Getting knocked down

Many times a setback feels like a direct blow to the head. Watching the TV news, listening to the horrific details and watching the very anguished look on the faces of parents and grieving friends. 17 people in Parkland, Florida were killed by an angry and confused 20 year old man. In the state of Florida, he can buy an assault rifle legally, along with smoke bombs and multiple magazines for his AR 15 rifle.

I’ve just been stuck in a nasty mood, funked up by seeing smiling president trump taking photo op pictures with first responders, and even one of the victims in her hospital bed. I’m very sorry for anyone still left with feelings that this dreadful human is concerned for anyone other than himself. He’s a constant embarrassment to the United States, most notably one year ago by signing proudly an executive order making it legal for mentally ill buyers to purchase weapons of mass destruction. In the cover of aftermath of new violent chaos, his administration announced the stripping of funds for the Americans With Disabilities Act (ADA), and an accounting for the $107 Million dollar budget for his poorly attended inauguration. All of the funds are gone, $26 Million awarded to a no bid contract to Melania trump’s friend.

I know this blog better serves depression, anxiety, and panic, however in my dreams last night, my home was beset by millions of red ants which later morphed into wasps. We live in very tumultuous times. The US is divided by their leader, and our democracy is being sold in Rubles. It fuels my depression to watch the many assaults to my country, and to feel as though I wanna can do nothing about it.

I meditate, I pray that we will soon see the complex and fraudulent dynasty of the trump family exposed for the excess and false royalty it portrays itself to be. In the meantime, if you have positive energy in abundance, please send it to those grieving families who must process huge loss, and accept that our nation values assault weapons over the lives of its citizens, even the young ones. If you’re a voter, please consider making stronger gun laws an issue to explore with your state’s leadership.

Evite: authors, send me your ideas

 

Thank you to those who have read my perspectives on insomnia, depression, and stress.  No one prepares you how to interpret the response or the lack of responses and discourse on works shared via this kind of blog, therefore I’m going to ask.

If you don’t have your own blog but would like to be a guest author here, please send me your thoughts via this website.  I will publish those insights that are in keeping with internet etiquette and the goal of helping others to shorten episodes of depression. Dissenting perspectives are also encouraged and invited.

But if there’s no interest, then I’ll end the site with thanks again to those who followed but offered no commentary.  All the best.

Receiving help

During your life you will likely spend the majority of your healthy years offering help and your energy to others. You’ll have lived through adolescence, you’ll know with years of experience what it feels like to depend on someone to provide for you. But what evolution, growth, and acceptance should evolve inside us as we begin to need help ourselves, and ask for it as adults? Do we know how to accept it? Will our ego allow it?

If anyone wants to understand the depressed mind, know that there is already great guilt associated with a depressed person dragging someone else down. Depression makes even simple favors difficult requests to ask. Depressed people purposefully create distance because many times they prefer to insulate themselves from happy people in the hope that whatever is bothering them, whatever has triggered a new and fresh piece of hell to erupt inside them, will pass quickly. To the depressed, there is a feeling that time slows down. I’ve described onset depression as trying to walk in chest-deep, wet cement, or very thick liquid. Along comes a friend or loved one able and willing to give you some help, and we may want to shoo them away temporarily. They think we’re just moody, and we’re certain we are doing them a favor.

Do you accept help well?

The writing of this question stuck in my throat. It’s so deeply ingrained in my makeup that I don’t know how to ask for help, hence accepting the offers of well-intended friends is also a challenge. When someone offers to help me it’s because I’ve been discovered. They’ve missed my annoying FaceBook posts, or they’ve detected a reduced number of calls, emails, or texts. These caring, terrific humans want to reach out, and I was never shown, nor did I learn well how to accept help on my own, with my dignity still left intact. Why is that? I’ve seen great movies. Anyone who has read just a few of my blog posts know that I enjoy good movies. So why aren’t contrived scenes of precisely measured offers of help enough to let me mimic the actor’s scripted and graceful receipt of help when it has been offered?

One friend suffers such anxiety that even trying to set a day and time to meet for lunch causes him to freeze up. Imagine for him, how tough it would be to allow someone inside his world long and fully enough to explain what would be helpful. These people believe it’s easier in every sense of the word just to do everything yourself, not explaining yourself, and keeping closed the door to the real darkness with which they must coexist. It’s like asking someone on a date for the first time over, and over, never gaining confidence, never gaining acceptance that your friends may want to bring you out of a tough hole if they could.

Friends who are worthy, family that really care… they don’t keep score, and they don’t count the cost. There are loving ways in which they seek a bond with you to demonstrate their entanglement. The entanglement we know is Quantum Mechanics, the proof that humans are interconnected and wired to care about each other. I’m grateful every day for my entanglements, and even for the tough ones, those people who are seemingly cold, or calloused, insulating themselves from my intentions. A long time friend, someone who has been a role model for me once told me the cold ones hardest to love are the ones who need to be shown love the most.

In our lives there may come the day that we can no longer do things for ourselves, independently and with precision. Doesn’t it make sense then to develop some skills around accepting help with grace?

Thoughts, prayers, good intentions are not enough

In this post, perhaps the most potentially powerful and personal of all, I want you to know that your good intentions will only go as far as assuaging your own guilt. If someone you know is suffering severe depression, and you don’t reach out to them, get ready to encounter some deep and lasting guilt. Reaching out can feel extremely dangerous, like crossing over an imaginary line to ask “are you okay?” “Is there something I can do, like just listen?” “I think there’s something troubling you.”

