Misconceptions About Depression

A few years ago I posted an Instagram photo with me crying and a caption that said, “This is the face of depression. Be kind to others because you don’t know what they’re going through.” That photo upset some of my friends because I hadn’t really discussed my depression before in such an open way. To them I was happy and a goof ball. What most didn’t see was I was moody, miserable and even suicidal at times.

Though I was diagnosed with depression 17 years ago, it was after my babies were born that it really got bad — and scary. I had dealt with postpartum and post-weaning depression but had inadequate psychiatric care.

On the outside I was posting pics of my kids in cute outfits and everything online told a completely different story.

Many people mask their pain for different reasons. I had the idea that depression wasn’t talked about, that having depression makes you weak. That it was a matter of willpower. I didn’t want to be the depressed mom, I wanted to be the mom that does it all, which is a dangerous and unrealistic expectation for anyone. That stigma that I was buying into keeps a lot of people silent about their struggle. It can be especially hard in certain cultures, such as Asian cultures (read more about that here.)

There are definitely common misconceptions about what depression looks like. In my case, I’m not sad every minute of everyday. There are good and bad days, just like anyone else. Sometimes my depression manifests in other ways, such as overeating or binge eating; sleeping too much; having a short fuse; or partaking in other unhealthy behavior.

I was freed of the heavy weight depression holds when I admitted to all my friends and family that I went to a psychiatric hospital in 2019. I even wrote a forum piece about my experience for the local paper. It was not easy, in fact it was a little terrifying knowing that essentially the whole city knew my secret, but like I said, it set me free. I just didn’t care about anyone’s opinion anymore. I know it can be annoying when I plug my blogs or pieces in the paper but I’m hoping they will reach someone who needs to hear what I’m saying — that it’s OK having depression and there is no shame in it. Those who I’ve met who struggle with depression are the strongest people I know. We are fighters. We are survivors.

Ideally, everyone should be able to talk about their mental illness but I understand why people don’t. It’s terrifying being vulnerable, especially when there’s a chance someone will react negatively. But I urge everyone to reach out, even if it’s to one person. You’d be surprised how free it makes you feel, and by telling a friend or family member, you’re lightening your load. Your support system can help you carry that load, and you should take help where you can get it.

If you can’t reach out to someone, please know there are several online resources that can help. To learn more about depression or find resources visit the Substance Abuse and Mental Health Services Administration. They have a 24-hour helpline.

Other Misconceptions About Depression:

  1. “It’s all in your head.” – Depression is a psychological and biological disease. You have no control over it, so if someone tells you to “buck up” just know that the problem is not with you — it’s with them and their lack of understanding. You don’t have to pretend or fake it, just do you.
  2. Depression = being really sad. – Sure, you get sad when you’re depressed but someone equating it to “just being sad” is trivializing your feelings and your disease.
  3. Depression means you’re weak – I already touched on this but it’s worth repeating — I think people with depression are so strong. Depression can wreak havoc in all areas of your life. Some people deal with suicidal ideation daily and others have to tap into a reserve of strength and energy just to take a shower (me!) or go to work. Often that reserve is depleted.
  4. Depression is not treatable – There are a variety of medications that are safe and effective in treating depression. There might be side effects and it might take a while before finding the right combination, but (most of) patients feel better. There are also therapies you can try, such as talk therapy, TMS (Transcranial Magnetic Stimulation), ketamine infusion therapy, and my favorite, ECT (electroconvulsive therapy). Please consult your doctor before trying any medication or other treatments.

These myths are damaging, but again, please reach out if you are struggling. It gets better.

If you are suicidal, please call the National Suicide Prevention Lifeline at 1-800-273-8255 or visit their site for chat support.

Punishment

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.

See you later, alligator

So, I’m taking off the next 6 to 8 weeks. I talked it over with my therapist and husband and we all decided I needed to be inpatient at a mental health facility this past week and, lucky for me, the clinic had an opening in the program starting this Monday that I wanted to be in and that was the best fit for me. One that focuses on my treatment-resistant Major Depressive Disorder, generalized anxiety disorder, social anxiety and PMDD, and emotional eating. Even substance abuse, because I’ve abused my anxiety medicine in the past.

The clinic is Menningers in Houston, which is well known in the psychiatric arena. I’ve heard such good things about it and I’m hopeful. I should be – the program cost a damn arm and a leg but now’s the time to get better. Nothing else has worked.

The one thing I’m worried about is ECT is not part of my program and I really want to do it. The program leader said I can meet with the doctor to see if I’m a candidate but I don’t know who else would be a better candidate. I’ve tried multiple medications (Prozac, Wellbutrin, Zoloft, Lamictal, Rexulti, Saphris, Doxepin Lexapro, Cymbalta, Abilify – just to name a few), TMS, ketamine infusions and now Spravato. I’ve been depressed (way) over 5 years, so really how can they turn me down? But they could, so good thoughts please. It’s really my one shot. I wont be able to afford a place like this again and I’m not willing to be away from my children for this long again.

