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mental illness

Q&A With My Psychiatrist

by Heather Loeb
written by Heather Loeb

I have a really great psychiatrist, Dr. Neysa Johnson in Southlake, and she was gracious enough to answer some questions for me about depression and treatment plans so I could share with you. 

If you have depression, will you always have depression?
You will not always feel depressed, but depression, unfortunately, is a recurring illness.  If you have an episode of depression, you have about a 50% chance of it coming back.

What kinds of things do you recommend as part of a treatment plan, i.e. meds, therapy, etc?
A treatment plan should be well rounded, and usually includes both medications and therapy, as well as self-care like good nutrition, exercise, and sleep.

After starting a treatment plan, how long does it take to feel better?
It partly depends on the treatment, but for most antidepressants that are used to treat depression or anxiety, it can take up to 6-8 weeks to feel the full benefit of treatment, but a lot of people start feeling better in 2-3 weeks.

How will I know if I’m getting better?
I tell people that they will begin to feel more like themselves.  Treatment doesn’t change your personality or who you are, but it gets you back to your baseline.  You may not notice things at first, sometimes others notice changes before you do.

What kind of lifestyle changes will help my depression/diagnosis?
Managing sleep, nutrition and exercise can definitely affect your depression.

What’s the best thing to do in a crisis?
Self-care is really important.  Keeping a regular sleep schedule and getting enough sleep and eating nutritional meals on a regular basis are very important.  Exercise is really vital to stress relief, and finding a way to exercise even if you are in ‘shelter in place’ is essential. Emotionally, sharing your feelings and fears with others is very helpful to knowing you are not alone in how you might be feeling.  Reaching out for treatment may be needed in a crisis; and if you already have a mental health condition, keeping in touch with your treatment providers can help a lot.

How many patients do you see?
I see up to 13 patients a day for follow ups, less than that if I am seeing a new patient.

How long have you been practicing?
I have been in practice for 13 years, private practice for 10 years.

What are your credentials?
I have my M.D. from UTMB Galveston, and I did my residency at UT Southwestern in Dallas in Psychiatry.  I am board-certified in Psychiatry.

If you could tell your patients anything what would it be?
To be open with me about how they are feeling and if they are having any side effects from treatment so we can decide if we need to make changes.

I think the question that resonates most with me is, “If you have depression, will you always have it?” I (and so many others) work hard daily to stave off depression and it’s tough to see that I’ll probably always have it – and that it might come back. Right now, my depression isn’t terrible; I’m pretty high functioning, but it seriously exhausts me going through all the daily tasks I have to do in order to make sure I’m ok. Not great, just functioning. Just ok. I think that’s why it’s so important to focus on a treatment plan, stick to a healthy routine and I’m glad Dr. Johnson mentioned sleep, good nutrition and exercise as cornerstones to a treatment plan. 

Also, I’m glad she talked about self care during a crisis. Self care is always important but now that most of us are in isolation, it should be a priority. Honestly, being at home and not able to do much is just fine for me; however, dealing with the kids all day is exhausting, both mentally and physically. I can see how others being at home, away from friends and family would be tough and the urge to reach out might not be there. 

I know it’s hard right now but every storm runs out of rain, right? Take care of yourselves.

For more information on depression and other mental illnesses, please check out the American Psychiatric Association’s website. 

And as always, if you are feeling suicidal, you can call  the National Suicide Prevention hotline at 1-800-273-8255 or chat online with someone here.
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When the Darkness Comes

by Heather Loeb
written by Heather Loeb

I can feel it coming. My body feels weighted down, I’m irritable and even more sensitive, which is saying a lot. It’s sort of like PMS but it’s more than being moody and there’s no relief in a few days. Sometimes I just want to die.

I can remind myself how lucky and privileged I am, who I need to live for but the pain is deep and distorts everything I know to be true. It’s a scary feeling and I hate feeling out of control. Despite having a safety plan (a plan of action for when or if you’re suicidal), I don’t feel safe. There have been times I have called the National Suicide Prevention Hotline and tried to use the chat feature but there were more than 70 people also waiting for help and support. I could have called the hotline but I resigned myself to sleep.

Things looked better in the morning but it was still creepily dark in my head. I didn’t want to get out of bed but had to take the kids to school. I couldn’t shower. I couldn’t brush my teeth. I forced myself to take my pills and retreated to the comfort of my bed.

After a couple of (weepy) days, I did feel the fog lift but it took awhile to return to “normal.” That’s the scary part of depression – one of them, anyway. You can do everything right – take your pills, see your doctors, see your therapist, put real pants on and shower but depression will find you.