Then wait quietly for your answer.

Practice the waiting if you have to, in front of a mirror. Tell someone else whom you trust what it is that you suspect, and if they have knowledge of the person, they may even participate in this kindness with you. Strength in numbers, the possibility that you may be right, and to perform a mitzvah, a good deed that both you and your subject may long remember are worth the risk. When is the last time that you stuck your neck out, really went out on a limb for someone, risking the embarrassment they might reject you?

I included the link above to the word mitzvah because the very idea captured my attention and stuck with me years after I learned about it. Twenty years ago, I met a very important person in my life, someone who has since often helped me to regain my perspective and shorten a dark depressive episode. Mel was a neighbor who walked into my newly purchased home to introduce herself, and she did it by saying “I almost bought this house, and you stole it out from under me!” The smile on her face and her calming laugh was my introduction to my most cherished neighbor and friend, someone who lived only a block away because I’d in fact been quicker to the draw when placing an offer on my home. Grandma Mel is a blessing. She knows the importance and value of being a good neighbor and I quickly became a member of her extended family. As such I was invited to family gatherings and learned that many of her family members lived all around me. We danced at weddings, we celebrated births and holidays together, and shared a deep love of good food. She was someone who had endured many losses in her life. She and I shared much about our individual lives, serious bouts of depression and lasting darkness, all discussed over her potato latkes, brisket, my Mojitos, or arroz con pollo. There was endless acceptance and love in her heart, and we have remained close friends years after I sold my beloved home. Mel explained the concept of a mitzvah to me. “It’s not supposed to be known that you did it,” she explained, “that would make you a fame seeker.” In her heart were many treasured memories of the people who have touched her life and helped to shape the giving, selfless woman that became my friend so many years ago. She often calls me to ask me, “what’s doing?” as though the mother of six, and grandmother to many didn’t have enough folks to look out for in her full and rich life. She is a shining example for my own approach to helping other people.

Another close friend had called it “putting myself in other people’s circles.” Aunt Bettie was another godsend in my life. She was generous with her time like a mother would be, but she spoke to me like a peer, a friend in whom she trusted and believed to be worthy of her time. Once after a few glasses of wine, she told me “I don’t like everybody; some are just a horse’s ass, and I have to be selective with my time.” I miss Bettie’s warmth and kindnesses almost daily. My best memory of her “circles” comment was getting a few phone calls after some promotion or achievement of mine that had circulated her way, and she’d sing Mister Roger’s “I’m Proud of You” song, all the way to the end. If you got one of those calls it was intended to let you know that you and your achievement meant something to her. The day of her celebration of life ceremony, the venue was packed, and many people stood in the back to share in her family’s loss. Both of Bettie’s daughters took the podium to eulogize their bigger-than-life mother, composed, eloquent, and exhausted from the thought of losing their cherished relationships with Bettie. Kate said “you always knew where you stood with Mom, and she wasn’t shy about telling you.” She continued through the beginning of tears, saying “those of you who knew her also know the I’m Proud of You tradition…” “Come on, let’s all sing it…”. In that room of greater than 200 people, so many joined Kate singing and laughing through their tears.

Why do some of us have the time, the energy, and the chutzpah to risk caring for others? What’s really in it for us?

Until it happens to you

The best idea of why humans extend themselves, why they bother to care about other people is because they receive something in return. In the movie “I Am,” Tom Shadyac set out to learn why we live in such a screwed up world. Why can we live in a modern age, yet still see ancient problems like hunger, ignorance, and apathy still alive and holding strongly? Shadyac instead learned what is right with the world. He proved Einstein’s theory of Quantum Mechanics and entanglement by using yogurt to demonstrate how strong human emotions influenced another living organism, a living culture of yogurt. The energy field within the yogurt detected Shadyac’s mood, and a meter that measured electromagnetic changes detected his feelings when Shadyac thought of his divorce. Further he concluded that humans are genetically wired to care about others, to offer others empathy.

I’m asking you to think about a time in your life when you put yourself out for someone else, and it mattered. Then think about those times in your life when you really felt a need for someone, a friend, or even an acquaintance who could be a sympathetic ear. There is great importance to realize that humans are interconnected, or entangled. There’s a special reward for those who get into the circles of others for good reasons. For Aunt Bettie it meant that she could right a terrible wrong, or tip the scales back toward the middle. She was one in a million, and that crowded room of mourning relatives knew who and what she was. It is my sincere hope to be just a little bit like her always. Her memory will never fade or die as long as I pay forward her empathy and generous spirit.

Good intentions are not enough

Actions matter, more important than books full of promises, or idle words from a well meaning procrastinator. Do it now. Take the risk. Pay forward a kindness that you remember. I hope we’ve all known a Grandma Mel or Aunt Bettie because those are the people who would tell you the truth, even if the truth hurt a little to hear. These kinds of friends can talk you off a ledge. They balance the dark times with a distraction, or a well timed piece of advice. They’ll drive you to the doctor appointment you’ve been dreading without having to be asked. Be one of those people just once and see how you feel afterwards.

Do you ever feel good?

There have been some deep and troubling subjects in the short few weeks I’ve blogged about anxiety and depression.  It would be irresponsible to omit the good times that depressed people do enjoy periodically.  Clan of the Depressed is not a secret society, but my friends, neighbors, and acquaintances have confided in me they’ve also endured depression or at least periods of situational depression in their lives.  I enjoy listening to their stories because each time that I do, I’m struck by how much the storyteller trusts me to share a personal experience from the files of fear inspiring mental illness. That’s a huge compliment, and I’m a glad listener. I sometimes learn different coping strategies, but also how to recognize that a friend might need an ear, or a break from feeling alone in a serious fight.