That’s the only thing making me nervous. My babies. I know my husband and mother-in-law (and my mom and dad are helping too) can handle everything, I’ll just miss them so much. I’ll miss my son’s birthday and I’ll miss the first day of school. It’s just hard. But when I come out I’ll hopefully be way better and won’t have to miss anything else, because let’s face it, I’m barely living now.

I won’t have access to internet, other than email., so this is so long for the next 6 to 8 weeks. I will miss blogging but I guess I’ll have some stories when I get back.

Stay well, my friends. See you on the other side.

Treatment Resistant Depression

As I’ve mentioned in 389,432 of my other blogs, I have treatment resistant depression (TRD). It may sound like its not curable, but by definition it means one is non responsive to at least two antidepressants for a period of time. It also is characterized by extreme sadness, sleep disturbances, low energy, suicidal ideation and suicidal attempts.

TRD is experienced by 45 percent of patients with a major depressive disorder. That’s just crazy to me. It contributes to nearly one-third of patients attempting suicide in their lifetime, a rate more than double that of their treatment responsive peers, according to this article by Psychiatry Advisors.

While psychiatrists cannot pinpoint why some are treatment resistant, researchers have seen correlations in certain populations who are more vulnerable than others. For instance, women and senior citizens. Individuals who have had severe or recurring bouts of depression also appear to be more susceptible, according to Johnson and Johnson’s website on health.

What I found most interesting is other medical illnesses can play a part in TRD. The article states that thyroid disease and chronic pain (I have both thyroid disease and chronic migraines) makes you a greater risk for treatment resistant depression. Mind blown.

Other factors include substance abuse and eating and sleep disorders. I also suffer from compulsive eating and insomnia. I should donate my body to science when I die.

So, what happens with you’re treatment resistance and your meds don’t work? We do have options. We can go on the highest dosages of our meds – IF YOU’RE DOCTOR THINKS THAT IS RIGHT FOR YOU – or there are non-drug therapies which I’ve mentioned in the past, such as transcranial magnetic stimulation, ketamine infusions and ECT, which helps reverse symptoms of TRD.

I think the only non-drug therapy I haven’t mentioned in detail is ECT (electro-convulsant therapy), which is effective to 70-80 percent of patients. This is not to be confused of electroshock therapy, poorly portrayed in movies and TV. ECT uses general anesthesia intentionally triggering a quick seizure. It’s meant to reverse symptoms of mental health problems and as of now is the best treatment for depression.

So, as of now I’ve definitely more than two antidepressants/antipychotics: Doxepin, Zoloft, Prozac, Lexapro, Wellbutrin, Abilify, Rexulti, Saphris and Seroquel. For me, that’s a lot. I’m also tried Lamictal as a mood stabilizer.

I’ve also tried TMS (transcranial magnetic stimulation), ketamine infusions and I’m about to try the Spravato nasal spray which is based on ketamine.

Here’s to my people who are treatment resistant. You’re not alone and hopefully there will be better alternatives in the future.

One thing I forgot, there’s also a genetic test you can take that can tell you which antidepressants will work better for you. It’s called the cytochrome P450 (CYP450) test. Ask your doctor if this is an option for you.

Stay well. Stay in the light.

TMS: Session 24

So it’s been awhile since I last updated my blog, my bad. I’ve also missed a couple of sessions of my TMS but am on session 24 and I’m feeling really good. It’s really helping – I have more energy, I no longer feel hopeless or depressed all day, and little chores that seemed impossible no longer do. I have 11 sessions of TMS to go.

I can’t wait to finish up in October, I should be feeling way better by then.

In other news, I stopped taking the Trintellix because it was just too expensive and went back to Zoloft. I haven’t noticed any changes – if anything, I’m doing better but it’s hard to tell because the TMS is so effective now.

I know this a short update but I don’t really have anything to report other than I’m doing great. Thanks for reading!

Migrainepalooza

Remember when I said my migraines were nearly non-existent a couple of blogs ago? Well, this week they came back with a vengeance. Usually I would go get a ketamine infusion, which keeps them at bay, but guess what? The ketamine clinic here – the only one in town – has closed. The closest clinic is two hours away.

Photo by Public Domain Pictures on Pexels.com

Now what exacerbates my migraines is really anything but since I’m doing TMS and it feels like a woodpecker pecking the shit out of my head, it tends to make things worse. Good times.

This week I had to go to my neurologist for two injections. When my migraines get very bad and my abortive meds aren’t working I go to my doc and he gives me an injection of Nubain and some nausea meds. It worked for a little bit Tuesday but then the migraine was back in full force Thursday. I also had a less intense one on Friday but didn’t end up going back to the doc.