So will anxiety. My depression and anxiety go hand and hand. Mine makes me obsess about the weirdest things – things that have happened years ago, hypothetical tragedies that could happen to friends/family, bad things happening. Sometimes there are no thoughts behind it. It’s just there, a heavy weight on my chest making it hard to breathe.

Since going to the Menninger Clinic these symptoms have gotten better but not all together gone. When I can muster the strength to combat my overwhelming sadness and panic, there are things I can do to help.

  • I take my anxiety pills
  • I get under my weighted blanket
  • I listen to guided mediations or favorite music
  • Write

But if you’re in a scary situation that you can’t get control of, please call the National Suicidal Prevention hotline at 1-800-273-8255 or call your city/county’s mental health resources to see what’s available to you. And you can always call your primary physician. There is help out there and I know sometimes you don’t feel you need help but that’s just the depression talking. People care.

I’d you’d like to list your positive coping skills, please feel free to in the comments.

Stay in the light, my friends.

 

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My Mother

by Heather Loeb
written by Heather Loeb

My mom is cut from a different cloth. Even from a young age, she has always done what she needed to do. At 19, her father died. She didn’t hesitate to help my Mema with the younger kids. She took a job right after high school so she could help pay bills. My mother had seven siblings but the two older siblings were married and were starting families, so she helped take care of the younger five. Still to this day she helps her siblings, financially or otherwise because that’s who she is – a caretaker.

Skipping years ahead, she got married and helped my dad and his brother open a business. She was the first employee and she excelled at it, even though it probably wasn’t her greatest passion. Still she learned everything about truck accessories for heavy duty trucks and continued to work that job for years. After some personnel issues, my mom and dad decided to open a second store, this one with my older brother at the helm. It too was a success and it still didn’t bother her talking shop about truck bumpers, wheels and other accessories. Like I said, she always did what she needed to do.

I can’t speak for my brother but I’m sure he would agree – she would do anything for us. In middle school when I developed migraines, that at times were uncontrollable and debilitating, she became my advocate. She navigated a new world of medicine and therapies and triggers. Fragrances were a trigger so she stopped wearing perfume and bought special soaps.

Years later I finally told her I had depression – bad depression. This was not her field of expertise and although she was probably really scared, she learned the ropes and how to help me calm down during a depressive episode.

When I had kids my depression worsened. Some days I couldn’t find my way out of the overwhelming sadness. I would often want to harm myself. My mom, who had never experienced mental illness herself, dug deeper and supported me the best way she knew how. It must’ve broken her heart when I became suicidal and needed intensive intervention. I stayed at a psychiatric treatment center for 6 long weeks. But she was there, helping take care of my children, visiting me and encouraging me once again.

As I’ve now stabilized, I think about the calls I made to her crying, suicidal. Her love, strength and endurance has never wavered and she just listened, not knowing how to help her daughter stop being suicidal. I firmly believe she was meant to be my mom, to help someone who struggled daily with invisible demons. Someone who wasn’t cut from that seemingly magical cloth. But I have learned from her, too. My bouts with depression have taught me strength, most importantly, compassion. My mom has been my advocate, leading me to be an advocate for those who suffer from depression and anxiety. Maybe to those who haven’t had support and are afraid of speaking out because of the stigma surrounding mental illness. Maybe I’m more like my mom than I think. At least I’d like to think so.

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Punishment

by Heather Loeb
written by Heather Loeb

A couple weeks ago I was flying high. I was very productive, making healthy choices and genuinely happy. Today, I am suffering. The weight of my depression is bearing down on me and I want to fight it so much. But I can’t. I can only go into survival mode and hope that I’ll feel differently in a few days.

I could feel this coming and what really sucks is that I don’t see light at the end of the tunnel. I feel like I need to be happy in order to make good decisions but I know I need to make good decisions to feel happy. And I’m feeling the pain of not being able to do things I need to do like eat healthier. Today I had a healthy breakfast and lunch but then when I picked up the kids I binged on their fruit snacks because they were fighting and stressing me out. Then I decided to punish myself and eat an unhealthy dinner. I of course overate, which is very painful now since I got the gastric sleeve surgery in November.

I’ll try again tomorrow. And the next day and the one after that. Maybe I’ll get it right someday. Maybe I won’t have to have a “survival mode.” Here’s hoping.

Stay in the light, my friends. At least one of us should.

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Out of the ashes, baby

by Heather Loeb
written by Heather Loeb

I’ve had depression since I was young; I can remember feeling anxiety in middle school and I definitely had depression in high school, I just didn’t know it then. It wasn’t until college (when my Mema died) that I really had a problem. When she died, I couldn’t handle it. I dropped classes because of the stress and overwhelming sadness I felt. I dropped so many classes that I was only going part-time. I can remember leaving campus to drive to my parents’ house multiple times a week.