There are many good times, thank you God. Many times the good ones will provide important perspective for when there may seem to be an abundance of the bad.  Thanks also for the caring people who place you in their thoughts, send you a text message to say hello, or pick up the phone just to chat. I’ve felt like a few of my friends really are on a link with me mentally, almost empathic, and they will intervene at the onset of a depressing event, bad day, or emotional plateau. They can mean the difference between my staying home, to deal with the blahs alone, or an invitation to distract the mind from unproductive thoughts, feelings of uncontrollable emotions, or just abject sadness and time spent trying to get restful sleep.

Depressed people are glad that others do no experience lasting episodes of dark feelings. Few of us would wish that on others.

What is noteworthy about the good times is that they’re like a chronically ill, hospital-bound patient who gets a pass to take a walk in the sun.  It’s like savoring a favorite, delicious meal with friends, a special occasion to be remembered and prized. One important puzzle piece in coping with depression is learning to prolong the feelings of calmness and the walk in the sun.  With practice, and as an exercise in increasing your personal mindfulness skills, we can think about the last time we laughed really hard, and what had been the situation that made us feel like laughing.  We’ve heard these simple techniques before , yet somehow in the moment and lost among the competing emotions that drag us into dark corners of sadness, we have lost perspective on our personal big picture.  We may have neglected rest, exercise, diet, or even compliance with taking medication for the chemical imbalance, the loss of normal process of endorphin uptake.

How are you mindful?

This blog is intended to provide a safe place for an exchange of ideas on a tough subject like depression and anxiety.  We have doctors who specialize in the treatment of mental illness, but often the best advice, or new skills come from simple sources like a google search, YouTube video, or even a blog.  If you have a perspective about living with greater feeling of balance, ideas to stay in the sun longer, won’t you take a few minutes and add voice to others who might need some help?

 

 

 

What dreams may come?

This topic shares the name of a favorite movie starring Robin Williams. In the movie, shot in fantasy genre, Williams’ beloved wife Annie commits suicide, and his character Chris suffers tremendous feelings of guilt that drive him to believe he can save her soul by rescuing her from the pits of hell.  Drastic and unpleasant subject matter I acknowledge, but if ever there was a picture with award winning imagery of what hell might look like, this is it.  For the severely depressed, it demonstrates the vivid dreams that seem to plague us during the dark times. I recommend that you watch the movie “What Dreams May Come” if you’ve never seen it.  It has its happy moments, but more importantly I think it is a clue, like another Williams movie “The Fisher King,” to Robin Williams’ personal battles with major depressive episodes. The hyperlink is the main character’s journey into hell, and the picture at top of this topic is borrowed from the cinematographer’s depiction of purgatory.

Dream studies suggest that when our bodies relax enough to let go of the conscious world we experience freedom that allows our subconscious mind to empty itself of unfinished thoughts, sometimes those troubling aspects of our waking life.

If my own dreams are an indication, there’s plenty of reasons for the vivid and terrifying dreams I’ve experienced for over five years as of this writing. Who knew that someone of average imagination and writing talents could fabricate elaborate landscapes, linked somehow to stimuli from the conscious, waking life? Medications for sleep also warn of vivid nightmares, so please consider reading the micro font printed warnings that come with medications related to sleep and depression if you are troubled by night terrors.

Dreams motivate us to understand what events or conditions might be troubling our souls; dreams can be whimsical fantasies that give our heavily burdened brains a good laugh.  I far prefer the latter, though sometimes I am troubled by nightmares long after they’ve occurred.  Before the depression and in my happier dreams I once wrote beautiful poetry, and poignant stories penning them with my finger on the bedsheet.  Some very creative people value dreams so much that they keep paper and pen next to their sleep space so they can free their minds of waking thoughts to be dealt with later, and to facilitate unfettered dreaming. If a dream provides the basis for needed action, they write ideas and the actions on paper upon waking and before they are forgotten. During the night terrors when I wake and try to go back to sleep, I’m pushed right back to the same scary place that my nightmare had paused just before my body woke up. Self study has taught me the recurring, re-entry at the place of paused nightmares is the definition of obsessive behavior associated with anxiety. Many times I would get out of bed, watch late night, bad TV shows until sufficiently bored enough to give sleep another try.

I’ve read some interesting materials about dreams over my lifetime. There has been much scientific thought given to whether people have dreams in color.  One study concluded that older people, those born during the age of black and white television, tended not to remember color in dreams. Young people claiming their dreams were color-filled remembered pastel shades. Further discussion about dreams revealed that nightmares occur during pre-REM sleep when the brain is less busy, which might explain my tendencies to dream about scary situations or people. Insomnia prevents me from achieving REM (rapid eye movement sleep stage) most nights.

What has been on your mind?

Do you remember your dreams?  Dream researchers in the past ten years theorized that we do not remember dreams, but instead, the waking mind tries to make sense of random pieces of the dream using reason.  Since the real life events in the dream seldom occur exactly as they did in waking time, our logical left brain struggles to relate the imagery to something real, the conscious mind making some sense of a dream in order to move past it.

To those who are reading this blog, when have you taken action based on a dream? Do you value dreaming?  Do your dreams reveal a need to make a change, or provide an outlet for funny thoughts to be expressed?  Please leave your thoughts for others to consider your perspective on dreams.

