data and they were going to have to remap my brain to find the exact spot where treatment is needed. The doc said she’s never had this problem with anyone else, of course, and it makes sense that my meds don’t work. If worse comes to worse, the corporate guys will come out and help so there’s still hope.

My brain is a real asshole.

Anyway, I’ll keep updating the blog and let you know how I feel as the treatments progress. The doc said it would take about a week to start feeling different. Keep your fingers crossed for me.

 

 

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