I started therapy at my college and after a couple years, I realized I needed medication to help with the depression. I was so embarrassed. I didn’t even tell my parents. Now, my parents have always supported me and never really talked about depression with me but I had it in my head that this was a major flaw – my family seemed stronger somehow, that I should just pull myself up from my bootstraps and get a grip. But I couldn’t.

After I graduated college and started my first job hundreds of miles away from my family and friends, my depression got worse. It made me miss work….a lot of it. My other coworkers were resentful and I felt like my bosses hated me. I didn’t fare well in Corpus Christi and after a bad breakup I moved back home. I felt unsuccessful and like a loser. My depression got even worse.

Fast forward to me going back to Corpus Christi: I got married, bought a house and got pregnant. After my first pregnancy I felt ok but after having my second child I was not ok. Postpartum depression reared it’s ugly head. I had to stop breastfeeding at 4 months so I could get back on my antidepressants but even the meds couldn’t save me from being suicidal. It was awful. I spent my energy on making sure my kids were ok and I simply didn’t have enough strength to fight the ugliness that had infiltrated my body. One day I had to go to the ER for suicidal thoughts. Luckily my parents were with my kids. I was sent to an acute behavioral center and saw an awful doctor who wouldn’t listen to anything I was saying. I was released after a couple days and I found a new psychiatrist who started me on different meds. I’d like to say that fixed me but it didn’t. I was diagnosed as having treatment resistant depression, meaning my meds were not effective in fighting the depression off.

Things were pretty bleak and my depression was not controlled at all. The only thing keeping me going were my kids – they of course had constant needs that I had to focus on. It was when they were sleeping that my anxiety increased. I couldn’t control ugly thoughts like I was a bad mom, a bad wife and a total loser.

I was running on empty with no hope in sight. After talking with my therapist and husband, we decided that I would go to a psychiatric facility for help. It was the hardest decision I ever had to make. It would mean at least 6 weeks away from my babies and husband and I felt incredibly guilty. But I had to go.

At the Menninger Clinic I was diagnosed with major depressive disorder, generalized anxiety and avoidant personality disorder. I started electroconvulsant therapy (ECT) and different meds. I was able to come home after 6 weeks but I have to do ECT treatments every now and then.

I still get depressed. I’m actually in a little funk right now but I know I’ll get through it. I will always rise. I used to think that people with depression were weak but now I know that’s nothing but bullshit. We are strong. We fight to live every day. It’s hard and some of us don’t make it because they don’t have the means or a support system. They suffer in silence and that’s why I cannot. Please do your part in eliminating the stigma around depression and help normalize it. Check on your loved ones, let them know you care and shine a little light in their darkness.

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STFU, please

by Heather Loeb
written by Heather Loeb

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

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

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

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

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

It’s still not your fault.

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

Just keep swimming, friends.

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Blah

by Heather Loeb
written by Heather Loeb

I haven’t written in a couple days and I don’t really feel like writing today. Yesterday, I had my first Spravato treatment, which I’ll get to later, and since then I haven’t felt right. I have a major migraine and I feel really depressed. So far not impressed with Spravato.

Anyway, that’s it for now.

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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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You don’t have to talk about your depression

by Heather Loeb
written by Heather Loeb

When I first starting writing about having depression, I had no idea so many people would reach out. The outpour of support was overwhelming and comforting. It can feel pretty lonely at times in the darkness of depression.

But some people – some surprising people – have not been so supportive or they have ignored my blogs and constant talk to normalize depression. One person, who will remain anonymous, said she understood that I was depressed but didn’t think I should always write about it – that it might make my sadder, that people didn’t need to know my business. I felt almost like I was embarrassing her by association. Actually, I’m pretty sure she was embarrassed – even embarrassed for ME. Like I should be ashamed.

But that’s what I don’t get – why people are weird about depression and mental illness. That’s what this blog is for – lending understanding to others and normalizing all mental disease.

What’s shocking the most is the person is my age, a part of my generation. Perhaps her feelings toward depression and mental illness came from her parents and family who considered it taboo or a weakness. Where does it come from?

But I’m not going to stop blogging. I don’t think I’m whining and complaining about being sad all the time. I think I’m telling the truth about what it feels to have depression. What’s weird to me is why it makes others uncomfortable? Why would you feel anything but compassion or even indifference in my journey? I think that reflects more on the people who are judging than it does me. I’m fine with having depression. Well, not fine, but I’ve come to terms with it. But it doesn’t bother me, so why should it bother you?

Why are people so uncomfortable with mental illness?

Before I end this blog, I wanted to remind y’all that I start TMS tomorrow and will blogging about the entire process and how I’m feeling after treatment.

Thanks for reading.

 

 

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