 

 

Coping

When you’re still functioning, but find yourself embattled mentally with feelings that drain you– almost surprisingly you’re able to get things done with acceptable quality, then we are coping.  We are motivated by the love of family, or compelled for the want of another solution. Humans are adaptable animals, capable of carrying very heavy burdens, sometimes for long periods of time.  How can we do it too?

If you’ve ever seen animals who lose limbs to accidents or to disease, they will learn to walk with one less leg.  My beloved golden retriever suffered a very aggressive cancer that began in the toe of her hind foot.   My veterinarian explained to me that he removed the cancerous tissue, but he insisted that I come to his office so we could discuss the pathology lab report, and then the medical journal explaining this cancer was going to return.   It did return, and quickly.  After 8 months my sweet Karat was undergoing a second surgery to remove half of the afflicted foot, and eventually 6 months later her third surgery to remove the hind leg. Her affect was the same throughout the ordeal of this illness. The vet did not prescribe pain pills, which I thought was a mistake.  He schooled me that she needed to stay off that foot, or she would damage the wound and begin to bleed. Eventually she walked again, cared for herself when nature called, and she continued to function like she did before these two cancer interventions.  After the third surgery the cancer spread and encroached upon her bowel and I made the tough decision to put her down.  I wrestled with that decision for weeks afterwards, and those around me assured me it was the right decision, unselfish, and timely due to the inability of managing her bowel habits normally.

Humans cope quite differently. We remember what it was like to function fully.  We look backward and we grieve more lastingly than would an animal like my beloved Karat. What force compels us to dwell on the past, and to mourn losses over which we have little to no control?  We age. We end relationships. We lose our sense of security in many ways: loss of a job, loss of a spouse, child, friend or family member.   We contemplate our mortality. We live on, and often flourish like beautiful plants that receive watering, a light source, and food.

Coping can be a healthy change of habits like water, sunlight, and food to a plant, or it can be self medicating, without the counsel of knowledgeable professionals.  We have the power at any time to get an outsider’s opinion, yet many people simply live with some form of depression and endure it’s creeping, cumulative impact to our ability to function. Unhealthy coping can lead us to addiction or masking of mental problems. We may not see it, but we have important choices to consider when faced with episodes of depression.

We learn favorite coping skills early in life, often at home while living with parents. Maybe your parents were good at telling you after a fall or a failure, “Good try!”  “Now shake it off, and get back in that game!” My parents didn’t take that approach, but that I believe was  because they did not have good role models in their upbringing.  Their bumps were huge craters, and their era was far different than was mine.

After the onset of adulthood however, it’s incumbent on intelligent people concerned with their health to prioritize the importance of looking after our own health, physical and mental.  Life can be stressful, and we must find effective ways to cope with problems. My parents used alcohol or prescription drugs to get through the toughest of stressful times.

We might do well to monitor our reactions to obstacles, especially those outcomes that don’t go our way.  My mother could hold onto a grudge like a grizzly bear holds onto a salmon– she was not letting go, and you’d better not get near her until she had processed through the anger.

My early career taught me that my employer had high expectations of my business results and the formal performance evaluation process every year was where we learned our manager’s perspective of the level of contribution we made as compared to others in similar jobs.  I had very successful role models both inside and outside of work, and I had a mentor.  If something at work went wrong, I evaluated the feedback I received about my actions for fairness and consistency.  If I felt slighted, then I held on to negative feelings for too long.  It wasn’t until my forties, after working with a mentor, that I began to realize  the great importance of letting go of toxic people and unproductive feelings like guilt, regret, and anger.  I’m still learning, and I enjoy opportunities to hear about those in my circle of friends who smartly live life for themselves and not for career or only financial reward alone.  I have some really smart friends.

How do you cope?

Do you have a successful coping technique that you’d be willing to share?  Maybe it’s yoga, great nutritious diet, or exercise.   There are great hobbies that take people far away from their jobs for long enough to recharge batteries and rejoin the working world with renewed resolve. Some people like reading or playing or listening to music.

Others have told me about “Mental Health Holidays,” those days we could be at work, but we take time off on short notice in order to enjoy a break in stress.  I’m encouraging anyone reading this post to please weigh in on your favorite coping strategy, and how it fits into your budget, your family life, and your mental health.  How do you cope? Do you cope effectively? Do you have a mentor?  Is there someone at church who gives you support and counsel?  What life obstacles have you had to deal with, and why could others benefit by taking a page from your book?

 

 

 

 

Supporting yourself

First Steps

When I felt the rug pulled out from under me a little over three years ago, I could not function properly. My hands shook, my mind was a massive short circuit, and I was panicked. So many thoughts were going through my mind it was as though there were loud conversations, all of them annoying, and they competed for my attention.  On the day I telephoned my manager in India, advising her I was not coming to work that day, I was seated for a long time, dizzy, and fearful that I would fall down if I stood up.

I remember just putting my head on  my desk for a time, and just closing my eyes and breathing, as though waiting for the calm to return.  I began to regain some composure, and I was conscious that the day was passing me by and I had spent a long time doing nothing, not even eating breakfast or lunch. I called my counselor and left a message asking that he please call me with the soonest appointment he had available. Within 2 hours I received a callback, and I was in Carl’s office the next day.

I had never had fits of trembling before, but there I sat in Carl’s office, shaking like a cold, wet dog.  “Carl, I’m not able to go to work!”  “I don’t know what happened, but I just can’t do this anymore.”