During the week I missed a board meeting, play date, didn’t get any chores done, barely saw my kids because they were either at after care at school or with my mother-in-law. And of course that all depressed me because 1. I felt like crap and 2. I felt useless because all I could do was lie down and take a massive amount of drugs that didn’t help.

My husband, who has picked up the slack for me this week, has decided to drive me to San Antonio for a ketamine infusion. Maybe he realized my job was too hard on top of his because I suggested getting an infusion before I started TMS to avoid this whole situation. Men, they never listen.

Last week I also talked about how good I was feeling and then I went a little downhill but with migraines three to four days a week it cant help but depress you. Chronic pain will do that to you, like I discussed in this blog.

I’ve now completed 10 TMS treatments and they say you’re supposed to feel a real difference by treatment 14 or so. I’m really hoping the ketamine will help my migraines, the TMS will start working better and then I can get my ass in gear. I do have two 5Ks coming up in the next four months and I haven’t exactly been running, unless it’s to the fridge for a Diet Coke (I needed the caffeine this week)….which I’m supposed to quit.

I’ll blog after my ketamine treatment and give an update on my TMS treatments next week. Wish my luck.

For more information on ketamine for chronic pain, go here.

Whomp, whomp

Once again, my brain is playing tricks on me. Last week I was flying high, going to the gym to run and eating healthy. These past two days I’ve felt myself going down the drain and it’s so frustrating because I haven’t done anything differently. I’ve been surrounding myself with positivity but now even that is hard to conjure up. The TMS technician did warn me that it’s a emotional roller coaster at first but I just wasn’t expecting such extreme mood changes. My anxiety is higher than it has been in weeks.

Photo by Pixabay on Pexels.com

Tomorrow I plan on eating a healthy breakfast, heading to the gym and continuing eating healthy throughout the day but there are knots in my stomach and fear that that won’t be the case tomorrow. And it’s already making me feel guilty. I’ve been reading all about showing up for yourself – not missing a workout or blowing your “diet” – and how it’s about integrity. Now I don’t feel like I have any integrity, which makes me feel even worse.

I’ve even regretting signing up for a 5K in November. I feel like I should’ve gone to the gym more last week, I should have run longer and farther. I’m scared that my depression will keep me from running more this week and then comes the guilt and fear again.

I know I’m in control. I know if I want to go to the gym tomorrow, I can go but there’s also that part of me that just wants to crawl in bed and ignore the world. I didn’t feel that way last week. I also know it’s all about getting uncomfortable and breaking habits but I’m just not sure I can be positive when all my brain is telling me is negative.

Stupid, asshole brain. It’s never easy with my brain.

Hopefully, it’ll get better as I’m approaching my 8th treatment and you’re supposed to feel better in about two weeks. I hope so. I really felt great last week.

It’s like being two different people at all times and that’s exhausting. Truly exhausting.

I feel weak, sad and worthless now. All I can do is pray for help and try to keep positive – fight all the horrible things my brain is saying and making me feel.

Here’s to tomorrow.

Feeling good

Today I went to the gym and ran a mile. Without stopping, dying or talking myself out of it. While that might not seem like a big milestone to some, it’s huge for me. I haven’t run since last year – I ran a 5K in June then begged off and probably haven’t run a mile since December. It’s usually hell getting back on track but today was doable. It’s a lot easier running with smaller boobs (compliments of a reduction in March).

It’s also a big deal because I actually went to the gym. I actually have energy right now. Dare I say that I’m feeling good? Well, I am. I thought it might be the TMS treatments but the technician said it was probably a coincidence – you’re not supposed to feel better until week 2 or 3 – but we all know how special my brain is. Maybe it’s cooperating this time. It owes me.

I’m also feeling better because I’ve been listening to podcasts and reading a book, Girl Wash Your Face, which has led to some realizations:  Mainly that I speak to myself in a mean, awful way and that I hardly ever say nice things to myself. The book and podcasts have helped me see that and I think it’s made a huge difference. I’ve told myself that I’m stupid, failing as a mom, a loser, an idiot and useless. I would NEVER talk that way to a friend, no matter what. What a terrible way to cope with negative feelings. I’m also eating healthier and not quitting just because I screwed up (eating half a pizza). I take one meal at a time and realize that I have to keep going.

Another thing I’ve been practicing is not to let negativity dominate my day. I still have negative emotions but I’m able to process them, dispute what I’m saying or feeling and let it go. It’s hard to do and I haven’t mastered it yet but I can already see a difference.

Long story short, I feel good and I really hope it stays this way.

What about y’all? How do you speak to and feel about yourself? Does it make a difference in your day?

 

 

 

Day 2 of TMS: Anatomical Variance

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.

Day 1: TMS

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.