Carl responded with his most calming voice and asked “why don’t you tell me what happened?”

“Well I survived the Christmas holidays, but the whole time I kept obsessing about the work that was waiting for me, the rotten weather where I’d be traveling, and I was cycling around the worst case of each thing I had to do.”  “It made me want to yell, and jump in the swimming pool and drown myself!” I said, and the words surprised me as soon as I’d said them.

Getting professional help

“Except for the drowning part, that doesn’t sound like a bad idea!” was Carl’s response. “Jump in that 70 degree water and wake yourself up.”  “I guarantee you’ll only do that a time or two before you won’t actually need to jump anymore before you regain your awareness!” as he laughed just a little.

I’d never thought Carl to be a sarcastic man, and he was being serious– I needed to snap out of the fear and panic, and the distraction and heart-stopping coldness of the pool water was one easy image to help me.  It breaks the cycle of irrational fear (panic) and helps regain the mind’s focus to get out of the water.   Suddenly this felt like the opposite of the sadistic frog boiling story, and was almost as unpleasant to my thinking.

Carl was sending me a message that I needed a trigger, some mild slap, in order to get out of the cycle of bad thoughts. He knew I would not jump in cold water, but just the thought of doing it helped me to see the irrational behavior involved when a panic “flight response” was taking over.  Calmness needs to prevail.  Nothing was ever as bad as it seemed, and now I had a new coping tool that was going to stop or greatly shorten panic attacks for me.

Carl immediately asked me questions, another technique that helps re-focus people who are upset.  “What about work?”  “Have you talked with your boss about some time off?” Indeed, the time off was IBM’s short term disability program.  This great benefit paid me my full salary for six months as I met with doctors and my counselor to understand why I was so stressed, and which prescription medications could help me rest, and function during the day.

This is a place that I had never expected to be.  I hated to call in sick to work, and seldom did. I was certain that my manager had some trouble finding available people to cover my full workload, and the inconvenience I was causing others bothered me badly. The purpose of allowing employees time off from work was intended to be used to get professional medical help, documented progress reports, with the goal of the employee getting better, sufficiently to rejoin the work stream when doctors had helped to regain normal function.

Securing an income while you recover

Six months passed, and the sleeping issues worsened.  Vivid, nightmarish dreams, all of them about drowning, flying on planes with no passengers, being unprepared for an important class, airport lines in foreign countries where I didn’t understand or speak the native language, uncomfortable job situations that occurred years ago being relived, and many abrupt awakenings with pounding heart and a big adrenaline rush that made falling asleep again very tough.  Worry consumed my waking and sleeping thoughts.

  • How was I going to get through this mentally but also financially?
  • What if I wasn’t ever going to get any better?
  • Why weren’t the drugs I was taking helping with the focus issues and the nightmares?

With each TMS treatment I kept expecting to feel better, but didn’t.  Each visit to the psychiatrist I was given the same list of questions to answer and rate the effect of my anxiety/panic/depression on my abilities.  Each office visit entailed a blood pressure check, weight check, and a photo for the file.  I can only guess how scary my photos must’ve looked in progression, sort of like the picture of Dorian Gray.

At the end of short term disability benefits the IBM Integrated Health Services group advised me I would now be turned over to the Long Term Disability provider MetLife for the next steps. Benefits were two-thirds of my full salary.

This change in short to long term insurance coverage was significant. MetLife had a clear mission to get me back to work at a job similar to the one I’d had with IBM, and my caseworker made clear during each conversation that she had every confidence that I would be back at work soon.  That goal may have been her reason for calling on average every two weeks to ask me “Are you better?” “When will you return to work?”  My answer was getting less cordial or friendly as lack of sleep wore down on my normally sunny affect. “I’ll be back on an airplane as soon as I can get a full night’s sleep without waking up five times a night in a panic!” This kind of exchange continued through all 8 weeks of TMS therapy, and the unhappy news that I was no better off, no improvement in the pattern of sleep or decrease in panic attacks.

I have said that I appreciated the very caring nature of my physician, psychiatrist, and psychotherapist.  My psychiatrist was as disappointed as I was that our TMS sessions hadn’t improved my problems, and mentioned in conversation that in the same building was a practice physician who performed Electro Convulsive Therapy, administered under general anesthesia, where a seizure is induced by passing electricity through the brain.  Yes, the same barbaric practice you may know about that took place during the 1950s, but now under new and improved conditions, and after much study and refinement in the administration of the treatment.  ECT shocks the brain back to normal rhythms and has been effective for patients for whom TMS did not work well according to my psychiatrist. I owe this kind man a great debt of thanks because he left no stone unturned while looking for medical interventions that could help me to return to a normal sleep pattern.

This conversation was annotated in my file that eventually made it into the hands of the MetLife case manager, which resulted in a call advising me that I could be cut off of benefits payments for refusing treatment.  When I heard this I suddenly became my father, exclaiming “Jesus Christ on a pogo stick woman, have you had an ECT treatment?”  “What gives you the medical authority to recommend treatment as extreme as shocking someone into seizure?”  “Oh Mr. Coleman,” she said, “I’ve done my research and see that ECT is very effective in cases like yours.”  That’s when I told her “oh, that’s very different… ”  “You first!”  and I ended the conversation.

After the next exchange of clarifying paperwork, we documented the reality that the discussion was just a discussion, not a recommendation, or a referral for treatment, or anything more.  It was shortly after that the harassing tone of MetLife changed.  I must admit that ECT is used by the mental health community, and there is information readily available about its efficacy.  My strong objection came from an insurance caseworker pressing me with threats of cutting off benefits if I didn’t submit to a procedure with possible side effects like death, permanent memory loss, and onset of seizures. I’d done my homework too.  After talking with my doctor we agreed there were clear and probable side effects that should be considered with care before agreeing to undergo ECT therapy.  My psychiatrist said “If it were me, unable to sleep, I think I’d do it.”  “I’ll keep that option toward the bottom of my list” was my response.

Learning as you go

The whole disability coverage thing was a huge learning curve for me.  I remember the words of my physician who said “you’re going to have to give these guys what they need on paper because yours is not the kind of illness that is visible to the eye.”  “You don’t have a cast on your arm, or a missing leg.”  Again I kept wishing for something to read, a chapter in Life’s Operating Manual, something that might make me feel more prepared for what to expect, someone to talk with, or some sort of checklist to help me for the road ahead. My doctor assured me “attorneys don’t accept these cases unless they’re confident they can win.”  My thought was “there are people far worse off than me who are denied coverage,” and his reply stuck with me “people with lesser needs also get approved.”

Long Term Disability benefits for mental issues do not continue past two years, as though by magic, in two years time the client is better and returns to work.  My “condition” was not caused by slip-and-fall, or negligence of some documented hazard like carpal tunnel syndrome, where a surgical intervention is used, or a worker’s compensation claim is filed to compensate claimants for future wages, loss of ability, etc.   I argued with IBM’s Integrated Health nurse why my claim could not be considered a worker’s compensation claim. After all, it was clearly brought on by working too many hours in transit to overseas delivery centers.  Her answer surprised me;  “there’s no date of injury,” was the response. “You didn’t suffer a traumatic brain injury that resulted in this condition.”

Legal help for the rebuffed claimants

At the time of transitioning to Long Term Disability, I remember there was a requirement that I apply for government Social Security Disability.  Interestingly enough, this would be the compensation that takes over after employer insurance ends.  Our over burdened government entitlements bureau takes about 3 years to hear and clear claims like mine.  Twice my applications for disability were denied for symptoms that do not match defined standards of full disability.  Around the end of my first year of receiving insurance benefits, I was contacted by Allsup Incorporated, a legal service that my employer provides when claims for social security disability get denied.  This wonderful organization reviews medical records and makes recommendations how to approach successfully an administrative Social Security judge, one who will make a final determination about eligibility for disability benefits.

My attorney Elizabeth Montefu is an outstanding human being.  She clearly understood the entire end-to-end government social security appeals process, and represented IBM employees in Florida who were on the same path to fighting government denials, just like mine.  Three months after my disability benefits ceased, my hearing date with Social Security was set.  Ms. Montefu and I met one week before the hearing in order to get acquainted, discuss the process, and to develop and answer any questions about what would be done to make a final determination for the purpose of securing benefits.  “There will be an occupational specialist with the judge, you, and me, whose purpose is to ask you questions why you couldn’t bag groceries, or watch TV screens in a building security office, or some job that would pay a living wage income (no longer income equal or near to previous salary earned at IBM).”  “Also there will be a qualified psychiatrist who will have reviewed your treatment notes in order to apply government standards for disability to evaluate eligibility.”  My first thought was, why wasn’t this done in the first application?  Why did it take two failed applications to get this attention to detail three years later?  OK, let’s get this done.   In one week we would meet at the social security administrative office at 9:00 am.

Judgement Day

The social security office was nearby Tampa airport.  The traffic was intense, and I was nervous as a person might be at a job interview, only this fear factor was 3 times greater.  I hadn’t been at a job interview in thirty five years.  I’d never been interviewed by a judge.  I’d been prepared we would spend an hour or more answering questions, but my session lasted about thirty minutes.  Afterwards Liz asked “How do you think that went?”  To my surprise she was smiling broadly.  “I’m not sure, I was trying so very hard to stay focused.”  “Well, in my experience, a hearing has never been so concise.”  What I thought odd was the occupational therapist who sat across the table from me never said a word except to say his name, and his role.  The questions came from the psychiatrist who said he had trouble reading my therapist’s handwriting and couldn’t make out a few of his answers. He’d had my medical records for three months, but never asked in advance of the hearing for clarification?  I asked Liz why he might not have asked for clarity before the hearing, she explained he had no difference of opinion about the major points on the checklist used for determining eligibility.  “I think you have a good chance of being approved” were her final words before saying good bye and good luck.

Looking Forward

Now that I’ve received formal approval, I am officially a disabled American.  My inability to sleep at least six hours, the panic, all of the reduced abilities have bought me medicare coverage and a fraction of my earnings on which I must continue to pay for medications and support myself.  I am grateful to everyone who had a hand in helping me up and out of the vat of depression.  I’m blogging because this process of seeing my story in writing is therapeutic.  To those of you who have read my thoughts I encourage your feedback, experience, and insights.  Please help others, and maybe yourself at the same time.  If you have a magic cure, if I’ve missed some fix that you’ve discovered for bad dreams, or overcoming panic I think it’s fair to assume that the internet needs to hear from you.

 

 

 

 

 

 

 

 

How bad does it get?

Have you wondered what happens if a depressive episode becomes extreme, lingering, and fatal?  To this reading, my stories have hovered in the mild depressive range.  Where is the rock bottom that we hear about?  When we hit bottom, do we bounce, or splat?  Do we cope, or do we put an end to the madness?

From personal experience I can speak about some extremes because I lived through them. Not many know how bad I felt during the dark times. I was ashamed. I’ll share with you that suicidal ideations often pass through the minds of people suffering depression. I’m told that is a common occurrence. Whether situational depression or chemical imbalance, the option to end the suffering is there in the minds of the depressed.  Something we need to consider is the commentary from those who have attempted suicide, but lived through the act and later described their experiences.  Many say there was a belief that the bad feelings had no end, and they wanted an immediate end to an unbearably painful situation.

One very brave young woman I know wrote about her attempted suicide as a high school class assignment.   She detailed the alarmingly high statistics of teenage suicide in a powerpoint presentation, and as the slideshow continued, she divulged her own true story of attempted suicide.  She is lesbian, she felt alone, angry, and determined to gain control and put an end to the pain that permeated her dreams, lasting through the waking days alongside teenagers who were nowhere near her level of intelligence, awareness, or understanding of what it meant to feel different and depressed. Her parents were atypically accepting of their lesbian daughter, in fact their acceptance included acknowledgement and acceptance of her choice of a partner, a man who was living with gender identification mismatch.  What extraordinary people, with the strength of characte to accept rather than shame their child for this reality. What life changing healing followed, for this family of  high achievers. My friend has since graduated college and made a life for herself, with her partner, in the United Kingdom. She is a thriving heroine.

My own wish for eternal peace and self-imposed end came after the realization I had put an end to a very rewarding career of teaching “people skills.”  No more paid vacations, no more salary checks, and for me the payoff of no more travels and sleepless nights on long haul international trips.  It was a terribly change-filled period of my life.  I had to sell my beloved home of 20 years for the knowledge I could no longer afford to pay for it.  I had to explain dozens of times to my long term disability (LTD) case manager what progress was not occurring as a result of my weekly visits with doctors.  I existed on 3 hour naps, several cycles in a day, but never reaching the Rapid Eye Movement (REM) sleep state.  REM is where adult growth hormone is synthesized and secreted, and restorative processes weren’t happening– waking up after only 3 hours meant trying to go back to sleep and not being able to do so.  Doctors assured me that keeping a regimen of going to sleep and waking at the same time was highly effective in achieving restful sleep, however, the practice instead of helping, facilitated an irrational anticipation of not being able to stay asleep, and self-fulfilling prophecy of premature waking.  I was in the no sleep Twilight Zone, part of the Walking Dead of The Tired Man bad reality TV show.

The feeling of exhaustion during “normal” waking hours meant that simple tasks like driving, managing payment of my bills, shopping for groceries, all required great planning and effort.  I found myself missing doctor appointments and at times forgetting how to get to the office of the doctor.  There were countless notes and lists, and reminders on my phone.  My LTD case manager would press me because she had not received requested status updates from physicians in charge of my care.  These setbacks, along with sleep deprivation, poor appetite, irritable bowel syndrome, erectile dysfunction, recurrent nightmares about work, all led me down the path to wanting an end to a dreadful and lingering madness.  I was having ideations that being dead would be preferable to enduring worsening insomnia.  I kept this from my doctors for reasons that seemed obvious at the time– who wants to be Baker Acted, forced into a hospital bed and housed in the psychiatric ward where others with mental illness were warehoused. Nope, I can live with that sin of omission, thanks.

It’s believed that if you have knowledge of the method you would use to end your life, that meant that the probability of actually following through was high.   I had my chosen method– overdosing on the sleep medications and going to sleep, only after maxing out my credit cards and enjoying a wonderful last meal alone. I remember the story of the death of Woolworth heiress Barbara Woolworth Hutton, rumored to have squandered her fortune and died with less than three thousand dollars in net worth.  By damn, that sounded like a pretty good way to leave this world given my circumstances.

How bad must it get before you’ll get help?

I’m still here.  At each time I felt the urge to take the pills, I gave thought to having to go max out the credit cards, make dinner reservations and get dressed, and suddenly the plan sounded like a lot of work.  In all seriousness, I ask you to think about breaching your own threshold, how long will you suffer before you take a positive step to get some help?  You can keep your ideations, just place them further down on the list of options and consider a few positive choices with priority.

“Ignoring facts does not make them go away.”   – Fran Tarkenton

Before you entertain ideas of ending your journey through a dark depressive episode, have a thought about those you’ll leave behind.  Will they feel like they’ve let you down by not reading your mind, or recognizing clues that you were suicidal?  Will someone you love be haunted inconsolably by your death?  Can you be certain that the bad conditions are permanent and unchangeable?

Here are some “Dos” that I recommend:

  • Have some dark chocolate (even diabetics– check sugar later)
  • Go to a public place and if you have a close friend, invite them along
  • Get your affairs in order
  • Consider the available, free resources available for quick help
  • Rest, breathe, meditate, exercise in the sunshine

No one can stop someone determined to end their life, that’s just not reasonable, nor rational.  What we can do is educate ourselves about the causes of suicidal ideations, and evaluate our own needs against our circumstances during calmer times, with the knowledge there will be calmer times ahead.  To those who have lost loved ones to suicide, I am sincerely sorry for your loss. For those survivors of suicide, I have walked your path before and am glad that we are among the living.  For those suffering depressive episodes, I hope that you get some meaningful, lasting relief and will consider joining this blog to share your perspective.

 

Where is the light?

Depression often is described as a dark period, or time of sadness.  Episodes of sadness have a distinctive onset, like a bad cold, and there are sometimes identifiable stimulus-response reactions.  Without an entire scientific double blind research project, for the sake of this blog let’s say that your life with depression falls into a continuum of darkness and light, or sadness and joy.

How do you bring about the light?  What is the joy in your life?  When you’re feeling depressed, as in situational depression, is it because there is an absence of the enjoyment of life, those things that normally cause you joy?  If depression is truly the dark, where then can you find the light? Do you know what those sources of light are?  What has happened to those points of light, those sources of joy when you’re feeling down?

In my own experience, I’ve felt the onset of depression when I’ve lost my perspective.  Something has not gone my way, and it has stuck in my consciousness somehow. I re-live the loss of perspective and what event or stimulus has brought it on.  I focus blame, usually on myself, and muse “I wish I’d thought to say …….. or do something else.”  There have been times when an event is important, and the feeling of lost perspective takes control quickly.  It is like being caught in a Groundhog’s Day loop that you can’t pause and walk away from.  What about my DNA, or my affect makes me this way?

I have read that depression is genetically inherited, and if that’s true I can pinpoint the source of mine because I saw it manifested in my mother’s behavior.  Mom raised four children, each as independent, motivated, and successful as she was. Yet in each child was evidence of varying degrees of depression. In her later years, and after Mom and I had only serious adult discussions about her health, and options to live out her most senior years, I found her focus and perspective were about loss of ability, degenerative conditions like spinal stenosis, arthritis, the ailments that many seniors endure as early as their fifties.  Mom, well into her nineties, had many gifts like independent living, the love of family, a companion who was faithful and generous with his time.  During one of Mom’s depressive episodes I learned that she was mourning the loss of driving privileges.  It meant to her that she’d lost her independence, though for the city of Tampa it meant one less driving menace on the road during rush hour traffic.  Mom’s thoughts cycled through other losses, inclusive of hearing, the ability to go out to dances, the loss of confidence in managing her medicine taking.  She had to depend on others, and she’d always been fiercely independent and confident in her abilities.

As her only son and the youngest child, I had a peer to peer relationship.  I talked to her directly about her last will and testament, advanced directives, and how she wanted to live out her final years given that she was deemed a “fall hazard,” and needed physical therapy in order to strengthen her muscles to permit her greater stability. The conversations usually meant working up to the subject by acknowledging that she’d once never had a care in the world about these terrible assaults of advancing age.  As someone who cared about her happiness I appreciated her strength and sacrifices. I often shared with her my perspective that many people her age didn’t enjoy the same freedoms that she had.  To illustrate the importance of maximizing joy in her life, I asked her what things she enjoyed doing.  This woman had traveled extensively in her 20s and 30s, but less and less as she grew older.  Her loving companion would plan and pay for an annual cruise to the western Caribbean, and Mom seemed to enjoy the time on the boat, the meals, and spending his money at the onboard casino.  “What about taking a trip Mom?”  “Wouldn’t you enjoy going on a cruise?” She thought briefly before waving me away, “Nah, I hate those.” “All those old people, and all that food!”

“Mom, you used to enjoy the cruise ships, what happened?”  “Oh, I guess I just lost interest in going.”  With some probing I got Mom to admit that her lost interest in travel hadn’t resulted in replacing that joy with something else, like going to the local casino, or going out to dinner.  After years of this cyclic pleading with my mother to try to identify something else that brought her some form of joy.   I sternly reminded her that no one could decide for her what things brought her an element of joy.  “If you had the writing tablet of the Almighty, would you identify one earthly thing that would bring you joy?” I asked in frustration.  Unfortunately I knew the answer.  My mother was no longer capable of helping herself up from the dark seriousness of age related depression.  She could no longer appreciate her many gifts and abilities, far greater than those of other people her same age. The average person ten years younger had fewer freedoms than did Mom. It occurred to me I wasn’t helping.  Imagine someone telling you “you should feel happy that you have a companion, independent living…” when the fact of the matter was, she didn’t feel happy at all, and my harping at her wasn’t helpful.  It made matters worse.

What should I do? Why does she grab onto the loss, and swat away the advantages?  My question of the day is “If you suffer a loss of joy, could you identify something reasonable that could bring it back?”  “If you feel like you’re surrounded by darkness, do you know where the points of light are in your life?”

I learned that prescription antidepressant Zoloft helped my mother’s mood exponentially.  When her geriatric physician gave her samples to try, her family noticed the improvement in her mood and her outlook.  Mom cooked for us, and she had cleaned up her house on her own.  She seemed brighter in mood than we had seen her in years.  Then after a few months, return of the old Mom canceled out her improvements.  She was glum.  She stayed up very late into the night, and we’d have to call her around noon to ensure she’d woken up to take her medicines.  I noticed no Zoloft in the box of pills and asked her why she was no longer taking it.

“That [expletive deleted] costs $50 per month,  I don’t need it!”

Do you allow time for joy in your life?

Please take a moment and make an inventory of those things that bring you joy.  If people are involved, please ensure they know they’re joy givers.  If your joy comes from beloved activities, please make certain that you get a fair dose of opportunity to do the things that bring you joy or happiness.  Please do not count the cost in dollars of the medications that facilitate improved moods, or decreased darkness.   Looking back, Mom has been gone for 2 years now.  In retrospect I would have gladly paid the $50 cost of Zoloft, filled the scrip, and brought the pills to her bedside if she’d only believed in what we knew Zoloft did for her.  If you’re taking a prescription antidepressant, but still feel like you’re struggling, please consider asking to try another medicine.  You are the one who can best help bring joy into your life.  Are you doing a good job?